vox--2020-04-15--The WHO isn’t to blame for Trump’s disastrous coronavirus response

In an April 14 press conference , President Donald Trump blamed the World Health Organization for the Covid-19 crisis in the United States and said he would halt its funding “ while a review is conducted.
” It ’ s not clear if the president has the authority to do this : Congress approved the United Nations agency ’ s budget in December 2019 , but the Wall Street Journal reports that Trump may be able to reroute the $ 116 million allocated for 2020 to other global health purposes or organizations or withhold funds for the next fiscal year @ @ @ @ @ @ @ the president has accused the agency of mismanagement .
A week earlier , when Trump first threatened to freeze funding , he sniped on Twitter : Others in the Trump administration , the GOP , and conservative media have also scolded WHO .
Deborah Birx , the White House coronavirus task force coordinator , and Scott Gottlieb , the former commissioner of the Food and Drug Administration under Trump , criticized its handling of China ’ s data and transparency .
Gottlieb told Face the Nation , “ Going forward , the WHO @ @ @ @ @ @ @ that specifically examines what China did or didn ’ t tell the world and how that stymied the global response to this.
” Senate Republicans , meanwhile , on April 13 announced a plan to investigate the origins of the virus and the global response , including WHO ’ s decisions .
Senate Homeland Security and Governmental Affairs Committee Chairman Ron Johnson told Politico , “ We need to know what role WHO might have had in trying to cover this thing up.
” Yet several global health experts Vox spoke to said @ @ @ @ @ @ @ the Covid-19 outbreak and avoided major missteps .
The SARS-CoV-2 virus that causes the disease swept across the globe not because of WHO ’ s errors but because of a “ very fragmented , chaotic , state-centric response , ” according to Yanzhong Huang , a senior fellow for global health at the Council on Foreign Relations .
And now , with over 2 million reported cases and 125,000 deaths worldwide , countries “ failing in their response have decided WHO is the culprit , ” says Ashish Jha , a professor at @ @ @ @ @ @ @ Health .
Global health megadonor Bill Gates also swiftly condemned Trump ’ s promise to cut funding to WHO .
Lawrence Gostin , a professor at Georgetown University and a past critic of WHO ’ s director-general , agrees Trump crossed a bridge too far .
“ How can you threaten to withdraw funding from the world ’ s leading global health agency in the midst of a pandemic , with tens of thousands of people dying ?
” he tells Vox .
“ It ’ s utterly irresponsible.
” Who is WHO @ @ @ @ @ @ @ improve global health in many ways , by improving access to health , strengthening health care systems , and , perhaps most importantly , preventing and responding to medical emergencies .
Countries cooperating to control disease actually began earlier than germ theory itself , which began with efforts to coordinate quarantines as far back as 1851 .
After the world wars , developing an international health organization was one of the first things the new United Nations did , launching the WHO in 1946 .
Today , when outbreaks occur , it ’ @ @ @ @ @ @ @ coordinate information and resources among countries .
“ WHO functions best when it is sharing information it knows , openly and transparently calling attention to problems of global concern , and setting norms and best practices , ” Jha says .
During Covid-19 , “ on those fronts , it ’ s done a pretty good job.
” Most experts agree there are some legitimate criticisms of how the agency has handled the current Covid-19 global health crisis , particularly in how it responded to China ’ s initial delays and suppression of @ @ @ @ @ @ @ say , are less founded .
Here are five common questions about WHO , with answers from the experts we spoke to .
1 ) Was the WHO slow to declare Covid-19 a public health emergency of international concern and then slow to call the outbreak a pandemic ?
In the April 14 briefing , President Trump claimed , “ The delays the WHO experienced in declaring a public health emergency cost valuable time — tremendous amounts of time.
” To parse this , it ’ s helpful to review the timeline .
@ @ @ @ @ @ @ pneumonia cases in Wuhan , China , to the WHO on December 31 , 2019 .
The same day , Taiwan ( which is not a WHO member because of objections from China ) , also emailed the agency , asking for information .
Six days later , the agency alerted the scientific community and global media about the new virus .
China did not publicly share the genome sequence of the virus until January 12 , delaying WHO ’ s ability to make tests for the new coronavirus .
On January 13 @ @ @ @ @ @ @ recorded Covid-19 case outside of China , in Thailand .
In mid-January , the WHO volunteered to send a team into China but was declined .
“ It wasn ’ t like WHO was going to be able to bully China into letting a team in .
That ’ s just not how it works , ” says Jha , pointing out that President Trump would equally be able to say no if the agency wanted to come to New York .
On January 22 , just three weeks after first being notified @ @ @ @ @ @ @ WHO Director-General Tedros Adhanom convened an emergency meeting to determine if the outbreak qualified as a public health emergency of international concern ( PHEIC ) , the agency ’ s term for an “ extraordinary event ” that requires a coordinated international response — like SARS , H1N1 , and Ebola outbreaks in 2014 and 2019 .
The experts couldn ’ t agree and decided to meet again .
After the director-general traveled to Beijing to meet with Chinese President Xi Jinping in Beijing on January 29 , a PHEIC was declared on @ @ @ @ @ @ @ measures to “ address travel , trade , quarantine , screening , treatment ” as well as national measures in countries that have tied their pandemic response plans to WHO declarations .
“ I called for WHO to do it a little earlier , ” says Gostin , “ but it had no impact on the epidemic.
” Jha agrees .
“ I think they could have called it when they initially met , but it wouldn ’ t have made a big difference , ” he says .
On March 11 , @ @ @ @ @ @ @ and governments ’ inaction , the director-general announced that Covid-19 could be considered a pandemic .
“ Ultimately , referring to it as a pandemic is simply a descriptor , ” says Adam Kamradt-Scott , a professor of global health at the University of Sydney , an informal classification that didn ’ t impact WHO obligations or powers .
Declaring a PHEIC at the end of January was what helped initiate states ’ preparedness plans and gave WHO the authority to issue recommendations and guidelines , although not to enforce them .
In @ @ @ @ @ @ @ was “ explicit that he was doing this precisely because he was concerned a number of countries haven ’ t responded forcefully enough , ” Kamradt Scott explains .
By March , Trump said , “ I don ’ t take responsibility at all ” for the slow American response to Covid-19 .
On April 14 , by which time the confirmed US death toll had exceeded 25,000 , he reiterated this opinion , saying , “ So much death has been caused by their mistakes.
” But again , all the experts @ @ @ @ @ @ @ ’ s lack of preparation for Covid-19 was not a result of WHO delays .
“ Trump has a penchant for rewriting history , ” Kamradt Scott says , “ So it ’ s not surprising to see him blaming the WHO for mistakes ultimately attributable to his own administration.
” ABC News reports US intelligence agencies warned the White House and the Pentagon of the disease as early as November .
In January , trade adviser Peter Navarro warned the White House the novel coronavirus could kill half a million Americans .
@ @ @ @ @ @ @ weeks failing to develop effective testing .
As late as February 27 , Trump told a press briefing the virus would “ disappear.
” The next day , the first American died from Covid-19 .
“ WHO is not responsible for America not heeding the warnings of its own scientists and security apparatus — for two months , ” says Jha .
“ That ’ s laughable.
” 2 ) Was the WHO too easy on China ?
As early as December , Chinese doctors knew that a new disease was circulating .
@ @ @ @ @ @ @ Wuhan , was detained for “ spreading rumors ” after trying to warn his colleagues ; he later died of Covid-19 at age 33 .
By the end of December , Wuhan had nearly three dozen cases of Covid-19 , and authorities had closed a market where they thought it was being spread .
But the government allowed 5 million people to leave the city for the Lunar New Year .
The Chinese government also did not confirm the virus could spread from human to human until January 20 .
One preprint study @ @ @ @ @ @ @ , China could have reduced its infections by 95 percent .
But when a WHO team visited China in early February , the report its members wrote did not mention these missteps and lack of transparency .
Instead , they wrote , “ China ’ s bold approach to contain the rapid spread of this new respiratory pathogen has changed the course of a rapidly escalating and deadly epidemic.
” For a time , Trump also repeatedly praised Xi Jinping ’ s response , saying in a press briefing on February 7 that @ @ @ @ @ @ @ well ” and telling Fox News on February 13 that China was “ extremely capable ” and handling the outbreak well .
That praise seems unfounded .
“ The Chinese government allowed the outbreak to evolve into a major epidemic and eventually a global pandemic , ” says Huang of CFR .
“ WHO shouldn ’ t have downplayed the initial mishandling of the crisis in Wuhan.
” He suggests that although the agency couldn ’ t have investigated without China ’ s permission , it could have done more to press the @ @ @ @ @ @ @ in a more timely and accurate manner.
” ( In particular , Chinese officials have made a number of grave errors , including silencing whistleblowers and delaying reporting . )
Gostin agrees that China was not transparent but says that ’ s not WHO ’ s fault .
He argues the director-general decided “ not to publicly criticize China , believing that smart diplomacy is better to coax cooperation and transparency.
” “ In a pandemic , you don ’ t choose sides , ” says Gostin .
“ Tedros has praised China @ @ @ @ @ @ @ have done it , but he also praised Trump , and perhaps he shouldn ’ t have done that either.
” “ WHO is not responsible for America not heeding the warnings of its own scientists and security apparatus — for two months ” Overall , WHO has offered little criticism of governments ’ responses .
“ People have fixated on the idea WHO is now in China ’ s pocket , ” says Kamradt Scott .
Back in 2003 , after WHO strongly criticized China ’ s lack of transparency during SARS @ @ @ @ @ @ @ to prevent future criticisms .
Kamradt Scott says that , fortunately , China has been much more transparent about Covid-19 .
“ It ’ s much more important to keep China engaged than closing down its correspondence with the international community.
” But the conflict between China and Taiwan has further politicized the global response to Covid-19 .
The island is not allowed into the WHO , even as an observer , because China claims Taiwan has refused to allow it to participate in multinational organizations as a member state .
As the @ @ @ @ @ @ @ Scott says , “ It ’ s not in the power of the secretariat to admit Taiwan.
” Although China has sometimes allowed Taiwan to participate in WHO ’ s annual World Health Assembly , it stopped in 2016 after Taiwan refused to endorse the One China policy .
As coronavirus cases were reported in Taiwan , Quartz reports WHO couldn ’ t even decide what to call the island .
At first , they called it “ China , Taiwan , ” and then “ Taiwan , China ” and most recently @ @ @ @ @ @ @ Taiwan , which is known for its excellent health care , is only 100 miles away from mainland China , it has only reported 393 cases as of April 14 .
In the latest twist , Tedros , the first African director-general of WHO , recently alleged that he had experienced racist attacks and death threats from Taiwan , and accused the Taiwanese government of knowing about them .
( Taiwan has denied these claims . )
It ’ s unclear if Taiwan ’ s reduced access to WHO has had health care @ @ @ @ @ @ @ briefing , begged members to put politics aside .
” For now , the focus should be on fighting the virus , ” he said .
“ The United States and China should come together and fight this dangerous enemy.
” 3 ) Should the WHO have recommended travel bans as Covid-19 spread ?
On February 2 , President Trump closed US borders to non-Americans who ’ d been in China in the previous two weeks .
On March 11 , the travel ban was expanded to Europe .
Many other countries have @ @ @ @ @ @ @ , an initiative of the Council on Foreign Relations , has a tally of 96 countries that have restricted travel from China .
New Zealand , for example , has been closed to almost all travelers since March 19 .
“ [ WHO ] actually criticized and disagreed with my travel ban at the time I did it .
And they were wrong , ” Trump said in a White House media briefing on April 7 .
It may be too early to determine what effect the US travel bans may have had @ @ @ @ @ @ @ in Science suggests China ’ s dramatic lockdown , with stringent travel restrictions between provinces , may have prevented more than 700,000 cases of Covid-19 .
But it ’ s not too early to say that American travel bans didn ’ t actually stop travel from China .
More than 430,000 people traveled from China to over 17 American cities after the virus was discovered but before the ban ; another 40,000 people arrived to the US from China after the ban went into place .
Huang explains that one of the main @ @ @ @ @ @ @ , “ But no one listened .
What you see basically is a very fragmented , chaotic , state-centric response to the outbreak in terms of trade and travel restrictions.
” Although WHO has not publicly criticized the American travel ban , it doesn ’ t recommend travel or trade restrictions during disease outbreaks , both because they often don ’ t work and because they can make disease response more difficult .
Kamradt Scott recalls first-hand his difficulty in trying to get from Australia to West Africa during the 2014 Ebola outbreak @ @ @ @ @ @ @ had stopped flying there .
“ It ’ s not simply that it causes economic damage , but that it impedes responses , ” he says .
“ The WHO guidance on travel and trade is entirely consistent with previous practice and with science , ” says Gostin , who notes that the agency is following the international health regulations that the US has signed but is currently disregarding .
“ Germs don ’ t respect borders , so it ’ s really just deflecting blame , ” he says .
Kamradt Scott @ @ @ @ @ @ @ .
He has just completed a literature review , looking at travel and trade restrictions , and his view is that travel bans “ may have helped delay the arrival of the virus.
” He predicts that eventually Covid-19 research will cause the WHO to revisit some of its guidelines .
“ It ’ s rather fraught .
It does create economic problems , but if it can help countries by giving them time to prepare , perhaps it can be justified on that ground.
” But , he adds , “ Trump @ @ @ @ @ @ @ to prepare the country , so again , that really comes back to his administration.
” 4 ) Unlike the CDC , the WHO still hasn ’ t recommended the general public use masks .
Should it ?
At first , many , including the surgeon general of the US , told the public that masks weren ’ t necessary and that health care workers needed the scarce supplies .
People were told they wouldn ’ t be able to properly fit them , although several studies suggest that even a homemade mask @ @ @ @ @ @ @ , in mid-March , both the CDC and the WHO recommended wearing masks if you are sick .
Today , the CDC is now recommending everyone wear a mask when out in public , while the WHO is standing by its recommendation to only wear one if sick or caring for someone else who is sick .
“ There is no specific evidence to suggest that the wearing of masks by the mass population has any potential benefit , ” said Mike Ryan , the head of the WHO health emergencies team .
@ @ @ @ @ @ @ have recommended everyone wear masks and say it has helped control the spread of Covid-19 .
Because this is a new virus , Gostin says , “ Everyone has to operate in circumstances of scientific uncertainty .
We have to do the best we can with the knowledge we have.
” But new information is coming out every week about the virus ’ s transmissibility , including one notable report in early April that it can be aerosolized just by breathing and talking .
( At this point , he , too , @ @ @ @ @ @ @ ) For now , the best we have are educated opinions — no one yet has definitive data on SARS-CoV-2 transmission rates and mask-wearing .
5 ) Does the US give WHO too much money ?
“ [ WHO ] called it wrong .
They call it wrong .
They really , they missed the call , ” President Trump said , referring to WHO ’ s declaring a pandemic during a press briefing at the White House on April 7 .
As a result , on April 14 , he declared a @ @ @ @ @ @ @ gets money in two-year cycles .
The US is currently the largest contributor to the agency , giving a total of $ 929 million ( including voluntary donations and membership fees ) in 2018 and 2019 .
The Trump administration has also , however , reduced the next round of American contributions to less than $ 58 million in its most recent budget proposal for fiscal year 2021 .
“ Trump implemented travel restrictions but then did nothing to prepare the country , so again , that really comes back to his administration @ @ @ @ @ @ @ are expected to contribute a certain amount based on their population size and GDP .
Because the US is one of the largest economies in the world , their assessed contributions were large in the 1980s , when the agency froze membership dues in real dollar terms , increasing only due to inflation and exchange rates .
“ It ’ s always irked some in the US that even though they pay 25 percent of the assessed contributions , they only get one vote , ” says Kamradt Scott .
“ But the @ @ @ @ @ @ @ , budget shortfalls have been a problem for the agency for decades .
After the 2008 recession , the agency had to cut $ 1 billion from its budget and disbanded its epidemic and pandemic response department .
The agency “ has the operational budget equivalent of a tertiary hospital in any high-income country , ” Kamradt Scott says .
WHO ’ s 2020-21 budget is $ 4.8 billion , or $ 2.4 billion per year .
Only around 20 percent of this comes from membership contributions ; the rest is voluntary donations @ @ @ @ @ @ @ funds have strings , ” says Kamradt Scott .
“ They are tied to particular initiatives , which means that even when WHO is confronted with a pandemic , they can ’ t reallocate funds.
” This is why , on February 5 , the WHO asked for an additional $ 675 million to fund coronavirus responses , although it took two months to reach its goal .
For all of its responsibility , the WHO has no teeth ; unlike other international organizations , the WHO has no ability to sanction its @ @ @ @ @ @ @ diplomacy and donations .
After the 2014 Ebola outbreak , an emergency contingency fund was set up in order to allow the WHO to respond early to emergencies , “ sending people to ground to help contain problems before they became a bigger crisis , ” Kamradt Scott explains .
But the $ 100 million fund has never reached its target .
“ Even when a new mechanism has been set up explicitly to deal with this pandemic , it hasn ’ t received support from member states.
” “ We still need @ @ @ @ @ @ @ , an international health agency that can effectively coordinate an international response , ” Huang says .
“ Slashing funding to WHO would actually reduce the US voice in the international agency and allow other countries to play a bigger role in the organization .
That is not something that is in the US interest.
” “ I ’ ve never hesitated to constructively criticize the WHO when I think it ’ s made a mistake , ” says Gostin , “ But frankly , I ’ m outraged and embarrassed by what @ @ @ @ @ @ @ t change where we are now There will be plenty of time for reviewing the WHO response , and Gostin says there are many possible reforms : He would double the budget and “ invest very widely and deeply in health system capacity , particularly in low- and middle-income countries ” as well as giving WHO enforcement powers during a public health emergency .
Kamradt Scott would like to see WHO enforce data-sharing during clinical trials .
Jha would like to improve transparency in spending .
“ You have to remember the fundamental @ @ @ @ @ @ @ two things in one , and in all the times it matters , those two things come into conflict , ” Jha says .
“ On the one hand , it ’ s a membership organization , ” meaning it doesn ’ t “ usually beat up on their own members.
” “ On the other hand , ” he says , “ It ’ s the world ’ s public health agency , so it has an obligation to the global public that goes beyond the interest of its member states.
” @ @ @ @ @ @ @ not the best time to be dismantling WHO .
“ The focus needs to be on the virus itself , ” says Rebecca Katz , professor and director of the Center for Global Health Science and Security at Georgetown University Medical Center .
“ What we need right now is the largest mobilization of public health we ’ ve ever seen in our lives .
We have no answers — we ’ re building the plane while flying it.
” We need to build capacity for contact tracing , for isolation , and @ @ @ @ @ @ @ through infection prevention and control at the same time as dealing with supply chain issues , to ensure we have enough protective personal equipment and critical medications .
We need to better understand the virus we ’ re fighting .
We need to find , validate , manufacture , and distribute a vaccine at a scale never seen before .
“ At this point , WHO is the only organization equipped to handle these challenges , ” Katz says .
“ If we didn ’ t have WHO , ” Gostin says , @ @ @ @ @ @ @ ” Lois Parshley is a freelance investigative journalist and the 2019-20 Snedden Chair of Journalism at the University of Alaska Fairbanks .
Follow her Covid-19 reporting on Twitter @ loisparshley .
Every day at Vox , we aim to answer your most important questions and provide you , and our audience around the world , with information that has the power to save lives .
Our mission has never been more vital than it is in this moment : to empower you through understanding .
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Your financial contribution will not constitute a donation , but it will enable our staff to continue to offer free articles , videos , and podcasts at the quality and volume that this moment requires .
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In an April 14 press conference, President Donald Trump blamed the World Health Organization for the Covid-19 crisis in the United States and said he would halt its funding “while a review is conducted.” It’s not clear if the president has the authority to do this: Congress approved the United Nations agency’s budget in December 2019, but the Wall Street Journal reports that Trump may be able to reroute the $116 million allocated for 2020 to other global health purposes or organizations or withhold funds for the next fiscal year.
This is not the first time the president has accused the agency of mismanagement. A week earlier, when Trump first threatened to freeze funding, he sniped on Twitter:
The W.H.O. really blew it. For some reason, funded largely by the United States, yet very China centric. We will be giving that a good look. Fortunately I rejected their advice on keeping our borders open to China early on. Why did they give us such a faulty recommendation? — Donald J. Trump (@realDonaldTrump) April 7, 2020
Others in the Trump administration, the GOP, and conservative media have also scolded the WHO. Deborah Birx, the White House coronavirus task force coordinator, and Scott Gottlieb, the former commissioner of the Food and Drug Administration under Trump, criticized its handling of China’s data and transparency. Gottlieb told Face the Nation, “Going forward, the WHO needs to commit to an after-action report that specifically examines what China did or didn’t tell the world and how that stymied the global response to this.”
Senate Republicans, meanwhile, on April 13 announced a plan to investigate the origins of the virus and the global response, including the WHO’s decisions. Senate Homeland Security and Governmental Affairs Committee Chair Ron Johnson told Politico, “We need to know what role WHO might have had in trying to cover this thing up.”
Yet several global health experts Vox spoke to said they believe the agency responded quickly to the Covid-19 outbreak and avoided major missteps. The SARS-CoV-2 virus that causes the disease swept across the globe not because of the WHO’s errors but because of a “very fragmented, chaotic, state-centric response,” according to Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations.
And now, with over 2 million reported cases and 125,000 deaths worldwide, countries “failing in their response have decided WHO is the culprit,” says Ashish Jha, a professor at the Harvard T.H. Chan School of Public Health.
Global health megadonor Bill Gates also swiftly condemned Trump’s promise to cut funding to the agency.
Halting funding for the World Health Organization during a world health crisis is as dangerous as it sounds. Their work is slowing the spread of COVID-19 and if that work is stopped no other organization can replace them. The world needs @WHO now more than ever. — Bill Gates (@BillGates) April 15, 2020
Lawrence Gostin, a professor at Georgetown University and a past critic of WHO’s director-general, agrees Trump went too far.
“How can you threaten to withdraw funding from the world’s leading global health agency in the midst of a pandemic, with tens of thousands of people dying?” he tells Vox. “It’s utterly irresponsible.”
Who is WHO?
The World Health Organization works to improve global health in many ways, by improving access to health, strengthening health care systems, and, perhaps most importantly, preventing and responding to medical emergencies. Countries cooperating to control disease actually began earlier than germ theory itself, which started with efforts to coordinate quarantines as far back as 1851. After the world wars, developing an international health organization was one of the first things the new United Nations did, launching the WHO in 1946.
Today, when outbreaks occur, it’s the agency’s job to coordinate information and resources among countries. “WHO functions best when it is sharing information it knows, openly and transparently calling attention to problems of global concern, and setting norms and best practices,” Jha says. During Covid-19, “on those fronts, it’s done a pretty good job.”
Most experts agree there are some legitimate criticisms of how the agency has handled the Covid-19 global health crisis, particularly in how it responded to China’s initial delays and suppression of key information. Other critiques, they say, are less founded. Here are five common questions about the WHO, with answers from the experts we spoke to.
1) Was the WHO slow to declare Covid-19 a public health emergency of international concern and then slow to call the outbreak a pandemic?
In the April 14 briefing, President Trump claimed, “The delays the WHO experienced in declaring a public health emergency cost valuable time — tremendous amounts of time.”
To parse this, it’s helpful to review the timeline. China first reported an unusual cluster of pneumonia cases in Wuhan, China, to the WHO on December 31, 2019. The same day, Taiwan (which is not a WHO member because of objections from China), also emailed the agency, asking for information.
Six days later, the agency alerted the scientific community and global media about the new virus. China did not publicly share the genome sequence of the virus until January 12, delaying WHO’s ability to make tests for the new coronavirus. On January 13, public health officials confirmed the first recorded Covid-19 case outside of China, in Thailand.
In mid-January, the WHO volunteered to send a team into China but was declined. “It wasn’t like WHO was going to be able to bully China into letting a team in. That’s just not how it works,” says Jha, pointing out that Trump would equally be able to say no if the agency wanted to come to New York.
On January 22, just three weeks after first being notified of the virus’s existence, WHO Director-General Tedros Adhanom Ghebreyesus convened an emergency meeting to determine if the outbreak qualified as a public health emergency of international concern (PHEIC), the agency’s term for an “extraordinary event” that requires a coordinated international response — like SARS, H1N1, and Ebola outbreaks in 2014 and 2019. The experts couldn’t agree and decided to meet again. After the director-general traveled to Beijing to meet with Chinese President Xi Jinping in Beijing on January 29, a PHEIC was declared on January 30.
This declaration activated WHO measures to “address travel, trade, quarantine, screening, treatment” as well as national measures in countries that have tied their pandemic response plans to WHO declarations. “I called for WHO to do it a little earlier,” says Gostin, “but it had no impact on the epidemic.” Jha agrees. “I think they could have called it when they initially met, but it wouldn’t have made a big difference,” he says.
On March 11, alarmed by the disease’s spread and governments’ inaction, the director-general announced that Covid-19 could be considered a pandemic. “Ultimately, referring to it as a pandemic is simply a descriptor,” says Adam Kamradt-Scott, a professor of global health at the University of Sydney, an informal classification that didn’t impact WHO obligations or powers.
Declaring a PHEIC at the end of January was what helped initiate states’ preparedness plans and gave the WHO the authority to issue recommendations and guidelines, although not to enforce them. In the March 11 press conference, Tedros was “explicit that he was doing this precisely because he was concerned a number of countries haven’t responded forcefully enough,” Kamradt-Scott explains.
By March, Trump said, “I don’t take responsibility at all” for the slow American response to Covid-19. On April 14, by which time the confirmed US death toll had exceeded 25,000, he reiterated this opinion, saying, “So much death has been caused by their mistakes.”
But, again, all the experts Vox interviewed agreed that the US government’s lack of preparation for Covid-19 was not a result of WHO delays. “Trump has a penchant for rewriting history,” Kamradt-Scott says, “So it’s not surprising to see him blaming the WHO for mistakes ultimately attributable to his own administration.”
ABC News reports US intelligence agencies warned the White House and the Pentagon of the disease as early as November. In January, trade adviser Peter Navarro warned the White House that the novel coronavirus could kill half a million Americans. In February, the US lost valuable weeks failing to develop effective testing. As late as February 27, Trump told a press briefing the virus would “disappear.” The next day, the first American died of Covid-19.
“WHO is not responsible for America not heeding the warnings of its own scientists and security apparatus — for two months,” says Jha. “That’s laughable.”
2) Was the WHO too easy on China?
As early as December, Chinese doctors knew that a new disease was circulating. Dr. Li Wenliang, an ophthalmologist in Wuhan, was detained for “spreading rumors” after trying to warn his colleagues; he later died of Covid-19 at age 33.
By the end of December, Wuhan had nearly three dozen cases of Covid-19, and authorities had closed a market where they thought it was being spread. But the government allowed 5 million people to leave the city for the Lunar New Year. The Chinese government also did not confirm the virus could spread from human to human until January 20. One preprint study suggests that by acting more quickly, China could have reduced its infections by 95 percent.
But when a WHO team visited China in early February, the report its members wrote did not mention these missteps and lack of transparency. Instead, they wrote, “China’s bold approach to contain the rapid spread of this new respiratory pathogen has changed the course of a rapidly escalating and deadly epidemic.”
For a time, Trump also repeatedly praised President Xi Jinping’s response, saying in a press briefing on February 7 that he’s handled it “really well” and telling Fox News on February 13 that China was “extremely capable” and handling the outbreak well.
That praise seems unfounded. “The Chinese government allowed the outbreak to evolve into a major epidemic and eventually a global pandemic,” says Huang of CFR. “WHO shouldn’t have downplayed the initial mishandling of the crisis in Wuhan.”
He suggests that although the agency couldn’t have investigated without China’s permission, it could have done more to press the government “to provide more accurate data in a more timely and accurate manner.” (In particular, Chinese officials have made a number of grave errors, including silencing whistleblowers and delaying reporting.)
Gostin agrees that China was not transparent but says that’s not the WHO’s fault. He argues the director-general decided “not to publicly criticize China, believing that smart diplomacy is better to coax cooperation and transparency.”
“In a pandemic, you don’t choose sides,” says Gostin. “Tedros has praised China, and perhaps he shouldn’t have done it, but he also praised Trump, and perhaps he shouldn’t have done that either.”
“WHO is not responsible for America not heeding the warnings of its own scientists and security apparatus — for two months”
Overall, WHO has offered little criticism of governments’ responses. “People have fixated on the idea WHO is now in China’s pocket,” says Kamradt-Scott. Back in 2003, after WHO strongly criticized China’s lack of transparency during SARS, checks were placed on the secretariat to prevent future criticisms. Kamradt-Scott says that, fortunately, China has been much more transparent about Covid-19. “It’s much more important to keep China engaged than closing down its correspondence with the international community.”
But the conflict between China and Taiwan has further politicized the global response to Covid-19. The island is not allowed into the WHO, even as an observer, because China claims Taiwan has refused to allow it to participate in multinational organizations as a member state. As the WHO is a UN agency, Kamradt-Scott says, “It’s not in the power of the secretariat to admit Taiwan.” Although China has sometimes allowed Taiwan to participate in the WHO’s annual World Health Assembly, it stopped in 2016 after Taiwan refused to endorse the One China policy.
As coronavirus cases were reported in Taiwan, Quartz reports WHO couldn’t even decide what to call the island. At first, they called it “China, Taiwan,” and then “Taiwan, China” and most recently, “Taipei and environs.” Although Taiwan, which is known for its excellent health care, is only 100 miles away from mainland China, it has only reported 393 cases as of April 14.
In the latest twist, Tedros, the first African director-general of WHO, recently alleged that he had experienced racist attacks and death threats from Taiwan, and accused the Taiwanese government of knowing about them. (Taiwan has denied these claims.) It’s unclear if Taiwan’s reduced access to WHO has had health care consequences.
Tedros, in the same briefing, begged members to put politics aside. ”For now, the focus should be on fighting the virus,” he said. “The United States and China should come together and fight this dangerous enemy.”
3) Should the WHO have recommended travel bans as Covid-19 spread?
On February 2, President Trump closed US borders to non-Americans who’d been in China in the previous two weeks. On March 11, the travel ban was expanded to Europe. Many other countries have since followed suit: Think Global Health, an initiative of the Council on Foreign Relations, has a tally of 96 countries that have restricted travel from China. New Zealand, for example, has been closed to almost all travelers since March 19.
The WHO “actually criticized and disagreed with my travel ban at the time I did it. And they were wrong,” Trump said in a White House media briefing on April 7. It may be too early to determine what effect the US travel bans may have had on transmission: A new study published in Science suggests China’s dramatic lockdown, with stringent travel restrictions between provinces, may have prevented more than 700,000 cases of Covid-19.
But it’s not too early to say that American travel bans didn’t actually stop travel from China. More than 430,000 people traveled from China to over 17 American cities after the virus was discovered but before the ban; another 40,000 people arrived to the US from China after the ban went into place.
Huang explains that one of the main functions of the WHO is to coordinate responses, “But no one listened. What you see basically is a very fragmented, chaotic, state-centric response to the outbreak in terms of trade and travel restrictions.”
Although the WHO has not publicly criticized the American travel ban, it doesn’t recommend travel or trade restrictions during disease outbreaks, both because they often don’t work and because they can make disease response more difficult. Kamradt-Scott recalls firsthand his difficulty in trying to get from Australia to West Africa during the 2014 Ebola outbreak, when all but two commercial airlines had stopped flying there. “It’s not simply that it causes economic damage, but that it impedes responses,” he says.
“The WHO guidance on travel and trade is entirely consistent with previous practice and with science,” says Gostin, who notes that the agency is following the international health regulations that the US has signed but is currently disregarding. “Germs don’t respect borders, so it’s really just deflecting blame,” he says.
Kamradt-Scott, however, is on the fence. He has just completed a literature review, looking at travel and trade restrictions, and his view is that travel bans “may have helped delay the arrival of the virus.” He predicts that eventually Covid-19 research will cause the WHO to revisit some of its guidelines. “It’s rather fraught. It does create economic problems, but if it can help countries by giving them time to prepare, perhaps it can be justified on that ground.”
But, he adds, “Trump implemented travel restrictions but then did nothing to prepare the country, so again, that really comes back to his administration.”
4) Unlike the CDC, the WHO still hasn’t recommended the general public use masks. Should it?
At first, many, including the surgeon general of the US, told the public that masks weren’t necessary and that health care workers needed the scarce supplies. People were told they wouldn’t be able to properly fit them, although several studies suggest that even a homemade mask is better than no mask. Finally, in mid-March, both the CDC and the WHO recommended wearing masks if you are sick.
Today, the CDC is recommending everyone wear a mask when out in public, while the WHO is standing by its recommendation to only wear one if sick or caring for someone else who is sick. “There is no specific evidence to suggest that the wearing of masks by the mass population has any potential benefit,” said Mike Ryan, the head of the WHO health emergencies team. Hong Kong health officials disagree; they have recommended everyone wear masks and say it has helped control the spread of Covid-19.
Because this is a new virus, Gostin says, “Everyone has to operate in circumstances of scientific uncertainty. We have to do the best we can with the knowledge we have.” But new information is coming out every week about the virus’s transmissibility, including one notable report in early April that it can be aerosolized just by breathing and talking. (At this point, he, too, thinks widespread mask use is justified.)
For now, the best we have are educated opinions — no one yet has definitive data on SARS-CoV-2 transmission rates and mask-wearing.
5) Does the US give the WHO too much money?
“[WHO] called it wrong. They call it wrong. They really, they missed the call,” President Trump said, referring to WHO’s declaring a pandemic during a press briefing at the White House on April 7. As a result, on April 14, he declared a hold on WHO funding.
The agency gets money in two-year cycles. The US is currently its largest contributor, giving a total of $929 million (including voluntary donations and membership fees) in 2018 and 2019. The Trump administration has also, however, reduced the next round of American contributions to less than $58 million in its most recent budget proposal for fiscal year 2021.
“Trump implemented travel restrictions but then did nothing to prepare the country, so again, that really comes back to his administration”
Under the UN system, countries are expected to contribute a certain amount based on their population size and GDP. Because the US is one of the largest economies in the world, its assessed contributions were large in the 1980s, when the agency froze membership dues in real dollar terms, increasing only due to inflation and exchange rates. “It’s always irked some in the US that even though they pay 25 percent of the assessed contributions, they only get one vote,” says Kamradt-Scott. “But the US agreed to that arrangement.”
Regardless, budget shortfalls have been a problem for the agency for decades. After the 2008 recession, it had to cut $1 billion from its budget and disbanded its epidemic and pandemic response department. The agency “has the operational budget equivalent of a tertiary hospital in any high-income country,” Kamradt-Scott says.
The WHO’s 2020-21 budget is $4.8 billion, or $2.4 billion per year. Only around 20 percent of this comes from membership contributions; the rest is voluntary donations. “The problem is those voluntary funds have strings,” says Kamradt-Scott. “They are tied to particular initiatives, which means that even when WHO is confronted with a pandemic, they can’t reallocate funds.”
This is why, on February 5, the WHO asked for an additional $675 million to fund coronavirus responses, although it took two months to reach its goal. For all of its responsibility, the WHO has no teeth; unlike other international organizations, the WHO has no ability to sanction its members and instead has to rely on diplomacy and donations.
After the 2014 Ebola outbreak, an emergency contingency fund was set up in order to allow the WHO to respond early to emergencies, “sending people to ground to help contain problems before they became a bigger crisis,” Kamradt-Scott explains. But the $100 million fund has never reached its target. “Even when a new mechanism has been set up explicitly to deal with this pandemic, it hasn’t received support from member states.”
“We still need, whether you like it or not, an international health agency that can effectively coordinate an international response,” Huang says. “Slashing funding to WHO would actually reduce the US voice in the international agency and allow other countries to play a bigger role in the organization. That is not something that is in the US interest.”
“I’ve never hesitated to constructively criticize the WHO when I think it’s made a mistake,” says Gostin, “But frankly, I’m outraged and embarrassed by what President Trump did.”
Scapegoating doesn’t change where we are now
There will be plenty of time for reviewing the WHO response, and Gostin says there are many possible reforms: He would double the budget and “invest very widely and deeply in health system capacity, particularly in low- and middle-income countries,” as well as giving WHO enforcement powers during a public health emergency. Kamradt-Scott would like to see the WHO enforce data-sharing during clinical trials. Jha would like to improve transparency in spending.
“You have to remember the fundamental problem of WHO is that it is two things in one, and in all the times it matters, those two things come into conflict,” Jha says. “On the one hand, it’s a membership organization,” meaning it doesn’t “usually beat up on their own members.”
“On the other hand,” he says, “It’s the world’s public health agency, so it has an obligation to the global public that goes beyond the interest of its member states.”
But the middle of this crisis is not the best time to be dismantling WHO. “The focus needs to be on the virus itself,” says Rebecca Katz, professor and director of the Center for Global Health Science and Security at Georgetown University Medical Center. “What we need right now is the largest mobilization of public health we’ve ever seen in our lives. We have no answers — we’re building the plane while flying it.”
We need to build capacity for contact tracing, for isolation, and for quarantine. We need to think through infection prevention and control at the same time as dealing with supply chain issues, to ensure we have enough protective personal equipment and critical medications. We need to better understand the virus we’re fighting. We need to find, validate, manufacture, and distribute a vaccine at a scale never seen before. “At this point, WHO is the only organization equipped to handle these challenges,” Katz says.
“If we didn’t have WHO,” Gostin says, “We would have to invent it.”
Lois Parshley is a freelance investigative journalist and the 2019-20 Snedden Chair of Journalism at the University of Alaska Fairbanks. Follow her Covid-19 reporting on Twitter @loisparshley.


vox--2020-04-15--Survey: 80 percent of Americans said they saw fake coronavirus news in the early days of the pandemi

Survey: 80 percent of Americans said they saw fake coronavirus news in the early days of the pandemic

A new study from the Pew Research Center suggests many Americans had a poor understanding of the risks posed by the coronavirus in the early days of the pandemic — and that the majority , some correctly and some incorrectly , felt they were being presented with untrue information from the media .
The survey of 8,914 US adults , conducted from March 10-16 ( with a 1.6 percentage point margin of error ) , found 80 percent of respondents noting they had been exposed to at least some false news reports about the virus ( 48 percent said they @ @ @ @ @ @ @ or “ some ” and 32 percent saying they ’ d seen some but “ not much ” fake news ) .
About half of those respondents gave examples of the misinformation they believed they ’ d seen — and not all of it was actually false news .
For example , 22 percent of those respondents said the news had exaggerated the risks of the pandemic , citing reports recommending people stock up on food and estimates of potential death tolls as overstating the seriousness of the virus .
Nineteen percent said @ @ @ @ @ @ @ could die from the virus and believed these to be exaggerated .
We now know the virus does indeed pose a serious threat , and it has , since the survey was conducted , been classified as a pandemic .
It is true that millions have not died from the virus , but in early March , many reports relied on models that were based on an assumption that governments would not take aggressive mitigation strategies , like social distancing and shelter-in-place orders — and that , as a result , millions of @ @ @ @ @ @ @ important to remember , however , that despite those measures , the confirmed worldwide death toll currently exceeds 100,000 and will continue to grow for the foreseeable future .
Some respondents reported seeing news that undersold the severity of the virus : 15 percent of respondents claimed the media was understating its risks , with 12 percent calling into question reports equating the virus with the flu .
And another 10 percent reported concerns about stories elevating false claims about the virus made at the time by President Donald Trump .
There is @ @ @ @ @ @ @ by Recode ’ s Peter Kafka : It ’ s clear now that the US government was woefully unprepared for the pandemic , and that ’ s been reflected in its messaging to the public since the start .
The Centers for Disease Control and Prevention ( CDC ) , for instance , didn ’ t tell the country to stop gathering in groups until March 15 — weeks after a top CDC official announced that the virus would begin spreading throughout the US .
And after telling Americans for months that they @ @ @ @ @ @ @ sick , the government formally flipped that advice on April 3 and said that everyone should wear some kind of covering on their face in certain public settings .
Much of the mainstream media amplified this slow and muddled reaction to the rapidly spreading virus .
Since alarming reports about Covid-19 began to emerge from China in January , the media often provided information to Americans that later proved to be wrong , or at least inadequate .
For instance : While President Trump has been correctly pilloried for describing the coronavirus as @ @ @ @ @ @ @ message was commonplace in mainstream media outlets throughout February .
And journalists — including my colleagues at Vox — were dutifully repeating exhortations from public health officials not to wear masks for much of 2020 .
The survey is a potent reminder of the effects this muddled messaging had , with some appearing to disregard accurate information as false .
A clear understanding of the risks inherent to the virus is critical to getting folks to buy into subsequent social distancing guidelines and state-level shelter-at-home orders .
Most Americans now seemingly understand that @ @ @ @ @ @ @ to staying safe from catching the virus and avoiding passing it on to others .
But the fact there wasn ’ t total clarity — or agreement on — the risks in early March means that valuable time may have been lost in getting Americans to adopt these practices .
Every day at Vox , we aim to answer your most important questions and provide you , and our audience around the world , with information that has the power to save lives .
Our mission has never been more vital than it @ @ @ @ @ @ @ you through understanding .
Vox ’ s work is reaching more people than ever , but our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an economic downturn .
Your financial contribution will not constitute a donation , but it will enable our staff to continue to offer free articles , videos , and podcasts at the quality and volume that this moment requires .
Please consider making a contribution to Vox today .

A new study from the Pew Research Center suggests many Americans had a poor understanding of the risks posed by the coronavirus in the early days of the pandemic — and that the majority, some correctly and some incorrectly, felt they were being presented with untrue information from the media.
The survey of 8,914 US adults, conducted from March 10-16 (with a 1.6 percentage point margin of error), found 80 percent of respondents noting they had been exposed to at least some false news reports about the virus (48 percent said they’d seen “a lot” or “some” and 32 percent saying they’d seen some but “not much” fake news).
About half of those respondents gave examples of the misinformation they believed they’d seen — and not all of it was actually false news.
For example, 22 percent of those respondents said the news had exaggerated the risks of the pandemic, citing reports recommending people stock up on food and estimates of potential death tolls as overstating the seriousness of the virus. Nineteen percent said they saw reports that millions of people could die from the virus and believed these to be exaggerated.
We now know the virus does indeed pose a serious threat, and it has, since the survey was conducted, been classified as a pandemic. It is true that millions have not died from the virus, but in early March, many reports relied on models that were based on an assumption that governments would not take aggressive mitigation strategies, like social distancing and shelter-in-place orders — and that, as a result, millions of deaths would be seen. It is important to remember, however, that despite those measures, the confirmed worldwide death toll currently exceeds 100,000 and will continue to grow for the foreseeable future.
Some respondents reported seeing news that undersold the severity of the virus: 15 percent of respondents claimed the media was understating its risks, with 12 percent calling into question reports equating the virus with the flu. And another 10 percent reported concerns about stories elevating false claims about the virus made at the time by President Donald Trump.
There is some truth to this, as explained by Recode’s Peter Kafka:
It’s clear now that the US government was woefully unprepared for the pandemic, and that’s been reflected in its messaging to the public since the start. The Centers for Disease Control and Prevention (CDC), for instance, didn’t tell the country to stop gathering in groups until March 15 — weeks after a top CDC official announced that the virus would begin spreading throughout the US. And after telling Americans for months that they should not wear masks unless they are sick, the government formally flipped that advice on April 3 and said that everyone should wear some kind of covering on their face in certain public settings. Much of the mainstream media amplified this slow and muddled reaction to the rapidly spreading virus. Since alarming reports about Covid-19 began to emerge from China in January, the media often provided information to Americans that later proved to be wrong, or at least inadequate. For instance: While President Trump has been correctly pilloried for describing the coronavirus as less dangerous than the flu, that message was commonplace in mainstream media outlets throughout February. And journalists — including my colleagues at Vox — were dutifully repeating exhortations from public health officials not to wear masks for much of 2020.
The survey is a potent reminder of the effects this muddled messaging had, with some appearing to disregard accurate information as false.
A clear understanding of the risks inherent to the virus is critical to getting folks to buy into subsequent social distancing guidelines and state-level shelter-at-home orders. Most Americans now seemingly understand that staying at home is the biggest key to staying safe from catching the virus and avoiding passing it on to others. But the fact there wasn’t total clarity — or agreement on — the risks in early March means that valuable time may have been lost in getting Americans to adopt these practices.


vox--2020-04-15--America’s embarrassingly mediocre coronavirus testing, in 2 charts

Over the last week , from April 8-15 , the US averaged about 151,000 coronavirus tests per day .
At the end of last month , from March 25 to April 1 , the country was performing about 110,000 tests every day .
The number of tests done each week is going up , which is good .
But experts say that ’ s far short of the millions upon millions more tests America needs to conduct every day if we ’ re to resume anything resembling normal life .
Testing right now is not nearly good enough .
If @ @ @ @ @ @ @ to reopen the country soon and wants to avoid a lot more people getting sick , they need to fix the testing problem — fast .
Because right now , we ’ re staring down the potentially toxic mixture of relaxed social distancing and insufficient testing .
To end social distancing , as Vox ’ s Umair Irfan put it quite plainly : “ Test millions .
Test early .
Test late .
Test over and over .
Test until the whole damn pandemic is over.
” The path forward is clear , @ @ @ @ @ @ @ Following through on this would require a massive increase in government funding , huge numbers of workers trained to administer the tests , and the coordination of raw materials , manufacturing , and delivery across the entire global economy .
It ’ s a costly , brute-force approach .
But it may be the only way out of the expensive and blunt measures already deployed to control the pandemic , from social distancing to shelter-in-place orders .
Right now , however , the US is struggling to test even 100,000 people per day @ @ @ @ @ @ @ researchers suggest would demand a huge ramp up in capacity .
Yet , they say , it ’ s possible to do it .
And despite the immense financial and social costs of a national testing system , it may yet be the cheapest path to reopening the economy .
But right now , our testing capability is being restrained , remarkably , by two equal but opposing forces : supply shortages , which limits the number of tests that can be processed , and overly restrictive testing criteria , which curbs the @ @ @ @ @ @ @ have actually more testing capacity .
” The system is decentralized and not coordinated , ” Jen Kates , director of global health and HIV policy at the Kaiser Family Foundation , told me .
“ And the federal government has not stepped in to provide that coordination and help ramp up the manufacturing .
Finally , we have such a testing deficit that we are playing a terrible game of catch-up.
” In both cases , the Trump administration and Congress could do more to fix it .
More federal funding would @ @ @ @ @ @ @ and less-stringent federal guidelines would allow doctors and hospitals to order more tests so everyone can better understand the scope of the pandemic .
As Brian Resnick and I reported a month ago , the testing fiasco started with faulty test kits getting sent out to labs .
That problem has been fixed , thankfully ; there are still some concerns about test accuracy , but that has been a problem for every country and would theoretically be mitigated if we were testing a whole lot more .
But now , testing is @ @ @ @ @ @ @ they ’ re short on staff and supplies , or they ’ re sitting open because federal guidance is restricting how many people get tested .
Vox ’ s German Lopez covered the first problem late last week : There is no widely accepted number for how many tests America should run each day , but the current number is generally considered far too low by experts .
Jha put the ideal at 500,000 tests a day .
Scott Gottlieb , former FDA commissioner and coauthor of the AEI report , suggested that @ @ @ @ @ @ @ be tested , which would amount to more than 500,000 a day .
A Harvard model proposed millions of tests a day .
Complaints vary , but labs say they don ’ t have enough swabs , test kits , reagents , personal protective equipment ( PPE ) , staff , or machines to run the specific tests required .
“ Any one link in the chain of supply , any restriction in the chain of supply , can suddenly create a bottleneck , ” Louise Serio , a spokesperson for the American @ @ @ @ @ @ @ which represents the private labs , told me .
“ No labs have , really , the predictable , consistent access to all the supplies we need , from reagents to test kits to PPE.
” Labs need more money , both for these supplies and to keep their staff employed , as their finances have taken a hit with most other kinds of medical testing sharply falling during the pandemic .
At the same time , Politico reported on Tuesday that some commercial labs were “ now sitting with unused testing capacity @ @ @ @ @ @ @ trade association for commercial labs , the American Clinical Laboratory Association , was practically begging for the testing criteria to be loosened .
“ ACLA members have now eliminated testing backlogs , and have considerable capacity that is not being used , ” ACLA President Julie Khani told Politico ’ s David Lim .
“ We stand ready to perform more testing and are in close communication with public health partners about ways we can support additional needs.
” The FDA commissioner , Stephen Hahn , was quoted saying the administration was examining @ @ @ @ @ @ @ , and Friday , Recode ’ s Rani Molla and I update our estimates of how many people the US and other countries are testing .
If you look back over the last month , the US has come a long way — but not far enough .
This was our chart from March 18 , when the United States was embarrassingly behind : And this is our chart from Monday .
America has risen all the way up to ... mediocre compared to Italy ( another one of the epicenters ) and @ @ @ @ @ @ @ practices ) .
We have to get this right — and fast .
As Vox ’ s Ezra Klein wrote last week , every single plan to relax social distancing and start to get life back to normal again depends on a dramatic increase in testing .
Nobel laureate Paul Romer thinks we should be conducting 22 million tests every day .
By that standard , the US testing capacity has barely budged since the last week of March .
Even much less ambitious testing proposals remain far out of reach for the @ @ @ @ @ @ @ of scale , there is also little coordination in how the tests are being administered .
Laurie Garret , a Pulitzer-winning author who has covered prior outbreaks , said we need a strategy for testing both the vulnerable populations ( like nursing-home residents ) and people who we want to return to their regular routines ( like students ) .
” We need wisdom , ” Garrett said .
“ Right now it ’ s nothing more than chaotic supply-and-demand.
” More than 600,000 cases and 26,000 deaths into this crisis and America @ @ @ @ @ @ @ challenge .
This story appears in VoxCare , a newsletter from Vox on the latest twists and turns in America ’ s health care debate .
Sign up to get VoxCare in your inbox along with more health care stats and news .
Are you interested in more discussions around health care policy ?
Join our Facebook community for conversation and updates .
Every day at Vox , we aim to answer your most important questions and provide you , and our audience around the world , with information that has the power @ @ @ @ @ @ @ never been more vital than it is in this moment : to empower you through understanding .
Vox ’ s work is reaching more people than ever , but our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an economic downturn .
Your financial contribution will not constitute a donation , but it will enable our staff to continue to offer free articles , videos , and podcasts at the quality and volume that this moment requires .
Please consider making a contribution to Vox today .

Over the last week, from April 8-15, the US averaged about 151,000 coronavirus tests per day. At the end of last month, from March 25 to April 1, the country was performing about 110,000 tests every day.
The number of tests done each week has gone up, which is good. But experts say that’s far short of the millions upon millions more tests America needs to conduct every day if we’re to resume anything resembling normal life. Testing right now is not nearly good enough.
If the Trump administration is serious about starting to reopen the country soon and wants to avoid a lot more people getting sick, they need to fix the testing problem — fast. Because right now, we’re staring down the potentially toxic mixture of relaxed social distancing and insufficient testing.
To end social distancing, as Vox’s Umair Irfan put it quite plainly: “Test millions. Test early. Test late. Test over and over. Test until the whole damn pandemic is over.”
The path forward is clear, according to Umair’s reporting:
Following through on this would require a massive increase in government funding, huge numbers of workers trained to administer the tests, and the coordination of raw materials, manufacturing, and delivery across the entire global economy. It’s a costly, brute-force approach. But it may be the only way out of the expensive and blunt measures already deployed to control the pandemic, from social distancing to shelter-in-place orders. Right now, however, the US is struggling to test even 100,000 people per day, so getting to the scale some researchers suggest would demand a huge ramp up in capacity. Yet, they say, it’s possible to do it. And despite the immense financial and social costs of a national testing system, it may yet be the cheapest path to reopening the economy.
But right now, our testing capability is being restrained, remarkably, by two equal but opposing forces: supply shortages, which limits the number of tests that can be processed, and overly restrictive testing criteria, which curbs the number of tests ordered even when labs have actually more testing capacity.
”The system is decentralized and not coordinated,” Jen Kates, director of global health and HIV policy at the Kaiser Family Foundation, told me. “And the federal government has not stepped in to provide that coordination and help ramp up the manufacturing. Finally, we have such a testing deficit that we are playing a terrible game of catch-up.”
In both cases, the Trump administration and Congress could do more to fix it. More federal funding would help labs keep their capacity up, and less-stringent federal guidelines would allow doctors and hospitals to order more tests so everyone can better understand the scope of the pandemic.
As Brian Resnick and I reported a month ago, the testing fiasco started with faulty test kits getting sent out to labs. That problem has been fixed, thankfully; there are still some concerns about test accuracy, but that has been a problem for every country and would theoretically be mitigated if we were testing a whole lot more.
But now, testing is sluggish. Labs are either overwhelmed because they’re short on staff and supplies, or they’re sitting open because federal guidance is restricting how many people get tested.
Vox’s German Lopez covered the first problem late last week:
There is no widely accepted number for how many tests America should run each day, but the current number is generally considered far too low by experts. Jha put the ideal at 500,000 tests a day. Scott Gottlieb, former FDA commissioner and coauthor of the AEI report, suggested that everyone who goes to a doctor could be tested, which would amount to more than 500,000 a day. A Harvard model proposed millions of tests a day. Complaints vary, but labs say they don’t have enough swabs, test kits, reagents, personal protective equipment (PPE), staff, or machines to run the specific tests required. “Any one link in the chain of supply, any restriction in the chain of supply, can suddenly create a bottleneck,” Louise Serio, a spokesperson for the American Clinical Laboratory Association (ACLA), which represents the private labs, told me. “No labs have, really, the predictable, consistent access to all the supplies we need, from reagents to test kits to PPE.”
Labs need more money, both for these supplies and to keep their staff employed, as their finances have taken a hit with most other kinds of medical testing sharply falling during the pandemic.
At the same time, Politico reported on Tuesday that some commercial labs were “now sitting with unused testing capacity waiting for samples to arrive.” The trade association for commercial labs, the American Clinical Laboratory Association, was practically begging for the testing criteria to be loosened.
“ACLA members have now eliminated testing backlogs, and have considerable capacity that is not being used,” ACLA President Julie Khani told Politico’s David Lim. “We stand ready to perform more testing and are in close communication with public health partners about ways we can support additional needs.”
The FDA commissioner, Stephen Hahn, was quoted saying the administration was examining the issue.
Every Monday, Wednesday, and Friday, Recode’s Rani Molla and I update our estimates of how many people the US and other countries are testing. If you look back over the last month, the US has come a long way — but not far enough.
This was our chart from March 18, when the United States was embarrassingly behind:
And this is our chart from April 16. America has risen all the way up to ... mediocre compared to Italy (another one of the epicenters) and Germany (a model for good testing practices).
We have to get this right — and fast. As Vox’s Ezra Klein wrote last week, every single plan to relax social distancing and start to get life back to normal again depends on a dramatic increase in testing. Nobel laureate Paul Romer thinks we should be conducting 22 million tests every day. By that standard, the US testing capacity has barely budged since the last week of March. Even much less ambitious testing proposals remain far out of reach for the time being.
Setting aside the issue of scale, there is also little coordination in how the tests are being administered. Laurie Garret, a Pulitzer-winning author who has covered prior outbreaks, said we need a strategy for testing both the vulnerable populations (like nursing-home residents) and people who we want to return to their regular routines (like students).
”We need wisdom,” Garrett said. “Right now it’s nothing more than chaotic supply-and-demand.”
More than 600,000 cases and 26,000 deaths into this crisis and America still hasn’t risen to the challenge.
This story appears in VoxCare, a newsletter from Vox on the latest twists and turns in America’s health care debate. Sign up to get VoxCare in your inbox along with more health care stats and news.
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vox--2020-04-15--Kentucky just made it harder to vote during a pandemic

Kentucky ’ s heavily Republican legislature voted Tuesday to require voters to show a government-issued photo ID , overriding Democratic Gov .
Andy Beshear ’ s veto in the process .
Meanwhile , if a Kentucky voter heads to the state ’ s webpage hoping to learn how to obtain such an ID , they will encounter a message telling them ID-issuing offices are closed .
Strict voter ID laws are increasingly common in Republican-controlled states , and left-leaning groups like students , low-income voters , and voters of color are especially less likely to have the ID that these @ @ @ @ @ @ @ s policy proponents often argue that the measure is necessary to combat voter fraud at the polls , such fraud is so rare that it is virtually nonexistent .
While voter ID laws , at best , are a solution in search of a problem , Kentucky ’ s new law could prove to be a particularly potent attack on the right to vote during a pandemic .
The ostensible function of a voter ID law is to prevent someone from impersonating another voter in order to cast a ballot in their name @ @ @ @ @ @ @ that the primary form of voter fraud addressed by these laws , impersonation fraud at the polls , is only slightly more common than unicorns .
A study by Loyola Law School professor Justin Levitt , who led much of the Justice Department ’ s voting rights work during the Obama administration , found only 35 credible allegations of in-person voter fraud among the 834 million ballots cast in the 2000-2014 elections .
A Wisconsin study found just seven cases of any kind of fraud among the 3 million cast in the 2004 @ @ @ @ @ @ @ were the kind that could be prevented by voter ID .
In 2014 , Iowa ’ s Republican Secretary of State Matt Schultz announced the results of a two-year investigation into election misconduct within his state .
He found zero cases of voter impersonation at the polls .
Notably , when the Supreme Court allowed an Indiana voter ID law to take effect in Crawford v. Marion County ( 2008 ) , it was only able to identify a single case of in-person voter fraud at the polls in the preceding 140 years @ @ @ @ @ @ @ problem , but at least some studies show that they particularly affect voters who lean Democratic .
While there ’ s no firm research consensus on the laws ’ effect , several studies have found that voter ID has no meaningful impact on voter turnout ( although others have found significant effects ) .
In a close election , though , even a small effect on turnout could matter .
At best , voter ID achieves nothing at all in an ordinary election while erecting an additional barrier to people exercising their right @ @ @ @ @ @ @ affects low-income and black and Latino Americans .
Under normal circumstances , voter ID could potentially make a difference in a close election .
Voter ID could have severe consequences during a pandemic It ’ s far from clear that November ’ s general election will be anything resembling normal .
Late last month , Gov .
Beshear handed down an executive order providing that “ all businesses that are not life-sustaining shall cease operations ... except as needed to conduct Minimum Basic Operations.
” Among other things , the order suspends “ @ @ @ @ @ @ @ not necessary to sustain or protect life , or to supporting Life-Sustaining Businesses.
” Thus , Kentucky voters who lack an ID — perhaps because they recently moved to the state and didn ’ t get around to obtaining a Kentucky driver ’ s license before the coronavirus lockdown began — may be unable to obtain this ID in time to vote because the state offices that issue such IDs are closed .
The future of life under coronavirus remains very uncertain , and it is , as yet , unclear when the @ @ @ @ @ @ @ .
Even if Kentucky is able to relax restrictions as more testing for the virus becomes available , it may need to reimpose strict limits on businesses and government offices if an outbreak occurs .
Voters may only have a limited window to acquire an ID , and that window might close just as a particular voter was preparing to obtain one .
Kentucky ’ s law , moreover , also resembles a similar Wisconsin law in that it requires voters to show ID in order to obtain an absentee ballot .
So @ @ @ @ @ @ @ law by voting by mail .
The new law does permit some voters to cast a ballot without showing photo ID — if they sign a sworn statement affirming that they are lawful voters and providing certain information .
But this exemption from the photo ID requirement is only available to a limited group of voters , and it is far from clear that a healthy voter qualifies because they were unable to obtain an ID because government offices were shut down during a pandemic .
Although the law allows a voter to @ @ @ @ @ @ @ if they were prevented from getting an ID due to “ disability or illness , ” the statute is not clear on whether the voter must themselves be infected by this illness in order to qualify .
And voters who misuse the exemption could potentially face perjury charges .
It ’ s worth noting that there could potentially be a very high-profile race on Kentucky ’ s ballot this November .
Senate Majority Leader Mitch McConnell is up for reelection , and there is some evidence that McConnell could be defeated if 2020 @ @ @ @ @ @ @ In January , for example , one poll showed McConnell just 3 percentage points ahead of possible Democratic challenger Amy McGrath , and a second poll showed McConnell and McGrath tied .
So , while the impact of voter ID is uncertain under normal circumstances , there are good reasons to believe that such a law could have a larger effect during a pandemic .
Whether that impact would be enough to skew a close election from McGrath to McConnell is also unclear .
But , at the very least , many voters @ @ @ @ @ @ @ they are unable to obtain the IDs they need to vote .
Every day at Vox , we aim to answer your most important questions and provide you , and our audience around the world , with information that has the power to save lives .
Our mission has never been more vital than it is in this moment : to empower you through understanding .
Vox ’ s work is reaching more people than ever , but our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an @ @ @ @ @ @ @ not constitute a donation , but it will enable our staff to continue to offer free articles , videos , and podcasts at the quality and volume that this moment requires .
Please consider making a contribution to Vox today .

Kentucky’s heavily Republican legislature voted Tuesday to require voters to show a government-issued photo ID, overriding Democratic Gov. Andy Beshear’s veto in the process.
Meanwhile, if a Kentucky voter heads to the state’s webpage hoping to learn how to obtain such an ID, they will encounter a message telling them ID-issuing offices are closed.
Strict voter ID laws are increasingly common in Republican-controlled states, and left-leaning groups like students, low-income voters, and voters of color are especially less likely to have the ID that these laws require. Although voter ID’s policy proponents often argue that the measure is necessary to combat voter fraud at the polls, such fraud is so rare that it is virtually nonexistent.
While voter ID laws, at best, are a solution in search of a problem, Kentucky’s new law could prove to be a particularly potent attack on the right to vote during a pandemic.
Voter ID laws serve no legitimate purpose
The ostensible function of a voter ID law is to prevent someone from impersonating another voter in order to cast a ballot in their name. But numerous studies and investigations show that the primary form of voter fraud addressed by these laws, impersonation fraud at the polls, is only slightly more common than unicorns.
A study by Loyola Law School professor Justin Levitt, who led much of the Justice Department’s voting rights work during the Obama administration, found only 35 credible allegations of in-person voter fraud among the 834 million ballots cast in the 2000-2014 elections. A Wisconsin study found just seven cases of any kind of fraud among the 3 million cast in the 2004 election — and none of these seven were the kind that could be prevented by voter ID. In 2014, Iowa’s Republican Secretary of State Matt Schultz announced the results of a two-year investigation into election misconduct within his state. He found zero cases of voter impersonation at the polls.
Notably, when the Supreme Court allowed an Indiana voter ID law to take effect in Crawford v. Marion County (2008), it was only able to identify a single case of in-person voter fraud at the polls in the preceding 140 years.
Voter ID laws target an imaginary problem, but at least some studies show that they particularly affect voters who lean Democratic. While there’s no firm research consensus on the laws’ effect, several studies have found that voter ID has no meaningful impact on voter turnout (although others have found significant effects). In a close election, though, even a small effect on turnout could matter.
At best, voter ID achieves nothing at all in an ordinary election while erecting an additional barrier to people exercising their right to vote — a barrier that disproportionately affects low-income and black and Latino Americans. Under normal circumstances, voter ID could potentially make a difference in a close election.
Voter ID could have severe consequences during a pandemic
It’s far from clear that November’s general election will be anything resembling normal.
Late last month, Gov. Beshear handed down an executive order providing that “all businesses that are not life-sustaining shall cease operations ... except as needed to conduct Minimum Basic Operations.” Among other things, the order suspends “all in-person government activities ... that are not necessary to sustain or protect life, or to supporting Life-Sustaining Businesses.”
Thus, Kentucky voters who lack an ID — perhaps because they recently moved to the state and didn’t get around to obtaining a Kentucky driver’s license before the coronavirus lockdown began — may be unable to obtain this ID in time to vote because the state offices that issue such IDs are closed. The future of life under coronavirus remains very uncertain, and it is, as yet, unclear when the country will return to anything resembling normal.
Even if Kentucky is able to relax restrictions as more testing for the virus becomes available, it may need to reimpose strict limits on businesses and government offices if an outbreak occurs. Voters may only have a limited window to acquire an ID, and that window might close just as a particular voter was preparing to obtain one.
Kentucky’s law, moreover, also resembles a similar Wisconsin law in that it requires voters to show ID in order to obtain an absentee ballot. So voters without ID cannot escape the law by voting by mail.
The new law does permit some voters to cast a ballot without showing photo ID — if they sign a sworn statement affirming that they are lawful voters and providing certain information. But this exemption from the photo ID requirement is only available to a limited group of voters, and it is far from clear that a healthy voter qualifies because they were unable to obtain an ID because government offices were shut down during a pandemic.
Although the law allows a voter to cast a ballot without showing photo ID if they were prevented from getting an ID due to “disability or illness,” the statute is not clear on whether the voter must themselves be infected by this illness in order to qualify. And voters who misuse the exemption could potentially face perjury charges.
It’s worth noting that there could potentially be a very high-profile race on Kentucky’s ballot this November. Senate Majority Leader Mitch McConnell is up for reelection, and there is some evidence that McConnell could be defeated if 2020 is a strong year for Democrats. In January, for example, one poll showed McConnell just 3 percentage points ahead of possible Democratic challenger Amy McGrath, and a second poll showed McConnell and McGrath tied.
So, while the impact of voter ID is uncertain under normal circumstances, there are good reasons to believe that such a law could have a larger effect during a pandemic. Whether that impact would be enough to skew a close election from McGrath to McConnell is also unclear. But, at the very least, many voters could struggle to cast a ballot if they are unable to obtain the IDs they need to vote.


vox--2020-04-15--Trump wants his name on millions of stimulus checks, even if it delays them

Between the multiple Trump Towers , Trump Plazas , Trump International Resorts , and the now-defunct Trump Steaks , it ’ s clear President Donald Trump has a penchant for putting his name on things .
And that predilection has now been extended to include the coronavirus stimulus checks .
The Treasury Department on Monday ordered that Trump ’ s name appear on the paper checks being rushed to millions of people by the IRS .
Those checks could end up being delayed a few days in order to add the president ’ s name to them , according to @ @ @ @ @ @ @ add Trump ’ s name — which will appear in typeface rather than as a signature given the checks are from the Treasury rather than from the president — the code in the IRS ’ s computers must be tweaked and subsequently tested .
“ Any last minute request like this will create a downstream snarl that will result in a delay , ” Chad Hooper , a quality control manager who serves as national president of the IRS ’ s Professional Managers Association , told the Washington Post .
A Treasury Department @ @ @ @ @ @ @ in a delay , however .
“ Economic Impact Payment checks are scheduled to go out on time and exactly as planned—there is absolutely no delay whatsoever , ” the representative said in a written statement to the Post .
It ’ s clear that many Americans need their stimulus checks as soon as possible .
Over the past three weeks , there have been 16.8 million new initial claims for unemployment as restaurants , retailers , and other nonessential businesses have been shuttered to limit the spread of the virus .
The @ @ @ @ @ @ @ calling for more stimulus funds , as Vox ’ s Dylan Matthews explained : [ The CARES Act ’ s ] cash checks are a one-off , with no automatic payments to kick in if and when unemployment spikes .
The increase in unemployment benefits is similarly temporary and not tied to objective economic metrics that could keep them from being withdrawn early .
The benefits to businesses are opaque and might be inferior to just having the government temporarily take over payroll for struggling companies , the way Denmark has done as @ @ @ @ @ @ @ too little aid to state and local governments to forestall budget cuts , and no mandate for postal voting in the 2020 election to be sure it ’ s conducted safely if the country is still under quarantine .
Regardless of whether the stimulus will work or if Congress will need to authorize more spending , Trump seems determined to grab whatever political credit comes from it .
The IRS , which is responsible for distributing the checks , is supposed to be a nonpartisan agency , and it has held to that @ @ @ @ @ @ @ political opponents , including civil rights groups , reporters , and prominent Democrats , with tax audits .
After that , Congress enacted laws to ensure that the agency operates apolitically .
Trump ’ s move , critics fear , changes that .
They argue this move is a blatantly political attempt to tie the president to the popular stimulus checks , even though Trump had initially pushed for a payroll tax cut rather than direct stimulus .
House Speaker Nancy Pelosi slammed the president for injecting politics into a process meant to @ @ @ @ @ @ @ payments to vulnerable families just to print his name on the check is another shameful example of President Trump ’ s catastrophic failure to treat this crisis with the urgency it demands , ” she said in a statement Wednesday .
Trump has long argued that putting his name on things is important branding , remarking on a tour of George Washington ’ s estate early in his presidency , “ You ’ ve got to put your name on stuff.
” This is the first time a president ’ s name will @ @ @ @ @ @ @ president reportedly initially pushed to have his name appear on the signature line ; however , presidents are not authorized signers for legal disbursements from the Treasury Department .
As a result , the president ’ s name will appear in the memo line , just below a note saying “ Economic Impact Payment , ” according to administration officials .
Every day at Vox , we aim to answer your most important questions and provide you , and our audience around the world , with information that has the power to save @ @ @ @ @ @ @ more vital than it is in this moment : to empower you through understanding .
Vox ’ s work is reaching more people than ever , but our distinctive brand of explanatory journalism takes resources — particularly during a pandemic and an economic downturn .
Your financial contribution will not constitute a donation , but it will enable our staff to continue to offer free articles , videos , and podcasts at the quality and volume that this moment requires .
Please consider making a contribution to Vox today .

Between the multiple Trump Towers, Trump Plazas, Trump International Resorts, and the now-defunct Trump Steaks, it’s clear President Donald Trump has a penchant for putting his name on things. And that predilection has now been extended to include the coronavirus stimulus checks.
The Treasury Department on Monday ordered that Trump’s name appear on the paper checks being rushed to millions of people by the IRS.
Those checks could end up being delayed a few days in order to add the president’s name to them, according to senior IRS officials. In order to add Trump’s name — which will appear in typeface rather than as a signature given the checks are from the Treasury rather than from the president — the code in the IRS’s computers must be tweaked and subsequently tested.
“Any last minute request like this will create a downstream snarl that will result in a delay,” Chad Hooper, a quality control manager who serves as national president of the IRS’s Professional Managers Association, told the Washington Post.
A Treasury Department representative denied that the change would result in a delay, however. “Economic Impact Payment checks are scheduled to go out on time and exactly as planned—there is absolutely no delay whatsoever,” the representative said in a written statement to the Post.
It’s clear that many Americans need their stimulus checks as soon as possible. Over the past three weeks, there have been 16.8 million new initial claims for unemployment as restaurants, retailers, and other nonessential businesses have been shuttered to limit the spread of the virus. The scale of this crisis has some lawmakers calling for more stimulus funds, as Vox’s Dylan Matthews explained:
[The CARES Act’s] cash checks are a one-off, with no automatic payments to kick in if and when unemployment spikes. The increase in unemployment benefits is similarly temporary and not tied to objective economic metrics that could keep them from being withdrawn early. The benefits to businesses are opaque and might be inferior to just having the government temporarily take over payroll for struggling companies, the way Denmark has done as its crisis response. There’s too little aid to state and local governments to forestall budget cuts, and no mandate for postal voting in the 2020 election to be sure it’s conducted safely if the country is still under quarantine.
Regardless of whether the stimulus will work or if Congress will need to authorize more spending, Trump seems determined to grab whatever political credit comes from it.
The IRS, which is responsible for distributing the checks, is supposed to be a nonpartisan agency, and it has held to that tradition since former President Richard Nixon targeted political opponents, including civil rights groups, reporters, and prominent Democrats, with tax audits. After that, Congress enacted laws to ensure that the agency operates apolitically.
Trump’s move, critics fear, changes that. They argue this move is a blatantly political attempt to tie the president to the popular stimulus checks, even though Trump had initially pushed for a payroll tax cut rather than direct stimulus.
House Speaker Nancy Pelosi slammed the president for injecting politics into a process meant to help everyday Americans. “Delaying direct payments to vulnerable families just to print his name on the check is another shameful example of President Trump’s catastrophic failure to treat this crisis with the urgency it demands,” she said in a statement Wednesday.
Trump has long argued that putting his name on things is important branding, remarking on a tour of George Washington’s estate early in his presidency, “You’ve got to put your name on stuff.”
This is the first time a president’s name will appear on an IRS disbursement. The president reportedly initially pushed to have his name appear on the signature line; however, presidents are not authorized signers for legal disbursements from the Treasury Department. As a result, the president’s name will appear in the memo line, just below a note saying “Economic Impact Payment,” according to administration officials.