talkingpointsmemo--2020-07-10--‘All the Hospitals Are Full’: In Houston, Overwhelmed ICUs Leave COVID-19 Patients Waiting in ERs

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 .
This article was produced in partnership with NBC News .
HOUSTON — Houston hospitals have been forced to treat hundreds of COVID-19 patients in their emergency rooms — sometimes for several hours or multiple days — as they scramble to open additional intensive care beds for the wave of seriously ill people streaming through their doors , according to internal numbers shared with NBC News and ProPublica .
@ @ @ @ @ @ @ ’ s 12 busiest hospitals are increasingly telling emergency responders that they can not safely accept new patients , at a rate nearly three times that of a year ago , according to data reviewed by reporters .
The increase in ambulance diversions , coupled with the spike in patients being held indefinitely in emergency rooms , are the latest indicators that Houston hospitals are straining to keep up with a surge of new coronavirus patients .
ProPublica and NBC News have previously reported that a public hospital in Houston ran out of @ @ @ @ @ @ @ that a spike in at-home deaths from cardiac arrest suggests that the death toll from the coronavirus may be higher than official statistics show .
On Thursday , 3,812 people were hospitalized with COVID-19 in the region , including more than 1,000 in intensive care units , a record since the pandemic began .
At the same time , since Texas officials have not issued another stay-at-home order to slow the virus ’ s spread , hospitals are also still seeing a steady flow of patients in need of care as a result @ @ @ @ @ @ @ heat-related medical emergencies .
Officials in Houston are warning that the situation could become a replay of what happened in New York City in March and April , when thousands of people died as hospitals struggled to keep up with the surge of patients , but without the same level of government intervention to stem the tide .
Typically when people arrive at a hospital emergency department , they ’ re evaluated and treated by the medical staff .
Those sick or injured enough to require hospitalization are then moved to other areas @ @ @ @ @ @ @ But increasingly in Houston , particularly for patients suffering from COVID-19 , there ’ s nowhere for them to go .
“ Normally that patient would just go to an ICU bed , but because there are no beds available , they continue to board in the emergency room , ” said Harris Health System president and CEO Esmaeil Porsa , who oversees the city ’ s two public safety-net hospitals .
“ It is not an optimal level of care .
This is not something we would choose to do .
The @ @ @ @ @ @ @ we are being forced to do it.
” Although hospital leaders say they are working to provide high-quality care for patients being held in emergency rooms — in part by bringing specialized medical staff and equipment to patients being treated there — studies done before the coronavirus pandemic show that the longer patients stay in ERs , the worse their outcomes .
ICUs and other hospital units are staffed with doctors , nurses and other support personnel who have specialized training and experience caring for critically ill patients in need of specific medical @ @ @ @ @ @ @ department medical workers is to quickly assess patients , stabilize them and get them to where they need to be .
“ The problem is you can ’ t get them to where they need to be , and now it puts the ER doc in the position of having to function like the hospitalist or the intensive care doctor , and that ’ s not a role that we ’ re really supposed to be in , ” said Dr. Cedric Dark , an emergency physician at Baylor College of Medicine in @ @ @ @ @ @ @ having any patient boarded in the emergency department , regardless of the situation , is that it slows down the beginning of care for somebody who needs hospitalization , and the beginning of care for any medical condition is the most crucial period of time.
” The same scenario is playing out at hospitals across the Houston region .
A daily status report prepared Wednesday by the SouthEast Texas Regional Advisory Council , which coordinates the Houston region ’ s emergency medical response , showed multiple hospitals running out of immediately available nonsurgical @ @ @ @ @ @ @ city ’ s top-tier trauma centers , Ben Taub Hospital and Memorial Hermann ’ s flagship hospital in the Texas Medical Center .
As of Wednesday afternoon , about 145 patients were being held in emergency departments throughout the Memorial Hermann Health System , according to internal numbers provided separately by a Memorial Hermann physician and confirmed by a hospital executive .
Several other Houston area hospitals have reported holding multiple patients in their ERs , including four with more than a dozen .
Dr. Jamie McCarthy , an executive vice president at @ @ @ @ @ @ @ room physician , acknowledged that the coronavirus crisis has forced his teams to hold more patients in ERs .
“ All the hospitals are full , ” McCarthy said .
“ All the hospitals in the city are boarding patients .
We are expanding capacity , but we can ’ t turn those on immediately .
It requires staffing .
It requires nurses and doctors to come in .
And so , as we ’ ve continued to expand our inpatient capacity , we ’ re just keeping up with the volume that @ @ @ @ @ @ @ s not unusual for a small number of patients to be held in ERs on busy days , especially during flu season , but three Houston ER physicians said they have never seen so many patients receiving prolonged care in emergency departments , or for such long periods of time .
Although treating patients in the ER for more than a few hours is “ not ideal , ” McCarthy said , Memorial Hermann has worked to mitigate the impact on patients by sending intensive care doctors and other specialists to emergency departments @ @ @ @ @ @ @ care regardless of where they ’ re located .
But he warned that there ’ s a limit to what Houston hospitals can do to respond to the crisis .
“ We are adding more capacity , but we are absolutely stretched now , and if it keeps going this way , we ’ re going to run out of room .
We ’ re going to look like New York , ” McCarthy said , emphasizing the need for Houston residents to stay home and avoid crowds to slow the virus ’ @ @ @ @ @ @ @ s largest hospital systems , HCA Healthcare , also has been caring for dozens of COVID-19 patients in its emergency departments .
In a statement , HCA spokeswoman Debra Burbridge said hospital officials have taken steps to reduce the impact on patients , including sending staff members who would normally be performing or assisting with elective surgeries — which have been suspended under an order by the governor — to treat patients with COVID-19 .
Dr. Kusum Mathews , an assistant professor of critical care and emergency medicine at the Icahn School of @ @ @ @ @ @ @ , said hospitals can take steps to reduce the risks of overcrowded ERs , including some of those described by Memorial Hermann and HCA officials .
Treating patients sickened by the virus “ has outstripped every stretch of our imagination , ” Mathews said .
“ We have had to put beds in hallways , double up patient rooms … just to allow for offloading the emergency department to get more patients in.
” While Houston ’ s top hospital executives have repeatedly said they can add hundreds of new intensive care beds @ @ @ @ @ @ @ for the next couple of weeks , the number of patients being treated in emergency rooms demonstrates the difficulty of executing those plans in the midst of a rapidly growing crisis , officials say .
“ Those things are not like a switch-key type of activity , ” said Porsa , the Harris Health System CEO , noting that his hospitals have had to send patients to hospitals outside of Houston to make room .
“ The bottleneck to do that is really staffing .
As you can imagine , ICU nurses are @ @ @ @ @ @ @ are very hard to come by , and it takes time to actually be able to do that.
” The logjam of patients being treated in ERs has also led to delayed emergency response times across the city , according to Houston Fire Department officials .
When hospitals get overloaded , they ask regional authorities to divert ambulances elsewhere .
For example , Memorial Hermann ’ s northeast hospital was on diversion status just 2 % of the time during an eight-day period in late June and early July last year ; it @ @ @ @ @ @ @ the time during the same time period this year .
At Houston ’ s busiest public hospital , Ben Taub , the number jumped to 81 % from 58 % .
The problem , said Houston Fire Department Assistant Chief Matt White , is that when every hospital is maxed out , ambulance crews have no choice but to take patients to emergency departments that are too busy to quickly receive them .
And by law , hospitals must screen and stabilize any patient who arrives .
“ When everyone is on diversion @ @ @ @ @ @ @ is on diversion.
” Earlier coronavirus outbreaks inundated emergency rooms in New York City and Detroit , but lockdown orders in those cities led to fewer car accidents and a reduction in violent crime , freeing more space in ERs for COVID patients .
With most Texas businesses still open and no mandatory stay-at-home order , hospitals in Houston and other COVID-19 hot spots face the added challenge of making room for COVID patients while still dealing with a steady flow of patients seeking care for other medical emergencies .
And across the @ @ @ @ @ @ @ who delayed seeking care earlier in the pandemic are now showing up for treatment , taking up beds , said Dr. Marc Eckstein , medical director of the Los Angeles Fire Department and a professor of emergency medicine at Keck School of Medicine of the University of Southern California .
Despite these challenges , McCarthy , the Memorial Hermann executive , said it ’ s essential that people continue to come to the hospital for medical emergencies .
He pointed to an NBC News and ProPublica report this week that showed a growing @ @ @ @ @ @ @ home , before emergency responders can reach them .
“ If a patient believes they have a serious medical issue , they still need to come to the emergency department , ” McCarthy said .
“ We will make the capacity to take care of them .
Delaying care for time-sensitive emergencies is time we don ’ t get back .
If they wait to call for help when they are having a heart attack , it will be worse than if they come in early .
”

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. This article was produced in partnership with NBC News.
HOUSTON — Houston hospitals have been forced to treat hundreds of COVID-19 patients in their emergency rooms — sometimes for several hours or multiple days — as they scramble to open additional intensive care beds for the wave of seriously ill people streaming through their doors, according to internal numbers shared with NBC News and ProPublica.
At the same time, the region’s 12 busiest hospitals are increasingly telling emergency responders that they cannot safely accept new patients, at a rate nearly three times that of a year ago, according to data reviewed by reporters.
The increase in ambulance diversions, coupled with the spike in patients being held indefinitely in emergency rooms, are the latest indicators that Houston hospitals are straining to keep up with a surge of new coronavirus patients. ProPublica and NBC News have previously reported that a public hospital in Houston ran out of a medication to treat COVID-19 patients and that a spike in at-home deaths from cardiac arrest suggests that the death toll from the coronavirus may be higher than official statistics show.
On Thursday, 3,812 people were hospitalized with COVID-19 in the region, including more than 1,000 in intensive care units, a record since the pandemic began. At the same time, since Texas officials have not issued another stay-at-home order to slow the virus’s spread, hospitals are also still seeing a steady flow of patients in need of care as a result of car accidents, violent crime and heat-related medical emergencies.
Officials in Houston are warning that the situation could become a replay of what happened in New York City in March and April, when thousands of people died as hospitals struggled to keep up with the surge of patients, but without the same level of government intervention to stem the tide.
Typically when people arrive at a hospital emergency department, they’re evaluated and treated by the medical staff. Those sick or injured enough to require hospitalization are then moved to other areas of the hospital for specialized care. But increasingly in Houston, particularly for patients suffering from COVID-19, there’s nowhere for them to go.
“Normally that patient would just go to an ICU bed, but because there are no beds available, they continue to board in the emergency room,” said Harris Health System president and CEO Esmaeil Porsa, who oversees the city’s two public safety-net hospitals. “It is not an optimal level of care. This is not something we would choose to do. The only reason this is happening is because we are being forced to do it.”
Although hospital leaders say they are working to provide high-quality care for patients being held in emergency rooms — in part by bringing specialized medical staff and equipment to patients being treated there — studies done before the coronavirus pandemic show that the longer patients stay in ERs, the worse their outcomes.
ICUs and other hospital units are staffed with doctors, nurses and other support personnel who have specialized training and experience caring for critically ill patients in need of specific medical interventions, whereas the mission of emergency department medical workers is to quickly assess patients, stabilize them and get them to where they need to be.
“The problem is you can’t get them to where they need to be, and now it puts the ER doc in the position of having to function like the hospitalist or the intensive care doctor, and that’s not a role that we’re really supposed to be in,” said Dr. Cedric Dark, an emergency physician at Baylor College of Medicine in Houston. “The bad thing about having any patient boarded in the emergency department, regardless of the situation, is that it slows down the beginning of care for somebody who needs hospitalization, and the beginning of care for any medical condition is the most crucial period of time.”
The same scenario is playing out at hospitals across the Houston region.
A daily status report prepared Wednesday by the SouthEast Texas Regional Advisory Council, which coordinates the Houston region’s emergency medical response, showed multiple hospitals running out of immediately available nonsurgical ICU beds, including both of the city’s top-tier trauma centers, Ben Taub Hospital and Memorial Hermann’s flagship hospital in the Texas Medical Center.
As of Wednesday afternoon, about 145 patients were being held in emergency departments throughout the Memorial Hermann Health System, according to internal numbers provided separately by a Memorial Hermann physician and confirmed by a hospital executive. Several other Houston area hospitals have reported holding multiple patients in their ERs, including four with more than a dozen.
Dr. Jamie McCarthy, an executive vice president at Memorial Hermann Health System and an emergency room physician, acknowledged that the coronavirus crisis has forced his teams to hold more patients in ERs.
“All the hospitals are full,” McCarthy said. “All the hospitals in the city are boarding patients. We are expanding capacity, but we can’t turn those on immediately. It requires staffing. It requires nurses and doctors to come in. And so, as we’ve continued to expand our inpatient capacity, we’re just keeping up with the volume that’s coming in.”
It’s not unusual for a small number of patients to be held in ERs on busy days, especially during flu season, but three Houston ER physicians said they have never seen so many patients receiving prolonged care in emergency departments, or for such long periods of time.
Although treating patients in the ER for more than a few hours is “not ideal,” McCarthy said, Memorial Hermann has worked to mitigate the impact on patients by sending intensive care doctors and other specialists to emergency departments, to ensure patients are receiving quality care regardless of where they’re located.
But he warned that there’s a limit to what Houston hospitals can do to respond to the crisis.
“We are adding more capacity, but we are absolutely stretched now, and if it keeps going this way, we’re going to run out of room. We’re going to look like New York,” McCarthy said, emphasizing the need for Houston residents to stay home and avoid crowds to slow the virus’s spread.
One of Houston’s largest hospital systems, HCA Healthcare, also has been caring for dozens of COVID-19 patients in its emergency departments. In a statement, HCA spokeswoman Debra Burbridge said hospital officials have taken steps to reduce the impact on patients, including sending staff members who would normally be performing or assisting with elective surgeries — which have been suspended under an order by the governor — to treat patients with COVID-19.
Dr. Kusum Mathews, an assistant professor of critical care and emergency medicine at the Icahn School of Medicine at Mount Sinai in New York, said hospitals can take steps to reduce the risks of overcrowded ERs, including some of those described by Memorial Hermann and HCA officials.
Treating patients sickened by the virus “has outstripped every stretch of our imagination,” Mathews said. “We have had to put beds in hallways, double up patient rooms … just to allow for offloading the emergency department to get more patients in.”
While Houston’s top hospital executives have repeatedly said they can add hundreds of new intensive care beds to meet the demand, at least for the next couple of weeks, the number of patients being treated in emergency rooms demonstrates the difficulty of executing those plans in the midst of a rapidly growing crisis, officials say.
“Those things are not like a switch-key type of activity,” said Porsa, the Harris Health System CEO, noting that his hospitals have had to send patients to hospitals outside of Houston to make room. “The bottleneck to do that is really staffing. As you can imagine, ICU nurses are not a dime a dozen. They are very hard to come by, and it takes time to actually be able to do that.”
The logjam of patients being treated in ERs has also led to delayed emergency response times across the city, according to Houston Fire Department officials.
When hospitals get overloaded, they ask regional authorities to divert ambulances elsewhere. For example, Memorial Hermann’s northeast hospital was on diversion status just 2% of the time during an eight-day period in late June and early July last year; it was on diversion status 58% of the time during the same time period this year. At Houston’s busiest public hospital, Ben Taub, the number jumped to 81% from 58%.
The problem, said Houston Fire Department Assistant Chief Matt White, is that when every hospital is maxed out, ambulance crews have no choice but to take patients to emergency departments that are too busy to quickly receive them. And by law, hospitals must screen and stabilize any patient who arrives.
“When everyone is on diversion,” White said, “nobody is on diversion.”
Earlier coronavirus outbreaks inundated emergency rooms in New York City and Detroit, but lockdown orders in those cities led to fewer car accidents and a reduction in violent crime, freeing more space in ERs for COVID patients.
With most Texas businesses still open and no mandatory stay-at-home order, hospitals in Houston and other COVID-19 hot spots face the added challenge of making room for COVID patients while still dealing with a steady flow of patients seeking care for other medical emergencies.
And across the country, people with chronic health problems who delayed seeking care earlier in the pandemic are now showing up for treatment, taking up beds, said Dr. Marc Eckstein, medical director of the Los Angeles Fire Department and a professor of emergency medicine at Keck School of Medicine of the University of Southern California.
Despite these challenges, McCarthy, the Memorial Hermann executive, said it’s essential that people continue to come to the hospital for medical emergencies. He pointed to an NBC News and ProPublica report this week that showed a growing number of people are dying suddenly at home, before emergency responders can reach them.
“If a patient believes they have a serious medical issue, they still need to come to the emergency department,” McCarthy said. “We will make the capacity to take care of them. Delaying care for time-sensitive emergencies is time we don’t get back. If they wait to call for help when they are having a heart attack, it will be worse than if they come in early.”


talkingpointsmemo--2020-07-10--Trump Campaign Postpones NH Rally Citing ‘Safety Reasons’ Due To Tropical Storm

President Donald Trump ’ s reelection campaign on Friday announced it would not hold a rally originally scheduled to take place in New Hampshire this weekend due to concerns about a tropical storm , which is expected to sweep up the coast , but is not projected to hit the rally-region too heavily on Saturday .
White House press secretary Kayleigh McEnany told reporters the event would be postponed for “ a week or two ” due to a “ big storm.
” Tim Murtaugh , the campaign ’ s communications director , also issued a statement regarding the rally @ @ @ @ @ @ @ because of Tropical Storm Fay.
” Murtaugh added that a new date for the campaign event set to take place in Portsmouth would be announced soon .
The news comes as the Trump campaign has adamantly fought off calls to cancel in-person campaign events due to safety and health concerns related to the coronavirus pandemic .
Just last month , the president ’ s re-election campaign continued with an indoor masks-optional rally in Tulsa , Oklahoma , despite pressure to reconsider after coronavirus cases were spiking around the country .
On Wednesday , @ @ @ @ @ @ @ Dart said that Trump ’ s rally “ likely contributed ” to a sharp increase in coronavirus cases there , according to the Associated Press .
On Monday , 261 new cases were confirmed — a singe-day record high in the area .
Another roughly 200 cases were reported on Tuesday .
In the week leading up to the June 20th event , there were 76 cases on Monday before the rally , and roughly 100 the following day — just about half of what reports show for earlier this week .
The @ @ @ @ @ @ @ Portsmouth indicate that some rain is possible , as of Friday afternoon .
Showers are expected in the morning though they are likely to occur “ mainly before 9 a.m. ” As for Saturday night , when the would-be rally was expected to take place , there ’ s a 40 percent chance of showers between 8 p.m. and 9 p.m. as well as winds between 5 and 10 mph and higher wind gusts up to 20 mph .
Weather forecasts otherwise indicate “ partly cloudy ” skies and “ new precipitation amounts @ @ @ @ @ @ @ inch possible.
” The remarks from both the White House and Trump ’ s campaign come within days of New Hampshire Governor Chris Sununu telling reporters on Tuesday that President Donald Trump ’ s upcoming rally in his state could be conducted safely and without a mask mandate .
He said that while he intended to greet the president personally as governor he was unlikely to attend the event .
“ I will not be in the crowd of thousands of people , I ’ m not going to put myself in the @ @ @ @ @ @ @ people , if that ’ s your question specifically , ” Sununu said , adding that , “ unfortunately ” he needed to be “ extra cautious as the governor , ” for himself and for his family considering health risks amid the pandemic .
Addressing reporters on Friday , Trump brushed off the looming storm saying Fay was “ under watch ” but “ shouldn ’ t be too bad.
” The President did not suggest that poor weather conditions were likely to get in the way of the campaign ’ s @ @ @ @ @ @ @ ’ s postponement in Friday afternoon tweets , saying that because of the tropical storm the campaign was “ forced to reschedule , ” adding his wishes that supporters “ stay safe .
”

President Donald Trump’s reelection campaign on Friday announced it would not hold a rally originally scheduled to take place in New Hampshire this weekend due to concerns about a tropical storm, which is expected to sweep up the coast, but is not projected to hit the rally-region too heavily on Saturday.
White House press secretary Kayleigh McEnany told reporters the event would be postponed for “a week or two” due to a “big storm.”
Tim Murtaugh, the campaign’s communications director, also issued a statement regarding the rally’s postponement for “safety reasons because of Tropical Storm Fay.” Murtaugh added that a new date for the campaign event set to take place in Portsmouth would be announced soon.
The news comes as the Trump campaign has adamantly fought off calls to cancel in-person campaign events due to safety and health concerns related to the coronavirus pandemic. Just last month, the president’s re-election campaign continued with an indoor masks-optional rally in Tulsa, Oklahoma, despite pressure to reconsider after coronavirus cases were spiking around the country.
On Wednesday, director of Tulsa Health Department Dr. Bruce Dart said that Trump’s rally “likely contributed” to a sharp increase in coronavirus cases there, according to the Associated Press. On Monday, 261 new cases were confirmed — a singe-day record high in the area. Another roughly 200 cases were reported on Tuesday. In the week leading up to the June 20th event, there were 76 cases on Monday before the rally, and roughly 100 the following day — just about half of what reports show for earlier this week.
The National Weather Service’s forecasts for Portsmouth indicate that some rain is possible, as of Friday afternoon. Showers are expected in the morning though they are likely to occur “mainly before 9 a.m.” As for Saturday night, when the would-be rally was expected to take place, there’s a 40 percent chance of showers between 8 p.m. and 9 p.m. as well as winds between 5 and 10 mph and higher wind gusts up to 20 mph. Weather forecasts otherwise indicate “partly cloudy” skies and “new precipitation amounts of less than a tenth of an inch possible.”
The remarks from both the White House and Trump’s campaign come within days of New Hampshire Governor Chris Sununu telling reporters on Tuesday that President Trump’s upcoming rally in his state could be conducted safely and without a mask mandate. He said that while he intended to greet the president personally as governor he was unlikely to attend the event.
“I will not be in the crowd of thousands of people, I’m not going to put myself in the middle of a crowd of thousands of people, if that’s your question specifically,” Sununu said, adding that, “unfortunately” he needed to be “extra cautious as the governor,” for himself and for his family considering health risks amid the pandemic.
Addressing reporters on Friday, Trump brushed off the looming storm saying Fay was “under watch” but “shouldn’t be too bad.” The President did not suggest that poor weather conditions were likely to get in the way of the campaign’s rally.
Trump later acknowledged the event’s postponement in Friday afternoon tweets, saying that because of the tropical storm the campaign was “forced to reschedule,” adding his wishes that supporters “stay safe.”


talkingpointsmemo--2020-07-10--US Bets On Untested Company To Deliver COVID-19 Vaccine

EDITOR ’ S NOTE — This story is part of an ongoing investigation by The Associated Press , the PBS series FRONTLINE and the Global Reporting Centre that examines the deadly consequences of the fragmented worldwide medical supply chain .
When precious vats of COVID-19 vaccine are finally ready , jabbing the lifesaving solution into the arms of Americans will require hundreds of millions of injections .
As part of its strategy to administer the vaccine as quickly as possible , the Trump administration has agreed to invest more than half a billion in tax dollars in ApiJect Systems America @ @ @ @ @ @ @ is not approved by federal health authorities and the company hasn ’ t yet set up a factory to manufacture the devices .
The commitment to ApiJect dwarfs the other needle orders the government has placed with a major manufacturer and two other small companies .
“ The fact of this matter is , it would be crazy for people to just rely on us .
I would be the first to say it , ” said ApiJect CEO Jay Walker .
“ We should be America ’ s backup at this point @ @ @ @ @ @ @ Trump administration officials would not say why they are investing so heavily in ApiJect ’ s technology .
The company has made only about 1,000 prototypes to date , and it ’ s not clear whether those devices can deliver the vaccines that are currently in development .
So far , the leading candidates are using traditional vials to hold the vaccine , and needles and syringes in their clinical trials .
ApiJect founder Marc Koska never intended to vaccinate the United States .
For the past five years , he ’ s @ @ @ @ @ @ @ creating an ultra low-cost prefilled syringe that would reduce the need to reuse needles in the developing world .
Instead , the company ’ s biggest customer has become the U.S. government .
ApiJect received a no-bid contract earlier this year from the Defense Department under an exception for “ unusual and compelling urgency.
” Authorities said the U.S. Department of Health and Human Services , tasked with buying the necessary supplies , “ does not have the resources or capacity to conduct procurements necessary to respond to the COVID-19 pandemic , ” @ @ @ @ @ @ @ .
The government promised ApiJect $ 138 million to produce 100 million of its devices by the end of the year , which will require the company to retrofit new manufacturing lines in existing factories .
And it ’ s offered another $ 456 million as part of a public-private partnership contract to bring online several new factories to make another 500 million devices to “ contain the pandemic spread to minimize the loss of life and impact to the United States economy , ” said the document .
These amounts are more @ @ @ @ @ @ @ is paying other companies for the work .
ApiJect first appeared on the U.S. government ’ s radar almost two years ago when the company piqued the interest of Admiral Brett P. Giroir , HHS ’ s assistant secretary for health , at the World Health Organization ’ s Global Conference on Primary Health Care in Astana , Kazakhstan .
Koska said Giroir was “ blown away ” by their technology and told them that if a pandemic hit , the strategic national stockpile was going to need a very fast way to @ @ @ @ @ @ @ and ready to deliver .
According to Walker , the CEO , ApiJect wasn ’ t interested in a federal contract — they were aiming to change the developing world with quick , inexpensive injection devices that could save millions of lives .
But at the conference , Walker found himself at a table with Giroir at a luncheon , just two seats apart .
The admiral was fascinated by the low-cost injection technology , Walker said , and when Walker showed him the prototype that he always carries in his pocket , @ @ @ @ @ @ @ this in the U.S. Walker said he told the admiral that the company wasn ’ t planning to operate in the U.S. but was struck by Giroir ’ s enthusiasm .
“ He was the first person , if not the only person at the event , who understood the revolutionary nature of this platform , ” Walker recalled in an interview with AP .
“ And he said , ‘ Wow this is amazing .
You need to do this in the U.S. ’ ” Walker continued to resist , he said @ @ @ @ @ @ @ a doctor specializing in pediatric critical care — “ wasn ’ t big on taking no for an answer , ” Walker said .
At Giroir ’ s urging they presented the prototype injector to U.S. officials .
HHS declined to make agency officials available for interviews .
It wasn ’ t until later , when Walker was introduced by a friend to Col. Matthew Hepburn at the Defense Advanced Research Projects Agency , that a plan for ApiJect to work in the United States began to take shape , he said .
@ @ @ @ @ @ @ Robert Kadlec approved a $ 10 million contract for ApiJect for research and development in January 2020 , according to a document in the federal procurement data system .
The company was responsible for securing private investments to create new production lines where the devices would be made over three to five years .
When the pandemic emerged weeks later , officials sounded the alarm about a potential shortage of needles and syringes to deliver a vaccine if and when one became available .
The federal Strategic National Stockpile of medical supplies had @ @ @ @ @ @ @ Rick Bright , who later left his position at Health and Human Services and filed a whistleblower complaint .
Bright warned White House trade adviser Peter Navarro and his HHS colleagues of a looming needle shortfall , according to a series of emails disclosed in his complaint .
“ We are hearing rumblings about the US inventory of needles and syringes … heading to other countries , ” wrote Bright .
“ There is limited inventory in the supply chain , it could take 2+ years to make enough to satisfy the U.S. @ @ @ @ @ @ @ would need 850 million needles .
“ We may find ourselves in a situation where we have enough vaccine but no way to deliver all of it , ” he said in a February memo to the White House coronavirus task force .
He recommended the task force “ direct HHS BARDA to initiate a program to identify all alternate vaccine delivery methods and ramp up production.
“ BARDA is the Biomedical Advanced Research and Development Authority within HHS .
Suddenly ApiJect ’ s 5-year plan to mass produce its devices became a @ @ @ @ @ @ @ $ 138 million contract , announced in May , to produce 100 million devices by year ’ s end .
Jefferies Financial Group is acting as the leader of the public-private partnership with HHS and invested $ 10 million to help ApiJect build surge production facilities in March .
The company said it would try to raise up to $ 1 billion more .
There have been no additional announcements of funding .
Walker said due to nondisclosure agreements with both the government and investors , the company is unable to say what @ @ @ @ @ @ @ far .
On a warm mid-May day in the White House Rose Garden , President Donald Trump introduced “ a massive scientific , industrial and logistical endeavor ” dubbed Operation Warp Speed .
The idea , he said , was to be ready to distribute a COVID-19 vaccine as soon as it was developed .
“ We must not be caught short on our capacity to deliver emergency drugs to Americans in need , ” said HHS Secretary Alex Azar .
An estimated 700 million injections may be needed to inoculate the nation @ @ @ @ @ @ @ person , according to the military document .
In early May , the government put in two orders , to Retractable Technologies in Little Elm , Texas , and Marathon Medical in Aurora , Colorado , totaling 320 million needles and syringes .
Later in May , the government announced plans for ApiJect to manufacture more than 500 million all-in-one devices that would come pre-loaded with the vaccine .
On Wednesday , the largest domestic manufacturer of needles and syringes , Becton Dickinson , announced the first U.S. order of $ 11.7 million @ @ @ @ @ @ @ the end of this year .
It plans to ramp up manufacturing over the next year .
And earlier this month Retractable entered into a second contract with the government , this one for $ 53 million meant to boost domestic manufacturing .
Together that sounds like enough injection devices .
But Retractable , which was worried enough about its financial future that earlier this year it received a $ 1.36 million loan from the Paycheck Protection Program , has been doing about 80 % of its manufacturing in China .
And Marathon @ @ @ @ @ @ @ there is no indication on its web site that it manufactures needles and syringes at all .
The company did not respond to repeated requests for comment .
Despite the race to replenish the domestic needle and syringe supply , about 400 shipping containers of syringes have left the U.S. for countries including Germany , Colombia , Australia , Brazil and Italy this year , according to Panjiva Inc. , a service that independently tracks global trade .
That ’ s the same , on average , as syringe exports over the past @ @ @ @ @ @ @ mass vaccination campaign is going to be complicated .
“ There are a lot of moving parts to this , ” said Dr. Bruce Gellin , the Sabin Vaccine Institute ’ s president of global immunization .
Darin Zehrung , who studied medical devices at PATH , a nonprofit advocating for health equity , said it ’ s wise to invest in new injection technologies .
But that only works if there are plenty of basic syringes and needles stocked up .
“ Hedging bets is the best approach , but plan for @ @ @ @ @ @ @ the best case scenario , ” said Zehrung .
ApiJect ’ s devices are self-contained , with soft plastic blisters that are squeezed , like a nose spray or eye drop , to push the vaccine through an attached needle and into the patient .
The device includes a little computer chip — like the ones in credit cards — that can transmit information about the drug , dose , location and time of administration .
The chip is not injected into patients .
Other injection devices Koska designed have been used in @ @ @ @ @ @ @ technology has not .
The company said they have started discussions with the U.S. Food and Drug Administration to review the device on a priority basis while the company moves ahead fitting factories to make their injectors .
The agency wouldn ’ t confirm this , citing its policy against discussing products involved in clinical trials .
Testing different vaccine candidates in the ApiJect devices will be critical before injecting the public .
Plastic could interact differently with the liquid than the glass vials currently used in trials , experts say .
And @ @ @ @ @ @ @ ’ s planned process is to pour vaccine doses into the warm plastic blisters as they come off the production line , the company says .
ApiJect says they can instantly cool the devices as they are made .
Walker , the ApiJect CEO , who founded the online travel agency Priceline , acknowledges that the government ’ s decision to rely on “ an emergency plan of refitting established pharmaceutical manufacturing facilities is risky .
But we feel good about it.
” The Associated Press asked the Health and Human Services department @ @ @ @ @ @ @ ’ s approach .
The agency didn ’ t allow an official to speak on the record for this story .
A senior administration official , speaking on condition of anonymity because the agency declined to allow him to identified by name , told AP he wasn ’ t familiar with ApiJect or the contract .
But he said the government was buying a range of devices to deliver the vaccine because they don ’ t know what they need .
And , he said , the Trump administration is looking to boost @ @ @ @ @ @ @ directly to Trump ’ s vaccine czar , Moncef Slaoui , to discuss the new technology , a spokesperson said the query was inappropriate .
“ If this continues , we will make no one else available either , ” Natalie Baldassarre , a special assistant at HHS , wrote in an email .
Last week , HHS Assistant Secretary of Public Affairs Michael Caputo wrote that the agency has “ lost interest in assisting your story ” and offered no further comment .
Mendoza reported from San Francisco .
Linderman reported from @ @ @ @ @ @ @ in Washington contributed .

EDITOR’S NOTE — This story is part of an ongoing investigation by The Associated Press, the PBS series FRONTLINE and the Global Reporting Centre that examines the deadly consequences of the fragmented worldwide medical supply chain.
When precious vats of COVID-19 vaccine are finally ready, jabbing the lifesaving solution into the arms of Americans will require hundreds of millions of injections.
As part of its strategy to administer the vaccine as quickly as possible, the Trump administration has agreed to invest more than half a billion in tax dollars in ApiJect Systems America, a young company. Its injector is not approved by federal health authorities and the company hasn’t yet set up a factory to manufacture the devices.
The commitment to ApiJect dwarfs the other needle orders the government has placed with a major manufacturer and two other small companies.
“The fact of this matter is, it would be crazy for people to just rely on us. I would be the first to say it,” said ApiJect CEO Jay Walker. “We should be America’s backup at this point, but probably not its primary.”
Trump administration officials would not say why they are investing so heavily in ApiJect’s technology. The company has made only about 1,000 prototypes to date, and it’s not clear whether those devices can deliver the vaccines that are currently in development. So far, the leading candidates are using traditional vials to hold the vaccine, and needles and syringes in their clinical trials.
RELUCTANT SUPPLIER
ApiJect founder Marc Koska never intended to vaccinate the United States. For the past five years, he’s been working on his lifetime mission of creating an ultra low-cost prefilled syringe that would reduce the need to reuse needles in the developing world.
Instead, the company’s biggest customer has become the U.S. government.
ApiJect received a no-bid contract earlier this year from the Defense Department under an exception for “unusual and compelling urgency.” Authorities said the U.S. Department of Health and Human Services, tasked with buying the necessary supplies, “does not have the resources or capacity to conduct procurements necessary to respond to the COVID-19 pandemic,” according to a June 5 military document.
The government promised ApiJect $138 million to produce 100 million of its devices by the end of the year, which will require the company to retrofit new manufacturing lines in existing factories. And it’s offered another $456 million as part of a public-private partnership contract to bring online several new factories to make another 500 million devices to “contain the pandemic spread to minimize the loss of life and impact to the United States economy,” said the document.
These amounts are more than double the per-syringe cost the government is paying other companies for the work.
ApiJect first appeared on the U.S. government’s radar almost two years ago when the company piqued the interest of Admiral Brett P. Giroir, HHS’s assistant secretary for health, at the World Health Organization’s Global Conference on Primary Health Care in Astana, Kazakhstan.
Koska said Giroir was “blown away” by their technology and told them that if a pandemic hit, the strategic national stockpile was going to need a very fast way to get injections filled with vaccines or therapeutics and ready to deliver.
According to Walker, the CEO, ApiJect wasn’t interested in a federal contract — they were aiming to change the developing world with quick, inexpensive injection devices that could save millions of lives.
But at the conference, Walker found himself at a table with Giroir at a luncheon, just two seats apart. The admiral was fascinated by the low-cost injection technology, Walker said, and when Walker showed him the prototype that he always carries in his pocket, Giroir asked how they plan to do this in the U.S.
Walker said he told the admiral that the company wasn’t planning to operate in the U.S. but was struck by Giroir’s enthusiasm.
“He was the first person, if not the only person at the event, who understood the revolutionary nature of this platform,” Walker recalled in an interview with AP. “And he said, ‘Wow this is amazing. You need to do this in the U.S.’”
Walker continued to resist, he said, but Giroir — who is also a doctor specializing in pediatric critical care — “wasn’t big on taking no for an answer,” Walker said.
At Giroir’s urging they presented the prototype injector to U.S. officials. HHS declined to make agency officials available for interviews.
It wasn’t until later, when Walker was introduced by a friend to Col. Matthew Hepburn at the Defense Advanced Research Projects Agency, that a plan for ApiJect to work in the United States began to take shape, he said.
HHS Assistant Secretary for Preparedness and Response Robert Kadlec approved a $10 million contract for ApiJect for research and development in January 2020, according to a document in the federal procurement data system. The company was responsible for securing private investments to create new production lines where the devices would be made over three to five years.
When the pandemic emerged weeks later, officials sounded the alarm about a potential shortage of needles and syringes to deliver a vaccine if and when one became available.
The federal Strategic National Stockpile of medical supplies had only 15 million syringes, according to Rick Bright, who later left his position at Health and Human Services and filed a whistleblower complaint.
Bright warned White House trade adviser Peter Navarro and his HHS colleagues of a looming needle shortfall, according to a series of emails disclosed in his complaint.
“We are hearing rumblings about the US inventory of needles and syringes … heading to other countries,” wrote Bright. “There is limited inventory in the supply chain, it could take 2+ years to make enough to satisfy the U.S. vaccine needs.”
Navarro said the U.S. would need 850 million needles.
“We may find ourselves in a situation where we have enough vaccine but no way to deliver all of it,” he said in a February memo to the White House coronavirus task force.
He recommended the task force “direct HHS BARDA to initiate a program to identify all alternate vaccine delivery methods and ramp up production.“ BARDA is the Biomedical Advanced Research and Development Authority within HHS.
Suddenly ApiJect’s 5-year plan to mass produce its devices became a sprint measured in months with a new $138 million contract, announced in May, to produce 100 million devices by year’s end.
Jefferies Financial Group is acting as the leader of the public-private partnership with HHS and invested $10 million to help ApiJect build surge production facilities in March. The company said it would try to raise up to $1 billion more. There have been no additional announcements of funding.
Walker said due to nondisclosure agreements with both the government and investors, the company is unable to say what private funding they’ve secured so far.
OPERATION WARP SPEED
On a warm mid-May day in the White House Rose Garden, President Donald Trump introduced “a massive scientific, industrial and logistical endeavor” dubbed Operation Warp Speed.
The idea, he said, was to be ready to distribute a COVID-19 vaccine as soon as it was developed.
“We must not be caught short on our capacity to deliver emergency drugs to Americans in need,” said HHS Secretary Alex Azar.
An estimated 700 million injections may be needed to inoculate the nation — at least two shots for every person, according to the military document.
In early May, the government put in two orders, to Retractable Technologies in Little Elm, Texas, and Marathon Medical in Aurora, Colorado, totaling 320 million needles and syringes.
Later in May, the government announced plans for ApiJect to manufacture more than 500 million all-in-one devices that would come pre-loaded with the vaccine.
On Wednesday, the largest domestic manufacturer of needles and syringes, Becton Dickinson, announced the first U.S. order of $11.7 million for 50 million needles and syringes by the end of this year. It plans to ramp up manufacturing over the next year.
And earlier this month Retractable entered into a second contract with the government, this one for $53 million meant to boost domestic manufacturing.
Together that sounds like enough injection devices.
But Retractable, which was worried enough about its financial future that earlier this year it received a $1.36 million loan from the Paycheck Protection Program, has been doing about 80% of its manufacturing in China. And Marathon is a medical supply distributor, and there is no indication on its web site that it manufactures needles and syringes at all. The company did not respond to repeated requests for comment.
Despite the race to replenish the domestic needle and syringe supply, about 400 shipping containers of syringes have left the U.S. for countries including Germany, Colombia, Australia, Brazil and Italy this year, according to Panjiva Inc., a service that independently tracks global trade. That’s the same, on average, as syringe exports over the past five years.
Experts acknowledge that a mass vaccination campaign is going to be complicated.
“There are a lot of moving parts to this,” said Dr. Bruce Gellin, the Sabin Vaccine Institute’s president of global immunization.
Darin Zehrung, who studied medical devices at PATH, a nonprofit advocating for health equity, said it’s wise to invest in new injection technologies. But that only works if there are plenty of basic syringes and needles stocked up.
“Hedging bets is the best approach, but plan for the worst case scenario and hope for the best case scenario,” said Zehrung.
AWAITING APPROVAL
ApiJect’s devices are self-contained, with soft plastic blisters that are squeezed, like a nose spray or eye drop, to push the vaccine through an attached needle and into the patient.
The device includes a little computer chip — like the ones in credit cards — that can transmit information about the drug, dose, location and time of administration. The chip is not injected into patients.
Other injection devices Koska designed have been used in the developing world, but this ApiJect technology has not.
The company said they have started discussions with the U.S. Food and Drug Administration to review the device on a priority basis while the company moves ahead fitting factories to make their injectors. The agency wouldn’t confirm this, citing its policy against discussing products involved in clinical trials.
Testing different vaccine candidates in the ApiJect devices will be critical before injecting the public.
Plastic could interact differently with the liquid than the glass vials currently used in trials, experts say. And there are strict temperature requirements. ApiJect’s planned process is to pour vaccine doses into the warm plastic blisters as they come off the production line, the company says. ApiJect says they can instantly cool the devices as they are made.
Walker, the ApiJect CEO, who founded the online travel agency Priceline, acknowledges that the government’s decision to rely on “an emergency plan of refitting established pharmaceutical manufacturing facilities is risky. But we feel good about it.”
NO COMMENT
The Associated Press asked the Health and Human Services department over many weeks to explain the government’s approach. The agency didn’t allow an official to speak on the record for this story.
A senior administration official, speaking on condition of anonymity because the agency declined to allow him to identified by name, told AP he wasn’t familiar with ApiJect or the contract. But he said the government was buying a range of devices to deliver the vaccine because they don’t know what they need. And, he said, the Trump administration is looking to boost domestic manufacturing.
When AP reached out directly to Trump’s vaccine czar, Moncef Slaoui, to discuss the new technology, a spokesperson said the query was inappropriate.
“If this continues, we will make no one else available either,” Natalie Baldassarre, a special assistant at HHS, wrote in an email.
Last week, HHS Assistant Secretary of Public Affairs Michael Caputo wrote that the agency has “lost interest in assisting your story” and offered no further comment.
___
Mendoza reported from San Francisco. Linderman reported from Baltimore. Lauran Neergaard and Stephen Braun in Washington contributed.


talkingpointsmemo--2020-07-10--COVID And Flu Season Are Set To Collide, And Experts Fear ‘Disaster’

The pandemic ’ s much-discussed summer respite never came .
Instead , the U.S. has found itself with COVID-19 cases surging around the country into July , foreshadowing a potentially deadly duo in the fall : continued COVID-19 outbreaks combined with the seasonal flu .
“ If COVID-19 and influenza peak at the same time this year , it could be quite disastrous , ” Dr. Dan Uslan , co-chief infection prevention officer at UCLA Health , told TPM .
Doctors and health officials painted a complex and stark picture to TPM .
The symptoms of influenza and COVID-19 are @ @ @ @ @ @ @ hospitals to quickly diagnose and isolate contagious patients .
Once the flu season begins , “ we will start from a higher level of COVID infection , ” Dr. Ali Mokdad of the Institute for Health Metrics and Evaluation told TPM .
“ The second wave , or the first wave as it keeps continuing , is gon na come at the same time as the flu season , pneumonia season , which also have a big impact.
” The current high level of COVID-19 cases suggests that without massive further interventions , @ @ @ @ @ @ @ the U.S. at the same time — a fate that the country narrowly avoided as the pandemic began in earnest in March , just as the 2019-2020 flu season came to an end .
The possibility that the U.S. could be hit by simultaneous waves of flu and COVID-19 presents a confounding problem : the symptoms look almost exactly alike .
Both respiratory illnesses frequently present with fever , a deep cough , and trouble breathing in serious cases .
Difficulty in distinguishing between the illnesses could complicate detection — and patients ’ @ @ @ @ @ @ @ , Adriane Casalotti , head of government relations for the National Association of County Health Officials , told TPM .
“ People are scared of coronavirus — they recognize that it ’ s a significant illness , that people are dying of it , have died of it , ” Casalotti said .
Dr. Paul Biddinger , director of emergency preparedness for Mass General Hospital and head of the emergency preparedness program at Harvard ’ s T.H .
Chan School of public health , told TPM that “ it ’ s basically impossible @ @ @ @ @ @ @ flu without a test.
” He cast the problem as one of managing finite resources in an emergency .
For hospitals seeking both to treat as many patients as possible and prevent the spread of both the flu and COVID-19 within their walls , having an onslaught of patients with both illnesses could throw a wrench in how quickly doctors can diagnose a patient and assign them to a bed for treatment .
Biddinger said that hospitals would likely have to prepare to test for both the flu and COVID-19 .
“ The @ @ @ @ @ @ @ both , you have to rule out both from an infection control perspective , and it slows down the bed placement process , ” he said .
Sarah Cobey , lead investigator at the University of Chicago ’ s Cobey lab which studies the interplay between immunity and pathogens with an eye towards epidemiological forecasting and vaccine design , has been focusing on the disparate testing issue .
She told TPM that she and officials at the National Institutes of Health have been discussing how to streamline the testing process with a dual @ @ @ @ @ @ @ said , are “ about trying to use COVID as a way to expand testing for the flu.
” “ It would be amazing if , when people show up with respiratory symptoms , we could test them not just for flu but a whole panel of things , ” she said .
“ But I feel like that would require remaking the health-care system .
Insurance totally dictates which kinds of tests are supported — it ’ s unfortunate.
” She added that she ’ s hoping to set up or expand @ @ @ @ @ @ @ with vigilant surveillance systems to try out testing for a slate of respiratory diseases at once .
There ’ s no easy way to quantify the impact a flu season will have on hospital capacity .
The flu changes every year in its severity , depending in part on subtle shifts in how the virus mutates , and on the success of mitigation strategies like annual vaccination campaigns .
And some vaccines , Cobey said , just end up working better than others .
That presents a challenge to ascertaining how hard the @ @ @ @ @ @ @ the temperature drops .
“ We ’ re not at a point where we can predict far in advance which flu virus will dominate , ” she said .
An additional problem , Cobey said , is that research suggests that getting the flu vaccine too early could actually weaken its effectiveness .
“ Some research is suggesting that if you get the vaccine too long before flu season starts , the vaccine won ’ t protect you as much , ” she said .
“ The antibodies wane.
” That could be @ @ @ @ @ @ @ wave of disease .
“ If we have a really bad flu season , that will increase the severity of the COVID-19 season and the health-care system will be strained , ” she added .
Uslan said that the strain will trickle down to specific equipment , given that the diseases both target the respiratory system .
“ Because both infections are quite similar , they use many of the same resources ( ICU beds , ventilators , etc ) , ” he said .
“ Since flu season on its own is @ @ @ @ @ @ @ infections peak around the same time will cause tremendous stress to our health-care system.
” As it is , the flu alone already strains hospitals across the country .
It ’ s common for the seasonal flu to fill up hospital ICUs .
In the 2017-2018 flu season — the worst in the past decade — the CDC estimated that the total number of people hospitalized throughout the season was higher than the number of staffed hospital beds which existed in the U.S. at that time .
Around 959,000 people were hospitalized that @ @ @ @ @ @ @ beds .
But to Biddinger , of Mass General , the problem looked to be one of sorting out which patient should go where .
If hospitals can ’ t quickly identify who is infected with what and , therefore , which bed to put the patient in , emergency rooms could begin to get backed up .
“ Any excess above what your normal Emergency Department wait time is is really a problem , ” Biddinger said .
“ Any excess results in very significant backloads in your Emergency Department ” Despite @ @ @ @ @ @ @ cold season , there is a bright side to the parallel illnesses : COVID-19 mitigation strategies also help tamp down the spread of flu .
“ The same preventive measures that work for COVID-19 ( physical distancing , handwashing , etc ) also help to prevent influenza , so it ’ s critically important to continue those measures as well , ” Uslan , of UCLA Health , said .
Cobey told TPM that there is promising evidence from Hong Kong , where there was an abrupt drop in flu infections when people @ @ @ @ @ @ @ COVID-19 hit earlier in the winter while flu season was still in full swing , a problem avoided in the United States the first time around .
“ I wouldn ’ t be surprised if the severity of seasons and epidemics track to each other a little bit , ” she said .

The pandemic’s much-discussed summer respite never came.
Instead, the U.S. has found itself with COVID-19 cases surging around the country into July, foreshadowing a potentially deadly duo in the fall: continued COVID-19 outbreaks combined with the seasonal flu.
“If COVID-19 and influenza peak at the same time this year, it could be quite disastrous,” Dr. Dan Uslan, co-chief infection prevention officer at UCLA Health, told TPM.
Doctors and health officials painted a complex and stark picture to TPM. The symptoms of influenza and COVID-19 are strikingly similar, making it difficult for hospitals to quickly diagnose and isolate contagious patients.
Once the flu season begins, “we will start from a higher level of COVID infection,” Dr. Ali Mokdad of the Institute for Health Metrics and Evaluation told TPM. “The second wave, or the first wave as it keeps continuing, is gonna come at the same time as the flu season, pneumonia season, which also have a big impact.”
The current high level of COVID-19 cases suggests that without massive further interventions, both diseases could end up intersecting in the U.S. at the same time — a fate that the country narrowly avoided as the pandemic began in earnest in March, just as the 2019-2020 flu season came to an end.
Different Illnesses, Similar Symptoms
The possibility that the U.S. could be hit by simultaneous waves of flu and COVID-19 presents a confounding problem: the symptoms look almost exactly alike. Both respiratory illnesses frequently present with fever, a deep cough, and trouble breathing in serious cases.
Difficulty in distinguishing between the illnesses could complicate detection — and patients’ decisions on when to seek hospital care, Adriane Casalotti, head of government relations for the National Association of County Health Officials, told TPM.
“People are scared of coronavirus — they recognize that it’s a significant illness, that people are dying of it, have died of it,” Casalotti said.
Dr. Paul Biddinger, director of emergency preparedness for Mass General Hospital and head of the emergency preparedness program at Harvard’s T.H. Chan School of public health, told TPM that “it’s basically impossible to tell the difference between COVID and flu without a test.”
He cast the problem as one of managing finite resources in an emergency. For hospitals seeking both to treat as many patients as possible and prevent the spread of both the flu and COVID-19 within their walls, having an onslaught of patients with both illnesses could throw a wrench in how quickly doctors can diagnose a patient and assign them to a bed for treatment.
Biddinger said that hospitals would likely have to prepare to test for both the flu and COVID-19.
“The problem is once you’re testing both, you have to rule out both from an infection control perspective, and it slows down the bed placement process,” he said.
Sarah Cobey, lead investigator at the University of Chicago’s Cobey lab which studies the interplay between immunity and pathogens with an eye towards epidemiological forecasting and vaccine design, has been focusing on the disparate testing issue.
She told TPM that she and officials at the National Institutes of Health have been discussing how to streamline the testing process with a dual flu-COVID-19 test.
The talks, she said, are “about trying to use COVID as a way to expand testing for the flu.”
“It would be amazing if, when people show up with respiratory symptoms, we could test them not just for flu but a whole panel of things,” she said. “But I feel like that would require remaking the health-care system. Insurance totally dictates which kinds of tests are supported — it’s unfortunate.”
She added that she’s hoping to set up or expand at least a few testing sites equipped with vigilant surveillance systems to try out testing for a slate of respiratory diseases at once.
Are Hospitals Prepared?
There’s no easy way to quantify the impact a flu season will have on hospital capacity.
The flu changes every year in its severity, depending in part on subtle shifts in how the virus mutates, and on the success of mitigation strategies like annual vaccination campaigns.
And some vaccines, Cobey said, just end up working better than others.
That presents a challenge to ascertaining how hard the U.S. will be hit this year when the temperature drops.
“We’re not at a point where we can predict far in advance which flu virus will dominate,” she said.
An additional problem, Cobey said, is that research suggests that getting the flu vaccine too early could actually weaken its effectiveness.
“Some research is suggesting that if you get the vaccine too long before flu season starts, the vaccine won’t protect you as much,” she said. “The antibodies wane.”
That could be a critical factor in combating the two-pronged wave of disease. “If we have a really bad flu season, that will increase the severity of the COVID-19 season and the health-care system will be strained,” she added.
Uslan said that the strain will trickle down to specific equipment, given that the diseases both target the respiratory system.
“Because both infections are quite similar, they use many of the same resources (ICU beds, ventilators, etc),” he said. “Since flu season on its own is a challenge to manage, having both infections peak around the same time will cause tremendous stress to our health-care system.”
As it is, the flu alone already strains hospitals across the country.
It’s common for the seasonal flu to fill up hospital ICUs. In the 2017-2018 flu season — the worst in the past decade — the CDC estimated that the total number of people hospitalized throughout the season was higher than the number of staffed hospital beds which existed in the U.S. at that time.
Around 959,000 people were hospitalized that season, while there were 902,202 staffed beds.
But to Biddinger, of Mass General, the problem looked to be one of sorting out which patient should go where.
If hospitals can’t quickly identify who is infected with what and, therefore, which bed to put the patient in, emergency rooms could begin to get backed up.
“Any excess above what your normal Emergency Department wait time is is really a problem,” Biddinger said. “Any excess results in very significant backloads in your Emergency Department”
Mitigation Efforts As The Silver Lining
Despite the fear and uncertainty of the coming cold season, there is a bright side to the parallel illnesses: COVID-19 mitigation strategies also help tamp down the spread of flu.
“The same preventive measures that work for COVID-19 (physical distancing, handwashing, etc) also help to prevent influenza, so it’s critically important to continue those measures as well,” Uslan, of UCLA Health, said.
Cobey told TPM that there is promising evidence from Hong Kong, where there was an abrupt drop in flu infections when people started taking COVID-19 precautions. There, COVID-19 hit earlier in the winter while flu season was still in full swing, a problem avoided in the United States the first time around.
“I wouldn’t be surprised if the severity of seasons and epidemics track to each other a little bit,” she said.


talkingpointsmemo--2020-07-10--Yovanovitch Slams Trump’s Attacks On Impeachment Witnesses: ‘Our Country Deserved Better Than This’

Former U.S .
Ambassador to Ukraine Marie Yovanovitch , who was central to the House ’ s impeachment of President Donald Trump , blasted Trump ’ s retaliatory crusade against fellow impeachment witness Lt. Col. Alexander Vindman on Thursday .
During an interview with the New Yorker , Yovanovitch expressed sympathy toward Vindman , who resigned from the military on Wednesday due to what Vindman ’ s lawyer described as Trump ’ s “ campaign of bullying , intimidation , and retaliation.
” Part of that campaign involved a White House attempt to torpedo the Defense Department ’ s plans @ @ @ @ @ @ @ pushing Pentagon officials to find evidence of misconduct by Vindman ( they were ultimately unable to do so ) .
Trump also had Vindman ousted from the National Security Council in February .
“ Alex is a decorated combat veteran and has served his country well and honorably , ” Yovanovitch told the New Yorker .
“ Alex should have received the honor and thanks and recognition of the nation.
” “ He deserved better than this , ” the former diplomat continued .
“ Our country deserved better than this.
” Yovanovitch @ @ @ @ @ @ @ for testifying to Congress about her abrupt removal from her post in Kiev as part of Trump ’ s scheme to pressure Ukraine into announcing an investigation into 2020 Democratic candidate Joe Biden .
Trump fired off the attacks via Twitter in the middle of Yovanovitch ’ s hearing , which the official described as “ very intimidating.
” Several months after the GOP-controlled Senate acquitted Trump in its impeachment trial , the President fired Intelligence Community Inspector General Michael Atkinson , who had submitted to Congress the whistleblower complaint that set off @ @ @ @ @ @ @ not publicly provide a reason for Atkinson ’ s ouster , multiple reports stated that he had removed Atkinson for his role in Trump ’ s impeachment .
The President also fired U.S .
Ambassador to the E.U .
Gordon Sondland , another bombshell witness in the House ’ s impeachment inquiry , a few days after the acquittal .

Former U.S. Ambassador to Ukraine Marie Yovanovitch, who was central to the House’s impeachment of President Donald Trump, blasted Trump’s retaliatory crusade against fellow impeachment witness Lt. Col. Alexander Vindman on Thursday.
During an interview with the New Yorker, Yovanovitch expressed sympathy toward Vindman, who resigned from the military on Wednesday due to what Vindman’s lawyer described as Trump’s “campaign of bullying, intimidation, and retaliation.”
Part of that campaign involved a White House attempt to torpedo the Defense Department’s plans to promote Vindman to full colonel by pushing Pentagon officials to find evidence of misconduct by Vindman (they were ultimately unable to do so). Trump also had Vindman ousted from the National Security Council in February.
“Alex is a decorated combat veteran and has served his country well and honorably,” Yovanovitch told the New Yorker. “Alex should have received the honor and thanks and recognition of the nation.”
“He deserved better than this,” the former diplomat continued. “Our country deserved better than this.”
Yovanovitch herself was targeted by Trump last year for testifying to Congress about her abrupt removal from her post in Kiev as part of Trump’s scheme to pressure Ukraine into announcing an investigation into 2020 Democratic candidate Joe Biden.
Trump fired off the attacks via Twitter in the middle of Yovanovitch’s hearing, which the official described as “very intimidating.”
Several months after the GOP-controlled Senate acquitted Trump in its impeachment trial, the President fired Intelligence Community Inspector General Michael Atkinson, who had submitted to Congress the whistleblower complaint that set off the impeachment process. Though Trump did not publicly provide a reason for Atkinson’s ouster, multiple reports stated that he had removed Atkinson for his role in Trump’s impeachment.
The President also fired U.S. Ambassador to the E.U. Gordon Sondland, another bombshell witness in the House’s impeachment inquiry, a few days after the acquittal.


talkingpointsmemo--2020-07-10--Hold Everything! Flynn’s Case Not Over Just Yet

The fight over whether a federal judge can scrutinize the Justice Department ’ s reasons for wanting Michael Flynn ’ s case dismissed will continue — at least temporarily .
The full U.S. Court of Appeals for the D.C .
Circuit on Friday put on hold an order that the judge immediately dismiss Flynn ’ s case .
The now-frozen order was issued by two GOP appointees on a three-judge appellate panel , after Flynn made an extraordinary request that the appeals court intervene in how his judge , U.S. District Judge Emmet Sullivan , was handling his case .
@ @ @ @ @ @ @ s move on Friday means that the Justice Department won ’ t be able to drop just yet its case against the former national security adviser , who had pleaded guilty in 2017 to lying the the FBI about his Russian contacts .
The dispute over whether Sullivan has to go along with the DOJ dismissal request is virtually unprecedented .
It represents the uncomfortable position the judiciary has found itself in as the Justice Department , under Attorney General Bill Barr , has bent in ways that favor allies of President Trump @ @ @ @ @ @ @ bombshell announcement in May that it was now requesting Flynn ’ s case be dismissed , Sullivan held off on immediately granting the request .
Instead he invited outside parties to brief him on the matter , and he appointed a retired judge to serve as a so-called friend of the court by opposing the dismissal request .
A hearing on what he should do next had been scheduled for next week .
The appellate panel blocked those efforts late last month and , absent any action from a higher court , Sullivan @ @ @ @ @ @ @ by next week under the order .
Sullivan on Thursday asked the full D.C .
Circuit , which is made up of a majority Democratic-appointees , to review that appellate decision .
In its order Friday , the D.C .
Circuit told Flynn to file within 10 days his response to Sullivan ’ s request that the full appeals court get involved .
The D.C .
Circuit also invited the Justice Department to weigh in within that time period .

The fight over whether a federal judge can scrutinize the Justice Department’s reasons for wanting Michael Flynn’s case dismissed will continue — at least temporarily.
The full U.S. Court of Appeals for the D.C. Circuit on Friday put on hold an order that the judge immediately dismiss Flynn’s case.
The now-frozen order was issued by two GOP appointees on a three-judge appellate panel, after Flynn made an extraordinary request that the appeals court intervene in how his judge, U.S. District Judge Emmet Sullivan, was handling his case.
Bigger picture, the D.C. Circuit’s move on Friday means that the Justice Department won’t be able to drop just yet its case against the former national security adviser, who had pleaded guilty in 2017 to lying the the FBI about his Russian contacts.
The dispute over whether Sullivan has to go along with the DOJ dismissal request is virtually unprecedented. It represents the uncomfortable position the judiciary has found itself in as the Justice Department, under Attorney General Bill Barr, has bent in ways that favor allies of President Trump.
When the Justice Department made the bombshell announcement in May that it was now requesting Flynn’s case be dismissed, Sullivan held off on immediately granting the request. Instead he invited outside parties to brief him on the matter, and he appointed a retired judge to serve as a so-called friend of the court by opposing the dismissal request. A hearing on what he should do next had been scheduled for next week.
The appellate panel blocked those efforts late last month and, absent any action from a higher court, Sullivan would have had to dismiss the case by next week under the order. Sullivan on Thursday asked the full D.C. Circuit, which is made up of a majority Democratic-appointees, to review that appellate decision.
In its order Friday, the D.C. Circuit told Flynn to file within 10 days his response to Sullivan’s request that the full appeals court get involved. The D.C. Circuit also invited the Justice Department to weigh in within that time period.
Read the order below:


talkingpointsmemo--2020-07-10--Fox Host On Trump Tax Ruling: Now SCOTUS Has Been Infiltrated By The ‘Deep State!’

Fox Business Network host Lou Dobbs railed against the Supreme Court on Thursday , suggesting the justices are now part of the amorphous “ deep state ” conspiracy and claiming they executed a coordinated effort with “ radical ” Democrats to undercut President Trump .
In a 7-2 ruling on Thursday , the Supreme Court upheld a New York prosecutor ’ s criminal subpoena for Trump ’ s tax returns , but justices left plenty of room for Trump ’ s legal team to jam up the enforcement of the subpoena with more legal maneuvering .
Similarly , the high @ @ @ @ @ @ @ subpoenas for Trump ’ s financial records .
But that didn ’ t stop the Fox Business host from spouting a conspiracy-laced hot take on the Supreme Court Thursday night during an interview with conservative reporter John Solomon .
( As you may recall , Solomon ’ s largely unsubstantiated writings on the Biden family and Ukraine fueled much of Trump lawyer Rudy Giuliani ’ s pressure campaign in the country , which ultimately formed the basis of the House ’ s impeachment inquiry . )
“ Let ’ s talk about the @ @ @ @ @ @ @ obviously , to the Supreme Court , ” Dobbs said Thursday evening .
It ’ s worth noting that both Justices Brett Kavanaugh and Neil Gorsuch — Trump nominees — sided with the majority in the tax return case .
In a Tulsa campaign rally speech last month Trump boasted that the pair were “ two great Supreme Court judges.
” Dobbs has repeatedly ranted about the Supreme Court in recent weeks .
Last month the Fox host launched an attack on John Roberts , whom he claimed “ has lost his mind @ @ @ @ @ @ @ ending DACA — an Obama-era program which protects some undocumented immigrants who were brought to the United States as children from deportation — and for safeguarding workplace protections for LGBT people .
On Thursday night , Dobbs ramped up his attack on the court — suggesting that the SCOTUS was kidding no one in its decision to allow “ left-winger ” District Attorney of Manhattan Cyrus Vance the room to obtain tax records , while simultaneously ruling that Congress does not have that power .
In reality , the court ruled that Congress @ @ @ @ @ @ @ financial documents , but the court kicked this specific case back to the lower courts — a decision that will prevent lawmakers from accessing those records until after the 2020 election .
Dobbs then accused the Manhattan DA of coordinating his efforts to take down the President with the “ radical Dems on Capitol Hill.
” Dobbs ’ aggressive defense of the President paid off .
Hours later , Trump praised Dobbs in a Friday morning tweet about his upcoming book entitled , “ The Trump Century .
”

Fox Business Network host Lou Dobbs railed against the Supreme Court on Thursday, suggesting the justices are now part of the amorphous “deep state” conspiracy and claiming they executed a coordinated effort with “radical” Democrats to undercut President Trump.
In a 7-2 ruling on Thursday, the Supreme Court upheld a New York prosecutor’s criminal subpoena for Trump’s tax returns, but justices left plenty of room for Trump’s legal team to jam up the enforcement of the subpoena with more legal maneuvering. Similarly, the high court punted on a case involving congressional subpoenas for Trump’s financial records.
But that didn’t stop the Fox Business host from spouting a conspiracy-laced hot take on the Supreme Court Thursday night during an interview with conservative reporter John Solomon. (As you may recall, Solomon’s largely unsubstantiated writings on the Biden family and Ukraine fueled much of Trump lawyer Rudy Giuliani’s pressure campaign in the country, which ultimately formed the basis of the House’s impeachment inquiry.)
“Let’s talk about the bureaucracy. The deep state extends, obviously, to the Supreme Court,” Dobbs said Thursday evening.
Fox Business host Lou Dobbs accused the SCOTUS for being apart of "the deep state" in a Thursday interview, railing on the justices for ruling in favor of a NY prosecutor's demands to subpoena for Trump's tax records. pic.twitter.com/yXW3Yk6gWS — TPM Livewire (@TPMLiveWire) July 10, 2020
It’s worth noting that both Justices Brett Kavanaugh and Neil Gorsuch — Trump nominees — sided with the majority in the tax return case. In a Tulsa campaign rally speech last month Trump boasted that the pair were “two great Supreme Court judges.”
Dobbs has repeatedly ranted about the Supreme Court in recent weeks. Last month the Fox host launched an attack on John Roberts, whom he claimed “has lost his mind” after the chief justice ruled against ending DACA — an Obama-era program which protects some undocumented immigrants who were brought to the United States as children from deportation — and for safeguarding workplace protections for LGBT people.
On Thursday night, Dobbs ramped up his attack on the court — suggesting that the SCOTUS was kidding no one in its decision to allow “left-winger” District Attorney of Manhattan Cyrus Vance the room to obtain tax records, while simultaneously ruling that Congress does not have that power. In reality, the court ruled that Congress does have the authority to subpoena the financial documents, but the court kicked this specific case back to the lower courts — a decision that will prevent lawmakers from accessing those records until after the 2020 election.
Dobbs then accused the Manhattan DA of coordinating his efforts to take down the President with the “radical Dems on Capitol Hill.”
Dobbs’ aggressive defense of the President paid off. Hours later, Trump praised Dobbs in a Friday morning tweet about his upcoming book entitled, “The Trump Century.”


talkingpointsmemo--2020-07-10--A Rollicking Tick-Tock Of The Comically Inept SharpieGate Scandal

The 81-year-old Secretary of Commerce Wilbur Ross , in Greece on an official trip last September , was awakened from his early-morning slumber by a call from the then-White House chief of staff .
It was about the President ’ s baffling claim on Twitter — made the previous Sunday — that Hurricane Dorian , bound for the east coast , was actually going to hit Alabama .
Local National Weather Service meteorologists in Alabama had contradicted the President that same day , saying in a tweet that the state faced no danger from the hurricane .
Now , on @ @ @ @ @ @ @ from Ross .
Mulvaney ’ s call to Ross was just one behind-the-scenes detail of many found in a report released Thursday by the Department of Commerce inspector general detailing the infamous affair now known as SharpieGate .
The report includes a timeline of how it all went down : In an email to Ross a few hours after his call — after the Commerce secretary had fallen back asleep — Mulvaney was blunt : “ As it currently stands , it appears as if NWS intentionally contradicted the president .
And we @ @ @ @ @ @ @ either a correction or an explanation or both.
” The messages from Mulvaney to Ross just happened to come a day after Trump displayed a Sharpied-up version of a hurricane forecast in the Oval Office .
And the chief of staff ’ s instructions set off a frantic day of meetings to decide what to do about the offending tweet from the weather service .
Finally , the National Oceanic and Atmospheric Administration released an unsigned statement backing Trump and criticizing the local meteorologists .
The missive sent morale at NOAA plummeting .
@ @ @ @ @ @ @ , felt like they ’ d been thrown “ under the bus.
” In Thursday ’ s report , the Commerce Department inspector general ’ s office concluded that the statement — released five days after the tweets in question — didn ’ t advance NOAA ’ s interests , and discounted participation from NOAA staff .
According to the timeline of events in the report , that statement came together notably without input from career meteorologists at NOAA or the National Weather Service .
Instead , Ross ’ s chief of staff @ @ @ @ @ @ @ , worked with then-acting deputy general counsel David Dewhirst and NOAA ’ s acting chief Neil Jacobs — who didn ’ t include other important officials at the organization .
“ I really viewed this as sort of a DOC led process , ” Jacobs told the inspector general ’ s office , referring to the Department of Commerce .
“ That wasn ’ t NOAA ’ s idea.
” The statement backed Trump even though a forecast just before his tweet showed only a slight chance that Alabama would experience tropical-storm-force winds @ @ @ @ @ @ @ in a text message to Walsh , “ just a windy day.
” Career staff at NWS Birmingham — whose tweet had thrown the Commerce Department and White House into damage-control mode — told investigators they weren ’ t even aware of Trump ’ s tweet when they sent their own : They were responding to questions from locals .
But , several days later when their bosses hung them out to dry , they felt the heat .
“ I saw the statement and kind of broke down , ” one Birmingham @ @ @ @ @ @ @ general ’ s report was delayed for several days because staff from Ross ’ office were “ actively preventing ” its release with vague objections about privileged information , Inspector General Peggy E. Gustafson alleged in a letter last week .
The published report Wednesday barely had any redactions .
In response to the report , an attorney for the Commerce Department wrote that “ the absence of any formal recommendation shows that there were no major flaws in the Department ’ s handling of this situation.
” Walsh , who is awaiting @ @ @ @ @ @ @ s official general counsel , said the report ’ s conclusions were “ unsupported by any of the evidence or factual findings that the report itself lays out.
” But the bottom line , per the report , is a simple one : “ It was unnecessary to correct the accuracy of a 5-day-old tweet .
”

The 81-year-old Secretary of Commerce Wilbur Ross, in Greece on an official trip last September, was awakened from his early-morning slumber by a call from the then-White House chief of staff. It was about the President’s baffling claim on Twitter — made the previous Sunday — that Hurricane Dorian, bound for the east coast, was actually going to hit Alabama.
Local National Weather Service meteorologists in Alabama had contradicted the President that same day, saying in a tweet that the state faced no danger from the hurricane. Now, on Thursday, Mick Mulvaney wanted an explanation from Ross.
Mulvaney’s call to Ross was just one behind-the-scenes detail of many found in a report released Thursday by the Department of Commerce inspector general detailing the infamous affair now known as SharpieGate. The report includes a timeline of how it all went down:
In an email to Ross a few hours after his call — after the Commerce secretary had fallen back asleep — Mulvaney was blunt: “As it currently stands, it appears as if NWS intentionally contradicted the president. And we need to know why. He wants either a correction or an explanation or both.”
The messages from Mulvaney to Ross just happened to come a day after Trump displayed a Sharpied-up version of a hurricane forecast in the Oval Office.
And the chief of staff’s instructions set off a frantic day of meetings to decide what to do about the offending tweet from the weather service.
Finally, the National Oceanic and Atmospheric Administration released an unsigned statement backing Trump and criticizing the local meteorologists.
The missive sent morale at NOAA plummeting. Career scientists, a union official said, felt like they’d been thrown “under the bus.”
In Thursday’s report, the Commerce Department inspector general’s office concluded that the statement — released five days after the tweets in question — didn’t advance NOAA’s interests, and discounted participation from NOAA staff.
According to the timeline of events in the report, that statement came together notably without input from career meteorologists at NOAA or the National Weather Service.
Instead, Ross’s chief of staff and acting general counsel, Michael Walsh, worked with then-acting deputy general counsel David Dewhirst and NOAA’s acting chief Neil Jacobs — who didn’t include other important officials at the organization.
“I really viewed this as sort of a DOC led process,” Jacobs told the inspector general’s office, referring to the Department of Commerce. “That wasn’t NOAA’s idea.”
The statement backed Trump even though a forecast just before his tweet showed only a slight chance that Alabama would experience tropical-storm-force winds. Or, as Jacobs put it in a text message to Walsh, “just a windy day.”
Career staff at NWS Birmingham — whose tweet had thrown the Commerce Department and White House into damage-control mode — told investigators they weren’t even aware of Trump’s tweet when they sent their own: They were responding to questions from locals.
But, several days later when their bosses hung them out to dry, they felt the heat. “I saw the statement and kind of broke down,” one Birmingham employee recalled.
Interestingly, the inspector general’s report was delayed for several days because staff from Ross’ office were “actively preventing” its release with vague objections about privileged information, Inspector General Peggy E. Gustafson alleged in a letter last week. The published report Wednesday barely had any redactions.
In response to the report, an attorney for the Commerce Department wrote that “the absence of any formal recommendation shows that there were no major flaws in the Department’s handling of this situation.” Walsh, who is awaiting Senate confirmation to become the department’s official general counsel, said the report’s conclusions were “unsupported by any of the evidence or factual findings that the report itself lays out.”
But the bottom line, per the report, is a simple one: “It was unnecessary to correct the accuracy of a 5-day-old tweet.”


talkingpointsmemo--2020-07-11--Trump Campaign Mocked On Twitter For Citing Weather As Reason To Cancel NH Rally

Following a decision Friday to postpone a campaign rally in New Hampshire due to a tropical storm , the Trump campaign is facing a storm of quite a different kind – that of Twitter users who are trolling the decision as a tactical move to avoid the low attendance that marred Trump ’ s rally in Tulsa last month .
White House press secretary Kayleigh McEnany told reporters on Friday the event would be delayed for “ a week or two ” due to a “ big storm ” — but that storm was not slated to hit New Hampshire @ @ @ @ @ @ @ Weather Service that mentioned the chance of showers early in the day , that would clear by the time of Trump ’ s evening event .
“ Cloudy with a chance of a puny crowd ” Washington Post opinion columnist , Jennifer Rubin tweeted on Friday , echoing the suspicions of others who have suggested that the event was cancelled in a last ditch effort to save face in case turnout was low as it had been at Trump ’ s first in-person , mask-optional rally last month – his first since the @ @ @ @ @ @ @ States .
On that occasion , roughly 6,200 of the 19,000-seat arena were filled , after Trump ’ s campaign manager Brad Parscale had bragged that the rally had fielded requests for close to a million tickets .
A contributing columnist to The Post and adviser to the Lincoln Project , George Conway , also tweeted a screenshot shortly after the announcement was made showing the hourly weather forecast for Portsmouth on Saturday evening – between the hours of 6 p.m. and 9 p.m. , the forecast showed no genuine threat of rain @ @ @ @ @ @ @ at 9 p.m. Vox political editor , Aaron Rupar , suggested that the White House ’ s cries about bad weather in Portsmouth were “ a pretext that Trump ’ s team were using “ avoid another Tulsa-style disaster.
” Others , including cofounder of a super-PAC called the Democratic Coalition Against Trutmp said there was “ no rain in sight.
” Greg Sargent opinion columnist for The Post ’ s blog “ The Plum Line ” said it was fitting that Trump would cancel the event amid attendance concerns .
“ The @ @ @ @ @ @ @ was his lie about his inaugural crowd , ” Sargent wrote , referring to qualms the president had about the media ’ s reporting of a smaller crowd than he claimed when he delivered his inaugural address in 2017 .
“ So it ’ s fitting that Trump is now gripped by fear of low rally turnout amid his coronavirus fiasco.
” It seems there was also a lack of local interest in the rally in Portsmouth even before warnings of a storm along the east coast .
New Hampshire Governor Chris Sununu @ @ @ @ @ @ @ intended to greet the president personally as governor he was unlikely to attend the event .
Daniel Uhlfelder , a Florida lawyer , joked in a tweet that the New Hampshire event had been cancelled “ due to a blue tsunami ” — referring ostensibly to poll numbers which increasingly indicate that Democratic opponent , former Vice President Joe Biden , is favored over Trump in forecasts for the presidential election in November .
A POLITICO/Morning Consult survey earlier this month showed disapproval of the job Trump is doing as president on the @ @ @ @ @ @ @ gave the president negative marks as coronavirus outbreaks devastate , among others , states in the Sun Belt .

Following a decision Friday to postpone a campaign rally in New Hampshire due to a tropical storm, the Trump campaign is facing a storm of quite a different kind – that of Twitter users who are trolling the decision as a tactical move to avoid the low attendance that marred Trump’s rally in Tulsa last month.
White House press secretary Kayleigh McEnany told reporters on Friday the event would be delayed for “a week or two” due to a “big storm” — but that storm was not slated to hit New Hampshire according to earlier predictions from the National Weather Service that mentioned the chance of showers early in the day, that would clear by the time of Trump’s evening event.
“Cloudy with a chance of a puny crowd” Washington Post opinion columnist, Jennifer Rubin tweeted on Friday, echoing the suspicions of others who have suggested that the event was cancelled in a last ditch effort to save face in case turnout was low as it had been at Trump’s first in-person, mask-optional rally last month – his first since the coronavirus pandemic made landfall in the United States.
On that occasion, roughly 6,200 of the 19,000-seat arena were filled, after Trump’s campaign manager Brad Parscale had bragged that the rally had fielded requests for close to a million tickets.
A contributing columnist to The Post and adviser to the Lincoln Project, George Conway, also tweeted a screenshot shortly after the announcement was made showing the hourly weather forecast for Portsmouth on Saturday evening – between the hours of 6 p.m. and 9 p.m., the forecast showed no genuine threat of rain. The event was scheduled to begin at 9 p.m.
Here’s the weather forecast for Portsmouth, New Hampshire for tomorrow evening. pic.twitter.com/rK307qGCfx — George Conway (@gtconway3d) July 10, 2020
Vox political editor, Aaron Rupar, suggested that the White House’s cries about bad weather in Portsmouth were “a pretext that Trump’s team were using “avoid another Tulsa-style disaster.”
Others, including cofounder of a super-PAC called the Democratic Coalition Against Trutmp said there was “no rain in sight.”
Trump’s staff said they canceled his NH rally due to weather, but there is no rain in sight. We all know they actually canceled because no one was gonna show. #BidenPledgesAllegianceToUS — Scott Dworkin (@funder) July 11, 2020
Greg Sargent opinion columnist for The Post’s blog “The Plum Line” said it was fitting that Trump would cancel the event amid attendance concerns.
“The original Big Lie of the Trump presidency was his lie about his inaugural crowd,” Sargent wrote, referring to qualms the president had about the media’s reporting of a smaller crowd than he claimed when he delivered his inaugural address in 2017. “So it’s fitting that Trump is now gripped by fear of low rally turnout amid his coronavirus fiasco.”
It seems there was also a lack of local interest in the rally in Portsmouth even before warnings of a storm along the east coast. New Hampshire Governor Chris Sununu told reporters on Tuesday that while he intended to greet the president personally as governor he was unlikely to attend the event.
Daniel Uhlfelder, a Florida lawyer, joked in a tweet that the New Hampshire event had been cancelled “due to a blue tsunami” — referring ostensibly to poll numbers which increasingly indicate that Democratic opponent, former Vice President Joe Biden, is favored over Trump in forecasts for the presidential election in November.
A POLITICO/Morning Consult survey earlier this month showed disapproval of the job Trump is doing as president on the rise. Nearly 6 in 10 voters gave the president negative marks as coronavirus outbreaks devastate, among others, states in the Sun Belt.