theintercept--2020-03-27--As Congress Pushes a $2 Trillion Stimulus Package, the “How Will You Pay For It?” Questi

As Congress Pushes a $2 Trillion Stimulus Package, the “How Will You Pay For It?” Question Is Tossed in the Trash

Democratic presidential primary , Vermont Sen. Bernie Sanders and Massachusetts Sen. Elizabeth Warren offered a slew of robust proposals to reshape the American economy .
Yet the Democratic presidential primary hardly engaged with questions of whether that restructuring was wise , who would benefit , and who would lose .
Instead , the debate was dominated in no small part by a single question : “ How will you pay for it ?
” On Friday , the House of Representatives , led by Speaker Nancy Pelosi who regularly dismissed the ideas put forward by Sanders and Warren as unrealistic @ @ @ @ @ @ @ to rubber-stamp a $ 2 trillion Senate package aimed at staving off economic collapse amid the coronavirus pandemic .
The details of the legislation — particularly the $ 500 billion , strings-optional corporate slush fund — may be shameful , as Rep. Alexandria Ocasio-Cortez , D-N.Y. , who represents the hardest-hit neighborhood of Queens , deemed on the House floor Friday morning , but the moment is instructive .
Last week , as it became clear that concerns about deficits and revenue had evaporated , Ocasio-Cortez joined Sanders for a virtual town hall @ @ @ @ @ @ @ unfolding economic crisis .
She raised a number of important points , but one observation touched an especially strong nerve with me .
She was talking about the speed with which the House and Senate have been working to pass spending bills to get cash into the hands of desperate workers , struggling businesses , and major industries : It ’ s a fascinating progressive moment because what it ’ s shown is that all of these issues have never been about ‘ how are you going to pay for it ?
’ @ @ @ @ @ @ @ we have the capacity to do these things or if the logistics have worked out .
All of these excuses that we have been given as to why we can not treat people humanely have suddenly gone up in smoke and what has been revealed is that all of these issues were really about a lack of political will and who you deemed worthy to be in an emergency or not .
She is outraged .
And she should be .
Congress has ignored millions of people who have existed in a state @ @ @ @ @ @ @ of Flint , Michigan , ( and elsewhere ) still do not have safe drinking water .
Millions of kids go hungry each day .
Half a million people , before the pandemic , were homeless on any given night .
And on it goes .
There has been no multitrillion-dollar spending bill to combat these and other domestic emergencies .
Instead , lawmakers have deprived communities of critical investments that could have attenuated their emergencies , often hiding behind the excuse that there isn ’ t enough money in the budget to @ @ @ @ @ @ @ congresswoman wants everyone to learn what the federal response to the pandemic is teaching us .
Because the coronavirus is a threat to all of us — not just the poor — we are choosing to act in ways we always could have acted .
We Always Could Have Acted How was Congress able to come up with $ 2 trillion so quickly ?
Why wasn ’ t there a knock-down-drag-out fight about how to “ pay for ” this multitrillion-dollar bill ?
Where is the money coming from ?
Let ’ s @ @ @ @ @ @ @ First , it ’ s important to understand what it means to say that Congress is “ paying for ” its spending .
I served as the chief economist ( for the Democrats ) on the U.S. Senate Budget Committee ( 2015/16 ) .
It ’ s important to understand that those words have a specific meaning in the budget world .
When a member of Congress drafts a bill , staffers often shop it around , looking for support from other members of Congress .
Inevitably , the first question a staffer @ @ @ @ @ @ @ ’ s your pay-for ?
” For example , suppose a staffer is shopping around a $ 1 trillion infrastructure bill .
Before lending support to the bill , everyone wants to know how the spending is going to be “ paid for.
” What that means in budget-speak is “ How are you going to fully offset the spending so that it doesn ’ t add to the deficit ?
” That ’ s what it means to “ pay for ” your spending .
This usually involves raising taxes ( though @ @ @ @ @ @ @ money out of some other part of the budget , e.g .
defense ) .
We did this with a $ 1 trillion infrastructure bill when I was in the Senate .
Our so-called pay-for involved closing tax loopholes that mainly benefit wealthy individuals and large , profitable corporations .
Lots of people were eager to do an infrastructure bill , but we couldn ’ t get enough support for the tax increase , so the bill didn ’ t pass .
When Congress passes a spending bill that is fully “ paid @ @ @ @ @ @ @ of instructions to the Federal Reserve .
The Fed is the government ’ s fiscal agent — i.e .
its bank — and virtually all payments made by ( and to ) the federal government are handled by the Fed .
The first set of instructions tells the Fed to make certain authorized payments on behalf of the U.S. Treasury .
The Fed makes these payments by using a computer to add dollars to bank accounts .
If we ’ re doing a big infrastructure bill , then the government might be paying @ @ @ @ @ @ @ equipment and hiring thousands of construction workers , architects , engineers , and so on .
Government spending adds dollars to bank accounts .
The second set of instructions tells the Fed to use the computer to subtract dollars from bank accounts .
In our example , closing tax loopholes would force people and companies to pay higher taxes .
On balance , “ paying for ” its spending means that the government instructs the Fed to subtract away ( via tax ) exactly as many dollars as it adds ( via spending @ @ @ @ @ @ @ not what Congress is doing today .
Instead of writing a bill that would send two sets of instructions to the Fed , Congress is pushing through a $ 2 trillion spending bill that will send just one set of instructions .
No one is bothering to try to offset — i.e .
“ pay for ” — that spending , because the goal is to get lots of money to people ( and companies ) without subtracting a lot away .
As Rep. Ocasio-Cortez correctly points out , Congress is doing now @ @ @ @ @ @ @ What Has Been Revealed Think back to 2019 , when the political conversation centered around the Democratic presidential primaries and whether we could afford the kinds of ambitious spending proposals being pushed by Sanders or Warren .
Neither of them admitted it at the time , but Congress could have canceled student loan debt , lowered Medicare ’ s eligibility age to zero , or paid to make public colleges and universities tuition-free simply by writing a bill that sent one set of instructions to the Fed .
Spending or not spending money @ @ @ @ @ @ @ ’ s not to say that Congress can authorize multitrillion-dollar spending bills left and right without ever building in offsets to subtract dollars out of the economy .
There are limits .
But the limits aren ’ t financial .
Uncle Sam can ’ t run out of dollars .
The U.S. government is the issuer of our currency — the U.S. dollar — which means that , unlike Greece , it can never find itself in a situation in which it has bills coming due that it can ’ t afford to @ @ @ @ @ @ @ its sovereign currency — the drachma — and started borrowing in what is effectively a foreign currency — the euro — when it joined the Economic and Monetary Union in 2001 .
That ’ s why it ( and other ) countries in the eurozone experienced a debt crisis and countries like Japan , the U.K. and the U.S. did not .
So what are the limits for a currency-issuing government like the United States ?
The answer is inflation .
The government can ’ t run out of money , but it @ @ @ @ @ @ @ ( including labor ) .
We are constrained by our real resources — i.e .
our technical know-how and the available supply of workers , factories , machines , raw materials , and so on .
As long as the economy isn ’ t already operating at full capacity , then it is reasonable for Congress to send just one set of instructions to the Fed .
We could have done that with a number of things the Democrats debated over the last year .
For example , Sanders proposed that we cancel @ @ @ @ @ @ @ We could have easily done that without offsets .
It would have allowed people who were paying down medical bills to spend some or all of that money on other things .
Even if they spent all of it buying consumer goods , the U.S. economy could easily have handled the additional spending .
There was no reason to “ pay for ” that kind of legislation because there was no chance it would have caused inflation to accelerate .
The numbers were just too small .
But even bigger things could have @ @ @ @ @ @ @ student debt .
Both Warren and Sanders wanted to cancel student loan debt .
He would have canceled all of it , and she would have canceled up to $ 50,000 for 95 percent of the population .
Both explained how it could be “ paid for.
” Long before any presidential candidate got behind the idea , I worked with a team of economists to analyze the macroeconomic effects of canceling ( what was then $ 1.4 trillion ) student loan debt .
What we found was that the economy had enough @ @ @ @ @ @ @ one-time cancellation without the need for offsets .
In other words , Congress didn ’ t need to “ pay for ” it .
That won ’ t always be the case .
It always comes down to inflation risk .
How much can the economy handle — in terms of higher spending — before you need the offsets ?
That ’ s the right way to think about the “ pay for ” question .
It ’ s also the right way to budget our nation ’ s real resources .
Even @ @ @ @ @ @ @ underway , there was enough slack in the economy to allow Congress to bring clean drinking water to the people of Flint , to beef up programs that provide nutritional assistance to children , and to build housing for those sleeping on the streets .
Congress could have addressed these and other emergencies by writing and passing spending bills without the need for so-called pay-fors .
If the votes are there , the money can always be made available .
When all of this is behind us , to the extent that it @ @ @ @ @ @ @ not forget what we ’ ve learned .

Photo illustration: Soohee Cho/The Intercept, Getty Images
Throughout the Democratic presidential primary, Vermont Sen. Bernie Sanders and Massachusetts Sen. Elizabeth Warren offered a slew of robust proposals to reshape the American economy. Yet the Democratic presidential primary hardly engaged with questions of whether that restructuring was wise, who would benefit, and who would lose. Instead, the debate was dominated in no small part by a single question: “How will you pay for it?”
On Friday, the House of Representatives, led by Speaker Nancy Pelosi who regularly dismissed the ideas put forward by Sanders and Warren as unrealistic, waved away that question, preparing to rubber-stamp a $2 trillion Senate package aimed at staving off economic collapse amid the coronavirus pandemic.
The details of the legislation — particularly the $500 billion, strings-optional corporate slush fund — may be shameful, as Rep. Alexandria Ocasio-Cortez, D-N.Y., who represents the hardest-hit neighborhood of Queens, deemed on the House floor Friday morning, but the moment is instructive. Last week, as it became clear that concerns about deficits and revenue had evaporated, Ocasio-Cortez joined Sanders for a virtual town hall to discuss the global pandemic and the unfolding economic crisis. She raised a number of important points, but one observation touched an especially strong nerve with me.
She was talking about the speed with which the House and Senate have been working to pass spending bills to get cash into the hands of desperate workers, struggling businesses, and major industries:
It’s a fascinating progressive moment because what it’s shown is that all of these issues have never been about ‘how are you going to pay for it?’ It’s never been about whether we have the capacity to do these things or if the logistics have worked out. All of these excuses that we have been given as to why we cannot treat people humanely have suddenly gone up in smoke and what has been revealed is that all of these issues were really about a lack of political will and who you deemed worthy to be in an emergency or not.
She is outraged. And she should be. Congress has ignored millions of people who have existed in a state of crisis for decades. The people of Flint, Michigan, (and elsewhere) still do not have safe drinking water. Millions of kids go hungry each day. Half a million people, before the pandemic, were homeless on any given night. And on it goes. There has been no multitrillion-dollar spending bill to combat these and other domestic emergencies. Instead, lawmakers have deprived communities of critical investments that could have attenuated their emergencies, often hiding behind the excuse that there isn’t enough money in the budget to deal with problems like these.
.@AOC "And it's actually a fascinating progressive moment, because what it's shown is that all of these issues have never been about how are you going to pay for it. It's never been about whether we have the capacity to do these things or if the logistics have worked out… pic.twitter.com/kkXaIbn2hq — People for Bernie (@People4Bernie) March 22, 2020
The congresswoman wants everyone to learn what the federal response to the pandemic is teaching us. Because the coronavirus is a threat to all of us — not just the poor — we are choosing to act in ways we always could have acted.
We Always Could Have Acted
How was Congress able to come up with $2 trillion so quickly? Why wasn’t there a knock-down-drag-out fight about how to “pay for” this multitrillion-dollar bill? Where is the money coming from?
Let’s get to the bottom of this.
First, it’s important to understand what it means to say that Congress is “paying for” its spending. I served as the chief economist (for the Democrats) on the U.S. Senate Budget Committee (2015/16). It’s important to understand that those words have a specific meaning in the budget world. When a member of Congress drafts a bill, staffers often shop it around, looking for support from other members of Congress. Inevitably, the first question a staffer is confronted with is, “What’s your pay-for?” For example, suppose a staffer is shopping around a $1 trillion infrastructure bill. Before lending support to the bill, everyone wants to know how the spending is going to be “paid for.” What that means in budget-speak is “How are you going to fully offset the spending so that it doesn’t add to the deficit?” That’s what it means to “pay for” your spending.
This usually involves raising taxes (though it can also be done by carving money out of some other part of the budget, e.g. defense). We did this with a $1 trillion infrastructure bill when I was in the Senate. Our so-called pay-for involved closing tax loopholes that mainly benefit wealthy individuals and large, profitable corporations. Lots of people were eager to do an infrastructure bill, but we couldn’t get enough support for the tax increase, so the bill didn’t pass.
Suppose it had.
When Congress passes a spending bill that is fully “paid for,” it sends two sets of instructions to the Federal Reserve. The Fed is the government’s fiscal agent — i.e. its bank — and virtually all payments made by (and to) the federal government are handled by the Fed.
The first set of instructions tells the Fed to make certain authorized payments on behalf of the U.S. Treasury. The Fed makes these payments by using a computer to add dollars to bank accounts. If we’re doing a big infrastructure bill, then the government might be paying Caterpillar Inc. for lots of new building equipment and hiring thousands of construction workers, architects, engineers, and so on. Government spending adds dollars to bank accounts.
The second set of instructions tells the Fed to use the computer to subtract dollars from bank accounts. In our example, closing tax loopholes would force people and companies to pay higher taxes.
On balance, “paying for” its spending means that the government instructs the Fed to subtract away (via tax) exactly as many dollars as it adds (via spending) to bank accounts.
That is not what Congress is doing today. Instead of writing a bill that would send two sets of instructions to the Fed, Congress is pushing through a $2 trillion spending bill that will send just one set of instructions. No one is bothering to try to offset — i.e. “pay for” — that spending, because the goal is to get lots of money to people (and companies) without subtracting a lot away. As Rep. Ocasio-Cortez correctly points out, Congress is doing now what it could always have done.
What Has Been Revealed
Think back to 2019, when the political conversation centered around the Democratic presidential primaries and whether we could afford the kinds of ambitious spending proposals being pushed by Sanders or Warren. Neither of them admitted it at the time, but Congress could have canceled student loan debt, lowered Medicare’s eligibility age to zero, or paid to make public colleges and universities tuition-free simply by writing a bill that sent one set of instructions to the Fed. Spending or not spending money is always a political choice.
That’s not to say that Congress can authorize multitrillion-dollar spending bills left and right without ever building in offsets to subtract dollars out of the economy. There are limits.
Spending or not spending money is always a political choice.
But the limits aren’t financial. Uncle Sam can’t run out of dollars. The U.S. government is the issuer of our currency — the U.S. dollar — which means that, unlike Greece, it can never find itself in a situation in which it has bills coming due that it can’t afford to pay. Remember, Greece gave up its sovereign currency — the drachma — and started borrowing in what is effectively a foreign currency — the euro — when it joined the Economic and Monetary Union in 2001. That’s why it (and other) countries in the eurozone experienced a debt crisis and countries like Japan, the U.K. and the U.S. did not.
So what are the limits for a currency-issuing government like the United States? The answer is inflation. The government can’t run out of money, but it can run out of things to buy (including labor). We are constrained by our real resources — i.e. our technical know-how and the available supply of workers, factories, machines, raw materials, and so on. As long as the economy isn’t already operating at full capacity, then it is reasonable for Congress to send just one set of instructions to the Fed.
We could have done that with a number of things the Democrats debated over the last year. For example, Sanders proposed that we cancel $81 billion in medical debt. We could have easily done that without offsets. It would have allowed people who were paying down medical bills to spend some or all of that money on other things. Even if they spent all of it buying consumer goods, the U.S. economy could easily have handled the additional spending. There was no reason to “pay for” that kind of legislation because there was no chance it would have caused inflation to accelerate. The numbers were just too small.
Read Our Complete Coverage The Coronavirus Crisis
But even bigger things could have been done without so-called pay-fors. Take student debt. Both Warren and Sanders wanted to cancel student loan debt. He would have canceled all of it, and she would have canceled up to $50,000 for 95 percent of the population. Both explained how it could be “paid for.”
Long before any presidential candidate got behind the idea, I worked with a team of economists to analyze the macroeconomic effects of canceling (what was then $1.4 trillion) student loan debt. What we found was that the economy had enough real resource capacity to safely handle a one-time cancellation without the need for offsets. In other words, Congress didn’t need to “pay for” it.
That won’t always be the case. It always comes down to inflation risk. How much can the economy handle — in terms of higher spending — before you need the offsets? That’s the right way to think about the “pay for” question. It’s also the right way to budget our nation’s real resources.
Even before the economic meltdown that is currently underway, there was enough slack in the economy to allow Congress to bring clean drinking water to the people of Flint, to beef up programs that provide nutritional assistance to children, and to build housing for those sleeping on the streets. Congress could have addressed these and other emergencies by writing and passing spending bills without the need for so-called pay-fors. If the votes are there, the money can always be made available.
When all of this is behind us, to the extent that it ever can be, let’s not forget what we’ve learned.


theintercept--2020-03-27--Vital Federal Contracts for Ventilators and Coronavirus Supplies Will Take Months to Complete

is in a rush to be done with the coronavirus .
Earlier this week , he said that he hopes to have the country “ just raring to go ” by Easter .
And in a letter he sent to the nation ’ s governors yesterday , Trump announced that the administration is preparing to release new guidelines for state and local policymakers that may include the relaxing of social distancing .
But a review of recent government contracts related to the coronavirus shows the response of federal agencies to the global pandemic is on a much slower timeline .
@ @ @ @ @ @ @ that new coronavirus infections will “ miraculously ” abate as the weather becomes warmer , explained that his aggressive schedule for reopening the country is in keeping with the nation ’ s character .
“ Our people are full of vim and vigor and energy , ” he explained on a Fox News special .
Health care workers at Elmhurst Hospital and other hospitals throughout New York City , which has just purchased 45 refrigerated trucks to expand its morgue capacity , would no doubt dispute that characterization .
Patients are already dying @ @ @ @ @ @ @ .
Because of a shortage of protective gear , health care workers there fear , for good reason , that they will soon be infected with the coronavirus too .
Many already have been .
Relaxing stay-at-home orders while the number of infections is still racing upwards could be disastrous , according to public health experts .
A report the Institute for Health Metrics and Evaluation at the University of Washington issued yesterday predicts that even with “ continued and uninterrupted vigilance by the general public , ” the demand for ventilators and @ @ @ @ @ @ @ begin to far exceed capacity for Covid-19 patients by the second week of April .
That ’ s just around Easter , which falls on the 12th .
The report ’ s authors anticipate that the current wave of deaths from the coronavirus will likely continue into July — again , that ’ s with the current protections in place .
Without them , experts predict , the number of excess coronavirus infections could climb into the millions .
Infectious disease specialists aren ’ t the only ones on a different timeline than @ @ @ @ @ @ @ to be preparing for the end of the crisis , the federal agencies are still gearing up to deal with the beginning of it .
Many of the contracts they ’ ve recently issued for supplies related to the pandemic won ’ t be awarded until after Easter .
And critical supplies are often scheduled to arrive far after that — in some cases , too late to meet the urgent needs .
Consider a $ 517,352 contract the Veterans Integrated Services Network entered into last week with Fidelis Sustainability Distribution , a @ @ @ @ @ @ @ be providing “ emergency ventilators , ” which are due back on June 10 — almost two months after Easter .
Even if they meet the target early , it will be too late for many hospitals that desperately need the breathing machines now .
A federal contract between Veterans Affairs headquarters and the consulting firm McKinsey & Company also reflects a far slower pace than the president ’ s .
That contract , which has a potential value of $ 11.98 million , is for modeling and consulting related to Covid-19 and @ @ @ @ @ @ @ .
Similarly , two VA contracts related to the virus — one for $ 3.4 million worth of respiratory protections systems and another for $ 62,800 worth of operating room gowns — aren ’ t due to be completed until September 30 .
Meanwhile , a $ 172.9 million Department of Health and Human Services contract with 3M for N95 masks related to Covid-19 has October 18 , 2021 , as its current completion date .
In some cases , such as the emergency shuttle services and rentals of extra beds that the @ @ @ @ @ @ @ long timeline will be helpful .
Even after infections and deaths peak , likely in the coming weeks , the virus will be with us for months if not years .
It will take a minimum of a year to approve a vaccine .
And though many possible treatments are now being tested , their development , too , will take time .
Much of that work is also being supported by the federal government , which is still in the process of awarding those contracts that have completion dates spread out over @ @ @ @ @ @ @ have us up and running far before that , of course .
Yesterday Trump hinted that his new plan will rely on testing to show the levels of risk in different parts of the country .
“ Our expanded testing capabilities will quickly enable us to publish criteria , developed in close coordination with the nation ’ s public health officials and scientists , to help classify counties with respect to continued risks posed by the virus , ” he wrote in his letter to the governors .
But after the administration badly @ @ @ @ @ @ @ unclear when the tests will be available to put in this expedited plan .
Thankfully , the government has recently entered into several contracts to procure tests for the coronavirus .
This week , the FDA approved the emergency use of a rapid coronavirus test that the company Cepheid developed with federal funding .
$ 148,600 of testing equipment the VA ordered from the company is due April 22 — 10 days after Easter .
And HHS recently awarded funding to three other companies to develop new coronavirus tests : Qiagen , Mesa @ @ @ @ @ @ @ the completion dates of those contracts are at the end of April , mid-May , and mid-July .

President Donald Trump is in a rush to be done with the coronavirus. Earlier this week, he said that he hopes to have the country “just raring to go” by Easter. And in a letter he sent to the nation’s governors yesterday, Trump announced that the administration is preparing to release new guidelines for state and local policymakers that may include the relaxing of social distancing. But a review of recent government contracts related to the coronavirus shows the response of federal agencies to the global pandemic is on a much slower timeline.
The president, who has previously predicted that new coronavirus infections will “miraculously” abate as the weather becomes warmer, explained that his aggressive schedule for reopening the country is in keeping with the nation’s character. “Our people are full of vim and vigor and energy,” he explained on a Fox News special.
Health care workers at Elmhurst Hospital and other hospitals throughout New York City, which has just purchased 45 refrigerated trucks to expand its morgue capacity, would no doubt dispute that characterization. Patients are already dying while waiting for beds in overwhelmed hospitals. Because of a shortage of protective gear, health care workers there fear, for good reason, that they will soon be infected with the coronavirus too. Many already have been.
Relaxing stay-at-home orders while the number of infections is still racing upwards could be disastrous, according to public health experts. A report the Institute for Health Metrics and Evaluation at the University of Washington issued yesterday predicts that even with “continued and uninterrupted vigilance by the general public,” the demand for ventilators and beds in hospital intensive care units will begin to far exceed capacity for Covid-19 patients by the second week of April. That’s just around Easter, which falls on the 12th. The report’s authors anticipate that the current wave of deaths from the coronavirus will likely continue into July — again, that’s with the current protections in place. Without them, experts predict, the number of excess coronavirus infections could climb into the millions.
Infectious disease specialists aren’t the only ones on a different timeline than Trump. While the president already seems to be preparing for the end of the crisis, the federal agencies are still gearing up to deal with the beginning of it. Many of the contracts they’ve recently issued for supplies related to the pandemic won’t be awarded until after Easter. And critical supplies are often scheduled to arrive far after that — in some cases, too late to meet the urgent needs.
Consider a $517,352 contract the Veterans Integrated Services Network entered into last week with Fidelis Sustainability Distribution, a Nevada-based emergency supply company. Fidelis will be providing “emergency ventilators,” which are due back on June 10 — almost two months after Easter. Even if they meet the target early, it will be too late for many hospitals that desperately need the breathing machines now.
A federal contract between Veterans Affairs headquarters and the consulting firm McKinsey & Company also reflects a far slower pace than the president’s. That contract, which has a potential value of $11.98 million, is for modeling and consulting related to Covid-19 and is due for completion on June 19. Similarly, two VA contracts related to the virus — one for $3.4 million worth of respiratory protections systems and another for $62,800 worth of operating room gowns — aren’t due to be completed until September 30. Meanwhile, a $172.9 million Department of Health and Human Services contract with 3M for N95 masks related to Covid-19 has October 18, 2021, as its current completion date.
In some cases, such as the emergency shuttle services and rentals of extra beds that the VA just arranged through September, the long timeline will be helpful. Even after infections and deaths peak, likely in the coming weeks, the virus will be with us for months if not years. It will take a minimum of a year to approve a vaccine. And though many possible treatments are now being tested, their development, too, will take time. Much of that work is also being supported by the federal government, which is still in the process of awarding those contracts that have completion dates spread out over the coming months.
The president would have us up and running far before that, of course. Yesterday Trump hinted that his new plan will rely on testing to show the levels of risk in different parts of the country. “Our expanded testing capabilities will quickly enable us to publish criteria, developed in close coordination with the nation’s public health officials and scientists, to help classify counties with respect to continued risks posed by the virus,” he wrote in his letter to the governors.
But after the administration badly bungled coronavirus testing, it’s unclear when the tests will be available to put in this expedited plan. Thankfully, the government has recently entered into several contracts to procure tests for the coronavirus. This week, the FDA approved the emergency use of a rapid coronavirus test that the company Cepheid developed with federal funding. $148,600 of testing equipment the VA ordered from the company is due April 22 — 10 days after Easter. And HHS recently awarded funding to three other companies to develop new coronavirus tests: Qiagen, Mesa Biotech, and DiaSorin Molecular. But the completion dates of those contracts are at the end of April, mid-May, and mid-July.


theintercept--2020-03-27--To Develop a Covid-19 Vaccine, Pharma and the Federal Government Will Have to Break Old Patterns

years of effort and millions of dollars in government investment , a team of Texas scientists finally developed a promising vaccine for SARS , the deadly strain of coronavirus that had infected over 8,000 people worldwide in the early 2000s .
But the outbreak that triggered the research had begun and ended , and no one was contracting new cases of the disease anymore .
Private industry and governments responded to the request to fund the human clinical trials with unanimity : not interested .
And so the SARS vaccine was shelved .
“ If investments had been made previously @ @ @ @ @ @ @ coronavirus ] vaccine ready to go now , ” lead scientist Dr. Peter Hotez told Congress earlier this month .
Scientists are now racing to develop a vaccine for Covid-19 , the strain of coronavirus that has quickly upended the world .
At least a dozen companies have joined the effort , from multinational giants like GlaxoSmithKline , Sanofi , and Johnson & Johnson , to smaller biotech firms like Inovio and Moderna .
The latter became the first to give its working vaccine to a healthy adult last week , entering clinical @ @ @ @ @ @ @ discourse has revolved mainly around how soon a vaccine could feasibly be ready ( at least 18 months ) and how much it would cost ( unclear ) .
But if and when a vaccine candidate does get approval from the Food and Drug Administration — or even multiple get approved — then what ?
Will distributing a vaccine resemble the embarrassing efforts to distribute coronavirus tests ?
Does the government even have the capacity to manufacture a vaccine as quickly and widely as needed ?
Sen. Mitt Romney , R-Utah , asked @ @ @ @ @ @ @ March 3 , and the answers weren ’ t encouraging .
Dr. Robert Kadlec , the Health and Human Services assistant secretary for preparedness and response , testified that the U.S. lacks the capacity for manufacturing the kinds of Covid-19 vaccines the federal government is currently pursuing .
“ We ’ d have a longer than a six-month wait to basically produce vaccines on scale , ” he told Romney .
Dr. Anthony Fauci , director of the National Institute of Allergy and Infectious Diseases added that it will essentially come down to @ @ @ @ @ @ @ government is not going to be able to make hundreds of millions of doses , ” he said .
we ’ ve been here before .
In October 2004 , as Americans began gearing up for flu season , Britain announced that it would be suspending the license for Chiron Corporation , one of just two flu vaccine manufacturers for the United States .
British regulators had found bacterial contamination in Chiron ’ s Liverpool factory , just as the U.S. had been waiting for it to ship 48 million doses over the @ @ @ @ @ @ @ America ’ s vaccine supply was cut nearly in half .
Policymakers were left scrambling , but there was little they could do .
The director of the Centers for Disease Control and Prevention apologized and said the scarce supply would be prioritized for those who were at a particularly high risk of getting sick .
What came next was vaccine price gouging , long waiting lines for the elderly and chronically ill , and threats by the government to jail or fine doctors who vaccinated those deemed not high-risk .
Federal prosecutors @ @ @ @ @ @ @ the shortage became a late-stage crisis for George W. Bush on the campaign trail .
Relying on just two companies to produce the seasonal flu vaccine had left the U.S particularly vulnerable .
( Britain , by contrast , used five different suppliers . )
And despite warnings for years about the dwindling number of U.S vaccine manufacturers , the federal government had done little to intervene .
According to a report released by the Institute of Medicine , in 1973 , 25 companies produced vaccines for the U.S , but three decades @ @ @ @ @ @ @ a classic market failure : Many drug companies had decided that vaccines were not profitable enough — they were too costly to develop and too underpriced to sell .
Following the colossal 2004 shortage and pressure resulting from SARS , the federal government vowed to take action .
In December 2004 , Congress approved $ 99 million for flu vaccine production and in 2005 , Congress passed a law to provide vaccine manufacturers with immunity from tort lawsuits .
By 2006 , Congress passed the Pandemic and All Hazards Preparedness Act , which @ @ @ @ @ @ @ and response in HHS , the same role Kadlec has today .
It also established the Biomedical Advanced Research Development Authority , which works with industry to develop so-called medical countermeasures against public health and bioterrorism threats .
“ The Bush-era initiatives to improve vaccine availability and medical surge capacity domestically were good starts but underfunded , as are most public health initiatives , ” said Dr. Adva Gadoth , an epidemiologist at UCLA Fielding School of Public Health .
The weaknesses were evident by 2009 , the next time the U.S. grappled @ @ @ @ @ @ @ — also known as swine flu — emerged that spring in Mexico , and the U.S government promised a vaccine would be ready by October to blunt a second wave of infections .
But when October rolled around , U.S. health leaders were only then waking up to the fact that their expected supply was not on schedule to arrive .
CDC officials hadn ’ t realized vaccine yields were lower than expected , because the tests used to measure those yields had also been delayed .
The new machines that manufacturers installed @ @ @ @ @ @ @ also ended up being glitchy , which caused more bottlenecks .
The rollout was complicated further by the fact that patients were asked to get both the H1N1 flu vaccine , on top of their seasonal flu vaccine , which weren ’ t ready at the same time .
And when it became clear that the H1N1 shipments would be delayed , manufacturers halted producing the seasonal vaccine to help ramp up H1N1 production .
“ Having two flu vaccines to receive was confusing enough to patients — usually there ’ s only @ @ @ @ @ @ @ and staggered timing in their availability made things worse , ” said Gadoth .
“ We ended up with a lot of lopsided protection : Those who visited their doctors early in the season and couldn ’ t return were only protected against seasonal flu , and those who visited once the H1N1 vaccine became available could no longer access the seasonal flu vaccine.
” One of the major lessons of the H1N1 shortage , says Dr. William Schaffner , a professor of preventive medicine and infectious diseases at Vanderbilt ’ s School @ @ @ @ @ @ @ over-deliver .
“ When the first batches of vaccine finally came off the line , the public health community was trying to communicate who should get it and where to go , but that message was completely drowned out because all the media focused on was that the vaccine was late , ” he said .
“ It undercut the whole introduction and confidence in the government response.
” In August 2010 , prompted by the vaccine problems from H1N1 , President Barack Obama ’ s team of science advisers released a report @ @ @ @ @ @ @ production in the future .
This had come a year after Sen. Susan Collins , R-Maine , successfully stripped $ 870 million in flu pandemic preparation money out of the 2009 stimulus .
The administration recommended spending roughly $ 1 billion per year for the next several years to implement its ideas , which included developing faster potency tests and better machines to do vial-filling .
This joined a separate 2010 HHS review , which had concluded that the U.S. “ lacks the domestic manufacturing capacity to rapidly produce and package a vaccine @ @ @ @ @ @ @ of a pandemic.
” But many of those Obama-era proposals were never fully executed , and four new vaccine manufacturing sites the federal government did invest in beginning in 2012 have barely been utilized to respond to Covid-19 .
The Washington Post reported recently that two of the four sites are currently taking no role in developing a vaccine , and the other two only have plans to conduct “ small-scale ” testing .
The U.S. government has been relatively successful though in attracting more private vaccine manufacturers , through a combination of @ @ @ @ @ @ @ .
“ We tried to entice manufacturers who might have additional capacity that were manufacturing for other parts of the world , and we tried to make it easier for them to get FDA approval , ” said Jesse Goodman , who served as FDA ’ s chief scientist between 2009 and 2014 and led the Obama administration ’ s H1N1 response .
In 2005 , only three of the top 10 pharmaceutical companies had significant investments in vaccines .
But by 2012 , that was up to eight out of 10 , @ @ @ @ @ @ @ Johnson .
Companies began realizing they could bring more expensive vaccines to market faster .
Dr. Ken Kaitlin , director of the Tufts Center for the Study of Drug Development , said the increase in companies focused on vaccines was partly driven by the growth of immuno-oncology drugs , which target a patient ’ s immune system to fight cancer .
“ Those drugs stimulated broader interest among firms in the immune system , and scientists realized there were other diseases they could focus on using similar techniques , ” he said .
@ @ @ @ @ @ @ finished in 2003 , also spurred new interest .
“ That increased our understanding of disease and allowed scientists to search for vaccines in areas that previously seemed intractable , ” Kaitlin said .
Yet more pharmaceutical companies being interested in vaccines is no guarantee that a Covid-19 vaccine would be affordable , as vaccine prices have soared over the years .
While Democratic politicians are sounding the alarm , saying that any coronavirus vaccine should be free or very affordable , pharmaceutical execs have already been questioning that .
“ Nobody is @ @ @ @ @ @ @ if there is not a certain return that you can get for your investment and the risks you have been taking , ” said David Loew , an executive vice president at Sanofi , in an interview with Financial Times last week .
And given how little we currently know about Covid-19 , if the outbreak peaks and panic wanes , investors and the government could lose interest in funding further stages of Covid-19 clinical trials , just as they did for SARS in 2016 .
“ We ’ re still very , @ @ @ @ @ @ @ we pour research dollars into and sustain , ” said Dr. Jason Schwartz , a professor at the Yale School of Public Health who studies vaccine development .
“ When the immediate need dissipates , those research efforts can drop off quickly.
” continues to spread , research dollars don ’ t disappear , and a vaccine or two or three is eventually approved , there are some things we can expect now about how that delivery process will play out .
One is that no matter how many pharmaceutical companies work to @ @ @ @ @ @ @ if the federal government ’ s four manufacturing sites do end up assisting with production , there simply will not be as many doses as needed in the beginning .
The vaccine will come in waves , in a series of shipments .
“ Leaders will have to decide who gets it first , and where to send it , and whoever does that should do it very transparently , ” said Schaffner .
While the federal government will likely set broad guidelines and principles , each state will be tasked with designing @ @ @ @ @ @ @ process spearheaded by the directors of immunization who work in each state ’ s health department .
Dr. Kelly Moore was working as Tennessee ’ s director of immunization during the H1N1 outbreak , a role she was particularly well suited for after having served for years as her state ’ s pandemic influenza planning coordinator .
The first step for vaccine distribution in an emergency , Moore said , is figuring out which medical providers will give it — including who wants to give it and who has clinics equipped to store @ @ @ @ @ @ @ out for Covid-19 I anticipate will be distributed through existing federal vaccine distribution channels , namely the Vaccines for Children program , ” Moore said .
The Vaccines for Children program , administered by every state , provides federally funded vaccines to volunteer clinics to give to basically any child who doesn ’ t have private health insurance .
“ In an emergency we ’ d much rather build off what already exists than create something from scratch , and all states already manage partnerships with private clinics , health departments , and @ @ @ @ @ @ @ so they ’ re already used to the ordering and the distribution , ” she explained .
Each provider that participates in VFC typically orders vaccine doses through an online portal managed by their state , and Moore said it would not be difficult to add coronavirus vaccines to those portals .
But since right now only clinics that serve children are part of the VFC system , each state would need to enroll more adult providers and pharmacies that might be able to help administer coronavirus vaccines .
In 2009 , Moore @ @ @ @ @ @ @ sign up on Tennessee ’ s online registry and also made separate distribution arrangements with big pharmacy chains like CVS and Walgreens .
Back then , using pharmacies to administer vaccines was relatively uncommon , and most people still went to their doctors ’ office or state health department to get vaccinated .
“ But our experience of working with pharmacies was so great , and we realized how valuable it is for people to just be able to walk in without making an appointment , ” said Moore .
In the decade @ @ @ @ @ @ @ laws to make it easier for pharmacies to administer vaccines — something physician groups had long fought for territorial reasons .
“ We have more than 360,000 pharmacists who have completed training in vaccinations and immunizations across the lifespan and are ready to help when a coronavirus vaccine becomes available , ” said Mitch Rothholz , chief strategy officer from the American Pharmacists Association .
From an access point , pharmacies will surely play an important role in distributing any Covid-19 vaccine .
Nearly 95 percent of the U.S. population lives within 5 @ @ @ @ @ @ @ people feel more comfortable walking into one than setting up a doctor ’ s appointment .
Some states may also opt for a more centralized vaccine distribution system compared to what was used in Tennessee .
In 2009 , for example , Rhode Island set up H1N1 clinics at every public school , and Chicago had mass clinics at its six city colleges .
Dr. Bruce Y. Lee , a professor of health policy and management at the City University of New York who has studied vaccine supply chains said some states may @ @ @ @ @ @ @ get the vaccine out , like churches or Central Park .
“ You can start preparing now , ” said Lee .
“ You know where the population is and that some people will vary significantly in terms of how reachable they are.
” Immunization program managers began talking about these state distribution plans on a conference call last week , according to Claire Hannan , executive director of the Association of Immunization Managers .
“ We ’ re encouraging them to start looking into this , to determine what their coronavirus tracking @ @ @ @ @ @ @ begin reaching out to providers who will help administer the vaccine.
” reports emerged that President Donald Trump had offered a Germany-based biopharmaceutical company money to secure a Covid-19 vaccine that would be exclusively for the United States .
The U.S denied the reports , but senior German government officials confirmed them and stressed that any vaccine would be for the entire world , not for individual countries .
While the U.S. does have some domestic manufacturers , most giant pharmaceutical companies — with the real muscular production capacity — are multinational .
@ @ @ @ @ @ @ , how are those initial hundreds of thousands or millions of doses distributed ?
” asked Schwartz .
Past history doesn ’ t lend the most encouraging examples of equity , as rich countries have dominated the marketplace and most countries have prioritized national sovereignty over international fairness .
In 2009 , developed countries placed large advance orders on H1N1 vaccines and purchased nearly all the doses companies could produce , leaving low-income countries , including Mexico , in the lurch .
Under pressure , a group of at least nine countries offered @ @ @ @ @ @ @ doses to poorer nations , but some then backtracked when faced with unexpected shortages .
The U.S. , for example , pledged in September 2009 to donate 10 percent of its 195 million doses , but about five weeks later said it would wait until all at-risk Americans had access first .
“ Pandemics really call for global health solidarity , to determine where the outbreak is most active , and where those vaccine doses can do the most good and prevent the most suffering , ” said Schwartz .
“ But it @ @ @ @ @ @ @ This story was supported in partnership with the Open Markets Reporting Fund .

In 2016, after years of effort and millions of dollars in government investment, a team of Texas scientists finally developed a promising vaccine for SARS, the deadly strain of coronavirus that had infected over 8,000 people worldwide in the early 2000s. But the outbreak that triggered the research had begun and ended, and no one was contracting new cases of the disease anymore. Private industry and governments responded to the request to fund the human clinical trials with unanimity: not interested. And so the SARS vaccine was shelved. “If investments had been made previously, we potentially could have a [coronavirus] vaccine ready to go now,” lead scientist Dr. Peter Hotez told Congress earlier this month.
Scientists are now racing to develop a vaccine for Covid-19, the strain of coronavirus that has quickly upended the world. At least a dozen companies have joined the effort, from multinational giants like GlaxoSmithKline, Sanofi, and Johnson & Johnson, to smaller biotech firms like Inovio and Moderna. The latter became the first to give its working vaccine to a healthy adult last week, entering clinical trials with unprecedented speed. The public discourse has revolved mainly around how soon a vaccine could feasibly be ready (at least 18 months) and how much it would cost (unclear).
But if and when a vaccine candidate does get approval from the Food and Drug Administration — or even multiple get approved — then what? Will distributing a vaccine resemble the embarrassing efforts to distribute coronavirus tests? Does the government even have the capacity to manufacture a vaccine as quickly and widely as needed? Sen. Mitt Romney, R-Utah, asked this question in a coronavirus hearing on March 3, and the answers weren’t encouraging.
Dr. Robert Kadlec, the Health and Human Services assistant secretary for preparedness and response, testified that the U.S. lacks the capacity for manufacturing the kinds of Covid-19 vaccines the federal government is currently pursuing. “We’d have a longer than a six-month wait to basically produce vaccines on scale,” he told Romney.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases added that it will essentially come down to the pharmaceutical companies. “The federal government is not going to be able to make hundreds of millions of doses,” he said.
In some ways, we’ve been here before.
In October 2004, as Americans began gearing up for flu season, Britain announced that it would be suspending the license for Chiron Corporation, one of just two flu vaccine manufacturers for the United States. British regulators had found bacterial contamination in Chiron’s Liverpool factory, just as the U.S. had been waiting for it to ship 48 million doses over the Atlantic. In one fell swoop, America’s vaccine supply was cut nearly in half. Policymakers were left scrambling, but there was little they could do. The director of the Centers for Disease Control and Prevention apologized and said the scarce supply would be prioritized for those who were at a particularly high risk of getting sick.
What came next was vaccine price gouging, long waiting lines for the elderly and chronically ill, and threats by the government to jail or fine doctors who vaccinated those deemed not high-risk. Federal prosecutors launched an investigation into Chiron, and the shortage became a late-stage crisis for George W. Bush on the campaign trail.
Relying on just two companies to produce the seasonal flu vaccine had left the U.S particularly vulnerable. (Britain, by contrast, used five different suppliers.) And despite warnings for years about the dwindling number of U.S vaccine manufacturers, the federal government had done little to intervene. According to a report released by the Institute of Medicine, in 1973, 25 companies produced vaccines for the U.S, but three decades later just five remained. It was a classic market failure: Many drug companies had decided that vaccines were not profitable enough — they were too costly to develop and too underpriced to sell.
Following the colossal 2004 shortage and pressure resulting from SARS, the federal government vowed to take action. In December 2004, Congress approved $99 million for flu vaccine production and in 2005, Congress passed a law to provide vaccine manufacturers with immunity from tort lawsuits. By 2006, Congress passed the Pandemic and All Hazards Preparedness Act, which created the new assistant secretary for preparedness and response in HHS, the same role Kadlec has today. It also established the Biomedical Advanced Research Development Authority, which works with industry to develop so-called medical countermeasures against public health and bioterrorism threats.
“The Bush-era initiatives to improve vaccine availability and medical surge capacity domestically were good starts but underfunded, as are most public health initiatives,” said Dr. Adva Gadoth, an epidemiologist at UCLA Fielding School of Public Health.
The weaknesses were evident by 2009, the next time the U.S. grappled with an embarrassing vaccine shortage. H1N1 — also known as swine flu — emerged that spring in Mexico, and the U.S government promised a vaccine would be ready by October to blunt a second wave of infections.
But when October rolled around, U.S. health leaders were only then waking up to the fact that their expected supply was not on schedule to arrive. CDC officials hadn’t realized vaccine yields were lower than expected, because the tests used to measure those yields had also been delayed. The new machines that manufacturers installed to put the H1N1 vaccines into vials also ended up being glitchy, which caused more bottlenecks.
The rollout was complicated further by the fact that patients were asked to get both the H1N1 flu vaccine, on top of their seasonal flu vaccine, which weren’t ready at the same time. And when it became clear that the H1N1 shipments would be delayed, manufacturers halted producing the seasonal vaccine to help ramp up H1N1 production.
“Having two flu vaccines to receive was confusing enough to patients — usually there’s only one cocktail vaccine delivered per season — and staggered timing in their availability made things worse,” said Gadoth. “We ended up with a lot of lopsided protection: Those who visited their doctors early in the season and couldn’t return were only protected against seasonal flu, and those who visited once the H1N1 vaccine became available could no longer access the seasonal flu vaccine.”
One of the major lessons of the H1N1 shortage is to under-promise and over-deliver.
One of the major lessons of the H1N1 shortage, says Dr. William Schaffner, a professor of preventive medicine and infectious diseases at Vanderbilt’s School of Medicine, is to under-promise and over-deliver. “When the first batches of vaccine finally came off the line, the public health community was trying to communicate who should get it and where to go, but that message was completely drowned out because all the media focused on was that the vaccine was late,” he said. “It undercut the whole introduction and confidence in the government response.”
In August 2010, prompted by the vaccine problems from H1N1, President Barack Obama’s team of science advisers released a report outlining ways the government could speed up production in the future. This had come a year after Sen. Susan Collins, R-Maine, successfully stripped $870 million in flu pandemic preparation money out of the 2009 stimulus. The administration recommended spending roughly $1 billion per year for the next several years to implement its ideas, which included developing faster potency tests and better machines to do vial-filling. This joined a separate 2010 HHS review, which had concluded that the U.S. “lacks the domestic manufacturing capacity to rapidly produce and package a vaccine for the American public in the face of a pandemic.”
But many of those Obama-era proposals were never fully executed, and four new vaccine manufacturing sites the federal government did invest in beginning in 2012 have barely been utilized to respond to Covid-19. The Washington Post reported recently that two of the four sites are currently taking no role in developing a vaccine, and the other two only have plans to conduct “small-scale” testing.
The U.S. government has been relatively successful though in attracting more private vaccine manufacturers, through a combination of financial incentives and accelerated pathways to approval. “We tried to entice manufacturers who might have additional capacity that were manufacturing for other parts of the world, and we tried to make it easier for them to get FDA approval,” said Jesse Goodman, who served as FDA’s chief scientist between 2009 and 2014 and led the Obama administration’s H1N1 response.
In 2005, only three of the top 10 pharmaceutical companies had significant investments in vaccines. But by 2012, that was up to eight out of 10, including players like Pfizer and Johnson & Johnson. Companies began realizing they could bring more expensive vaccines to market faster.
Dr. Ken Kaitin, director of the Tufts Center for the Study of Drug Development, said the increase in companies focused on vaccines was partly driven by the growth of immuno-oncology drugs, which target a patient’s immune system to fight cancer. “Those drugs stimulated broader interest among firms in the immune system, and scientists realized there were other diseases they could focus on using similar techniques,” he said. The Human Genome Project, which was finished in 2003, also spurred new interest. “That increased our understanding of disease and allowed scientists to search for vaccines in areas that previously seemed intractable,” Kaitin said.
Yet more pharmaceutical companies being interested in vaccines is no guarantee that a Covid-19 vaccine would be affordable, as vaccine prices have soared over the years. While Democratic politicians are sounding the alarm, saying that any coronavirus vaccine should be free or very affordable, pharmaceutical execs have already been questioning that.
“Nobody is going to embark as a large company if there is not a certain return that you can get for your investment and the risks you have been taking,” said David Loew, an executive vice president at Sanofi, in an interview with Financial Times last week.
And given how little we currently know about Covid-19, if the outbreak peaks and panic wanes, investors and the government could lose interest in funding further stages of Covid-19 clinical trials, just as they did for SARS in 2016.
“We’re still very, very reactive when it comes to what we pour research dollars into and sustain,” said Dr. Jason Schwartz, a professor at the Yale School of Public Health who studies vaccine development. “When the immediate need dissipates, those research efforts can drop off quickly.”
A woman receives a flu shot at a pharmacy in Brooklyn, New York, on Jan. 19, 2016. Photo: Nicole Craine/The New York Times via Redux
Assuming that Covid-19 continues to spread, research dollars don’t disappear, and a vaccine or two or three is eventually approved, there are some things we can expect now about how that delivery process will play out.
One is that no matter how many pharmaceutical companies work to produce the coronavirus vaccine, and even if the federal government’s four manufacturing sites do end up assisting with production, there simply will not be as many doses as needed in the beginning. The vaccine will come in waves, in a series of shipments.
“Leaders will have to decide who gets it first, and where to send it, and whoever does that should do it very transparently,” said Schaffner.
While the federal government will likely set broad guidelines and principles, each state will be tasked with designing their own vaccine distribution system, a process spearheaded by the directors of immunization who work in each state’s health department.
Dr. Kelly Moore was working as Tennessee’s director of immunization during the H1N1 outbreak, a role she was particularly well suited for after having served for years as her state’s pandemic influenza planning coordinator.
The first step for vaccine distribution in an emergency, Moore said, is figuring out which medical providers will give it — including who wants to give it and who has clinics equipped to store it.
“Any vaccine that comes out for Covid-19 I anticipate will be distributed through existing federal vaccine distribution channels, namely the Vaccines for Children program,” Moore said. The Vaccines for Children program, administered by every state, provides federally funded vaccines to volunteer clinics to give to basically any child who doesn’t have private health insurance. “In an emergency we’d much rather build off what already exists than create something from scratch, and all states already manage partnerships with private clinics, health departments, and hospitals to give vaccines to children, so they’re already used to the ordering and the distribution,” she explained.
Each provider that participates in VFC typically orders vaccine doses through an online portal managed by their state, and Moore said it would not be difficult to add coronavirus vaccines to those portals.
But since right now only clinics that serve children are part of the VFC system, each state would need to enroll more adult providers and pharmacies that might be able to help administer coronavirus vaccines. In 2009, Moore had invited interested H1N1 vaccine providers to sign up on Tennessee’s online registry and also made separate distribution arrangements with big pharmacy chains like CVS and Walgreens.
Back then, using pharmacies to administer vaccines was relatively uncommon, and most people still went to their doctors’ office or state health department to get vaccinated. “But our experience of working with pharmacies was so great, and we realized how valuable it is for people to just be able to walk in without making an appointment,” said Moore.
From an access point, pharmacies will surely play an important role in distributing any Covid-19 vaccine.
In the decade since, most states have passed new laws to make it easier for pharmacies to administer vaccines — something physician groups had long fought for territorial reasons. “We have more than 360,000 pharmacists who have completed training in vaccinations and immunizations across the lifespan and are ready to help when a coronavirus vaccine becomes available,” said Mitch Rothholz, chief strategy officer from the American Pharmacists Association.
From an access point, pharmacies will surely play an important role in distributing any Covid-19 vaccine. Nearly 95 percent of the U.S. population lives within 5 miles of a pharmacy, and many people feel more comfortable walking into one than setting up a doctor’s appointment.
Some states may also opt for a more centralized vaccine distribution system compared to what was used in Tennessee. In 2009, for example, Rhode Island set up H1N1 clinics at every public school, and Chicago had mass clinics at its six city colleges. Dr. Bruce Y. Lee, a professor of health policy and management at the City University of New York who has studied vaccine supply chains said some states may decide that they need bigger channels to get the vaccine out, like churches or Central Park. “You can start preparing now,” said Lee. “You know where the population is and that some people will vary significantly in terms of how reachable they are.”
Immunization program managers began talking about these state distribution plans on a conference call last week, according to Claire Hannan, executive director of the Association of Immunization Managers. “We’re encouraging them to start looking into this, to determine what their coronavirus tracking system will look like, and to begin reaching out to providers who will help administer the vaccine.”
Earlier this month, reports emerged that President Donald Trump had offered a Germany-based biopharmaceutical company money to secure a Covid-19 vaccine that would be exclusively for the United States. The U.S denied the reports, but senior German government officials confirmed them and stressed that any vaccine would be for the entire world, not for individual countries.
While the U.S. does have some domestic manufacturers, most giant pharmaceutical companies — with the real muscular production capacity — are multinational. “If we need a large-scale rollout, how are those initial hundreds of thousands or millions of doses distributed?” asked Schwartz.
Past history doesn’t lend the most encouraging examples of equity, as rich countries have dominated the marketplace and most countries have prioritized national sovereignty over international fairness. In 2009, developed countries placed large advance orders on H1N1 vaccines and purchased nearly all the doses companies could produce, leaving low-income countries, including Mexico, in the lurch. Under pressure, a group of at least nine countries offered to donate a percentage of their H1N1 doses to poorer nations, but some then backtracked when faced with unexpected shortages. The U.S., for example, pledged in September 2009 to donate 10 percent of its 195 million doses, but about five weeks later said it would wait until all at-risk Americans had access first.
“Pandemics really call for global health solidarity, to determine where the outbreak is most active, and where those vaccine doses can do the most good and prevent the most suffering,” said Schwartz. “But it could be every country for itself.”
This story was supported in partnership with the Open Markets Reporting Fund.


theintercept--2020-03-26--In West African Coronavirus Hotspot, War Has Left 700,000 Homeless and Exposed

Burkina Faso suffered the first confirmed Covid-19 fatality in all of sub-Saharan Africa .
The victim was Rose-Marie Compaoré , the first vice president of the Sahelian nation ’ s parliament .
Tiny , impoverished , and conflict-scarred , Burkina Faso is now West Africa ’ s worst-affected country , with 146 confirmed cases , including four government ministers .
The U.S. ambassador to Burkina Faso , Andrew Young , has also tested positive for the disease .
Burkina Faso has seen more than its share of hardships : poverty , drought , hunger , coups .
But the coronavirus @ @ @ @ @ @ @ a country wracked by a war that has displaced around 700,000 Burkinabe in the last year .
Many of those people now find themselves under great physical and emotional strain , lacking proper shelter , food , and the other necessities — all of which makes them more vulnerable to the pandemic .
Experts fear that Covid-19 could decimate entire settlements of Burkina Faso ’ s displaced , and they are bracing for devastating outbreaks in conflict zones , refugee camps , and the poorest countries in the developing world .
Globally , @ @ @ @ @ @ @ , or IDPs , living in cramped , squalid conditions find themselves at risk .
“ When the virus hits overcrowded settlements in places like Iran , Bangladesh , Afghanistan , and Greece , the consequences will be devastating , ” warned Jan Egeland , secretary general of the Norwegian Refugee Council , a leading humanitarian relief agency , in a recent statement about the dangers caused by Covid-19 .
He also spoke of “ carnage when the virus reaches parts of Syria , Yemen , and Venezuela where hospitals have been demolished @ @ @ @ @ @ @ the U.S. government and the media coverage have focused on individual vulnerabilities , like age and preexisting medical conditions , Jerry-Jonas Mbasha , the health cluster coordinator for the World Health Organization in Burkina Faso , also stressed the dangers of social vulnerabilities and the fact that the social status of IDPs makes them especially susceptible to the disease because they have limited access to basic social services , health care , safe water , sanitation , and hygiene .
A failure to fully address these issues , he told The Intercept , @ @ @ @ @ @ @ I have no reason to believe Moumoumi Sawadogo had Covid-19 when I met him eight weeks ago in Burkina Faso .
After living 89 years in an arid , impoverished land on the fringe of the Sahara Desert , surviving a massacre , walking for a week and enduring hunger and homelessness , it was clear that Sawadogo was a survivor .
But Covid-19 posed a different kind of danger .
“ These populations are already very vulnerable to diseases that are otherwise easy to treat .
But that ’ s not the @ @ @ @ @ @ @ water or proper sanitation or health care , ” Alexandra Lamarche , senior advocate for West and Central Africa at Refugees International , told The Intercept .
“ We could watch entire populations vanish.
” In late January , Sawadogo was driven from his village , Rofenega , by jihadi militants .
For the next week , he shuffled along with a walking stick through wind-whipped scrubland .
He now lives in Kaya , a market town bulging with tens of thousands of displaced victims of terrorist violence who are scraping by without @ @ @ @ @ @ @ care .
The town is at serious risk for an outbreak of Covid-19 , which spreads rapidly and , according to a WHO study in China , can kill close to 22 percent of infected people in Sawadogo ’ s age range .
Rofenega is just one of scores of villages emptied by attacks from groups including the Al Qaeda-linked Jama ’ at Nusrat al-Islam wal Muslimin ( better known by its acronym JNIM ) and the Islamic State in the Greater Sahara .
Over the last five years , militant Islamist violence @ @ @ @ @ @ @ jihadi attacks in 2015 to 450 in 2019 , according to Héni Nsaibia , a senior researcher for the Armed Conflict Location and Event Data Project .
The violence has worsened living conditions in Burkina Faso , which is home to just under 21 million people , more than 1 million of whom are food insecure ; nearly 2 million are now in desperate need of water , sanitation , and hygiene support , and 2.2 million require humanitarian assistance .
The number of IDPs , which stood at just 60,000 at the @ @ @ @ @ @ @ 1 million , and most who have fled are living in host communities , like Kaya , where more than half the displaced population is homeless or lacks adequate shelter .
“ Refugees and migrants , as well as urban poor communities who live in highly dense populations , are particularly vulnerable to respiratory infections , including Covid-19 , ” said Dr. Margaret Harris , a WHO spokesperson .
The U.N .
Refugee Agency is pressing governments to include displaced populations in their Covid-19 response plans , Romain Desclous , the agency ’ @ @ @ @ @ @ @ Africa , told The Intercept .
“ Everyone — including refugees , asylum-seekers , and IDPs — should be able to access health facilities and services , ” he said .
While Burkina Faso has recently adopted a Covid-19 response plan that takes IDPs into account , it doesn ’ t change the fact that 135 health centers in the country have closed due to violence , 140 have reduced their services , and 1.5 million Burkinabe now depend on humanitarian health assistance .
Covid-19 will exacerbate an already dire situation .
“ @ @ @ @ @ @ @ to access government health centers when they ’ re displaced , and that ’ s going to affect the situation if the virus begins to spread , ” Lamarche told The Intercept .
“ The prospects are incredibly grim because there isn ’ t enough infrastructure or a strong enough health system — whether government or humanitarian-led — to detect and treat these cases.
” Meanwhile , the burden on the remaining medical facilities continues to grow as attacks make access more difficult and concentrate IDPs in already overburdened towns .
Sawadogo remembers @ @ @ @ @ @ @ blur punctuated by gunfire .
The long-legged octogenarian with rheumy eyes and a white beard seemed dazed by the violence that had left him homeless and destitute .
“ I ’ ve never seen a situation like this in my life , ” he told me as he sat on a woven mat along the side of a road in 90-degree heat .
Other survivors of the attack on Rofenega recounted a story that is increasingly common among farmers and cattle herders in rural Burkina Faso .
Armed men on motorbikes roared into @ @ @ @ @ @ @ .
“ They shot our men at the gates of our homes , ” Dialla Seybata , a 50-year-old survivor of the massacre , also stranded in Kaya , told The Intercept .
The militants killed 15 people in Rofenega , Seybata said , including her husband , a son , and two other relatives .
“ We ran .
We couldn ’ t even bury the bodies .
We — 20 women and children together — walked for 8 kilometers to get here.
” It took Sawadogo nearly seven days to cover @ @ @ @ @ @ @ to walk even a short distance without difficulty , he was forced to travel alone after the rest of his family fled in a different direction .
Carrying only a walking stick polished smooth by years of use and a well-worn blanket , Sawadogo hobbled along the dusty roadside almost the entire 8 kilometers from Rofenega to Kaya , finally catching a ride on a donkey cart for the last leg of the trip .
Along the way , he spent all his money on food and had to beg to avoid going @ @ @ @ @ @ @ a distant relative had just agreed to take him in , even though it meant that Sawadogo would now be one of the many displaced in a home overflowing with people , including several other relatives also recently made homeless by violence .
While Sawadogo was grateful to have a roof over his head , such living situations are considered particularly dangerous in the age of Covid-19 .
“ You have entire families , or multiple families , or families with multiple wives and a massive brood of children , staying in poorly @ @ @ @ @ @ @ coronavirus is likely to spread very rapidly , ” said Lamarche .
Mbasha , the WHO coordinator , echoed these warnings , noting that the disease taking hold in IDP camps would lead to a crisis like that in China or Italy , two countries that have suffered some of the most Covid-19 deaths .
If humanitarian aid and the response to the pandemic isn ’ t swift , it could result in a “ very big failure to control the spread of the disease , ” he told The Intercept .
There @ @ @ @ @ @ @ which to act , he said .
“ That time is now and not tomorrow.
” Nick Turse is a reporter with Type Investigations .
This article was reported in partnership with Brown University ’ s Costs of War Project .

On March 18, Burkina Faso suffered the first confirmed Covid-19 fatality in all of sub-Saharan Africa. The victim was Rose-Marie Compaoré, the first vice president of the Sahelian nation’s parliament.
Tiny, impoverished, and conflict-scarred, Burkina Faso is now West Africa’s worst-affected country, with 146 confirmed cases, including four government ministers. The U.S. ambassador to Burkina Faso, Andrew Young, has also tested positive for the disease.
Burkina Faso has seen more than its share of hardships: poverty, drought, hunger, coups. But the coronavirus poses a new kind of threat to a country wracked by a war that has displaced around 700,000 Burkinabe in the last year. Many of those people now find themselves under great physical and emotional strain, lacking proper shelter, food, and the other necessities — all of which makes them more vulnerable to the pandemic. Experts fear that Covid-19 could decimate entire settlements of Burkina Faso’s displaced, and they are bracing for devastating outbreaks in conflict zones, refugee camps, and the poorest countries in the developing world.
Globally, millions of refugees and internally displaced persons, or IDPs, living in cramped, squalid conditions find themselves at risk. “When the virus hits overcrowded settlements in places like Iran, Bangladesh, Afghanistan, and Greece, the consequences will be devastating,” warned Jan Egeland, secretary general of the Norwegian Refugee Council, a leading humanitarian relief agency, in a recent statement about the dangers caused by Covid-19. He also spoke of “carnage when the virus reaches parts of Syria, Yemen, and Venezuela where hospitals have been demolished and health systems have collapsed.”
While the U.S. government and the media coverage have focused on individual vulnerabilities, like age and preexisting medical conditions, Jerry-Jonas Mbasha, the health cluster coordinator for the World Health Organization in Burkina Faso, also stressed the dangers of social vulnerabilities and the fact that the social status of IDPs makes them especially susceptible to the disease because they have limited access to basic social services, health care, safe water, sanitation, and hygiene. A failure to fully address these issues, he told The Intercept, would lead to high death rates.
Read Our Complete Coverage The Coronavirus Crisis
I have no reason to believe Moumoumi Sawadogo had Covid-19 when I met him eight weeks ago in Burkina Faso. After living 89 years in an arid, impoverished land on the fringe of the Sahara Desert, surviving a massacre, walking for a week and enduring hunger and homelessness, it was clear that Sawadogo was a survivor. But Covid-19 posed a different kind of danger.
“These populations are already very vulnerable to diseases that are otherwise easy to treat. But that’s not the case when they have no access to water or proper sanitation or health care,” Alexandra Lamarche, senior advocate for West and Central Africa at Refugees International, told The Intercept. “We could watch entire populations vanish.”
In late January, Sawadogo was driven from his village, Rofenega, by jihadi militants. For the next week, he shuffled along with a walking stick through wind-whipped scrubland. He now lives in Kaya, a market town bulging with tens of thousands of displaced victims of terrorist violence who are scraping by without adequate food, shelter, or medical care. The town is at serious risk for an outbreak of Covid-19, which spreads rapidly and, according to a WHO study in China, can kill close to 22 percent of infected people in Sawadogo’s age range.
Rofenega is just one of scores of villages emptied by attacks from groups including the Al Qaeda-linked Jama’at Nusrat al-Islam wal Muslimin (better known by its acronym JNIM) and the Islamic State in the Greater Sahara. Over the last five years, militant Islamist violence in Burkina Faso has skyrocketed from four jihadi attacks in 2015 to 450 in 2019, according to Héni Nsaibia, a senior researcher for the Armed Conflict Location and Event Data Project.
The violence has worsened living conditions in Burkina Faso, which is home to just under 21 million people, more than 1 million of whom are food insecure; nearly 2 million are now in desperate need of water, sanitation, and hygiene support, and 2.2 million require humanitarian assistance. The number of IDPs, which stood at just 60,000 at the beginning of 2019, will soon reach 1 million, and most who have fled are living in host communities, like Kaya, where more than half the displaced population is homeless or lacks adequate shelter. “Refugees and migrants, as well as urban poor communities who live in highly dense populations, are particularly vulnerable to respiratory infections, including Covid-19,” said Dr. Margaret Harris, a WHO spokesperson.
The U.N. Refugee Agency is pressing governments to include displaced populations in their Covid-19 response plans, Romain Desclous, the agency’s regional spokesperson for West and Central Africa, told The Intercept. “Everyone — including refugees, asylum-seekers, and IDPs — should be able to access health facilities and services,” he said. While Burkina Faso has recently adopted a Covid-19 response plan that takes IDPs into account, it doesn’t change the fact that 135 health centers in the country have closed due to violence, 140 have reduced their services, and 1.5 million Burkinabe now depend on humanitarian health assistance. Covid-19 will exacerbate an already dire situation.
“In Burkina Faso, people already struggle to access government health centers when they’re displaced, and that’s going to affect the situation if the virus begins to spread,” Lamarche told The Intercept. “The prospects are incredibly grim because there isn’t enough infrastructure or a strong enough health system — whether government or humanitarian-led — to detect and treat these cases.” Meanwhile, the burden on the remaining medical facilities continues to grow as attacks make access more difficult and concentrate IDPs in already overburdened towns.
“People already struggle to access government health centers when they’re displaced, and that’s going to affect the situation if the virus begins to spread.”
Sawadogo remembers the raid on Rofenega as a chaotic blur punctuated by gunfire. The long-legged octogenarian with rheumy eyes and a white beard seemed dazed by the violence that had left him homeless and destitute. “I’ve never seen a situation like this in my life,” he told me as he sat on a woven mat along the side of a road in 90-degree heat.
Other survivors of the attack on Rofenega recounted a story that is increasingly common among farmers and cattle herders in rural Burkina Faso. Armed men on motorbikes roared into villages just before dusk and begin shooting. “They shot our men at the gates of our homes,” Dialla Seybata, a 50-year-old survivor of the massacre, also stranded in Kaya, told The Intercept. The militants killed 15 people in Rofenega, Seybata said, including her husband, a son, and two other relatives. “We ran. We couldn’t even bury the bodies. We — 20 women and children together — walked for 8 kilometers to get here.”
It took Sawadogo nearly seven days to cover that same distance. Frail and unable to walk even a short distance without difficulty, he was forced to travel alone after the rest of his family fled in a different direction. Carrying only a walking stick polished smooth by years of use and a well-worn blanket, Sawadogo hobbled along the dusty roadside almost the entire 8 kilometers from Rofenega to Kaya, finally catching a ride on a donkey cart for the last leg of the trip. Along the way, he spent all his money on food and had to beg to avoid going hungry. When I met him, a distant relative had just agreed to take him in, even though it meant that Sawadogo would now be one of the many displaced in a home overflowing with people, including several other relatives also recently made homeless by violence.
While Sawadogo was grateful to have a roof over his head, such living situations are considered particularly dangerous in the age of Covid-19. “You have entire families, or multiple families, or families with multiple wives and a massive brood of children, staying in poorly built shelters, and that means that coronavirus is likely to spread very rapidly,” said Lamarche.
Mbasha, the WHO coordinator, echoed these warnings, noting that the disease taking hold in IDP camps would lead to a crisis like that in China or Italy, two countries that have suffered some of the most Covid-19 deaths. If humanitarian aid and the response to the pandemic isn’t swift, it could result in a “very big failure to control the spread of the disease,” he told The Intercept. There is only a very short window in which to act, he said. “That time is now and not tomorrow.”
Nick Turse is a reporter with Type Investigations. This article was reported in partnership with Brown University’s Costs of War Project.


theintercept--2020-03-26--Charles Koch Network Pushed $1 Billion Cut to CDC, Now Attacks Shelter-in-Place Policies for Harming

Charles Koch Network Pushed $1 Billion Cut to CDC, Now Attacks Shelter-in-Place Policies for Harming Business

, the pro-corporate pressure group founded and funded by billionaire industrialist Charles Koch , wants employees to return to work despite desperate pleas from public health officials that people should stay home as much as possible to help contain the spread of the coronavirus .
As states began to order nonessential businesses to shut down last week , AFP released a statement calling for all businesses to remain open .
“ Rather than blanket shutdowns , the government should allow businesses to continue to adapt and innovate to produce the goods and services Americans need , while continuing to do @ @ @ @ @ @ @ health , ” said Emily Seidel , chief executive of AFP , in a press release .
Some of the group ’ s state chapters have taken a similar tone .
AFP Pennsylvania ’ s state director , as well as a regional director with the group , have taken to Twitter to lambast shelter-in-place policies .
The Michigan chapter of AFP on Monday slammed Democratic Gov .
Gretchen Whitmer ’ s stay-at-home order , which closed down fitness centers , nail salons , amusement parks , casinos , and other businesses deemed @ @ @ @ @ @ @ approach for our state.
” Whitmer ’ s order , variations of which are being implemented by state and local governments nationwide , contains exceptions for critical industries such as grocery stores , pharmacies , health care providers , financial services , transportation , child care , hazardous materials , and energy .
“ All businesses are essential — to the people who own them , the people who work in them , and the communities they serve , ” said Annie Patnaude , the Michigan state director for AFP , in a @ @ @ @ @ @ @ ’ s position , which directly contradicts the advice of medical experts who say that social isolation is essential to curbing the spread of the coronavirus , comes after the group lobbied the Trump administration in 2018 to rescind $ 1 billion from the Centers for Disease Control and Prevention .
Much of AFP ’ s recommended cuts to government programs , which included CDC money for infectious disease control and global health , became part of the official White House budget request , though most were not adopted by Congress .
The @ @ @ @ @ @ @ relieve the burden overspending is placing on all taxpayers.
” The CDC is now one of the front-line organizations dealing with the coronavirus pandemic , which has impacted nearly 70,000 people in the United States and has claimed over 1,000 lives .
The libertarian advocacy network has spent tens of millions of dollars lobbying for corporate tax cuts , deregulation , and reductions to social welfare programs , particularly state Medicaid programs .
This aggressive advocacy record has come into focus in recent days as Americans confront the coronavirus pandemic .
Medicaid funding @ @ @ @ @ @ @ treating sick patients , and many are now questioning the wisdom of reductions to the CDC ’ s funding and staff .
from AFP reveal the size and scope of the organization , which employed 650 staff members during the 2016 election and has successfully worked to block Medicaid expansion in at least four states .
During the 2016 election , the group also aired sharply criticizing Hillary Clinton and Senate Democrats , an electioneering push that dramatically shaped the current balance of power in Washington , D.C .
The group has since @ @ @ @ @ @ @ , retreat from the Paris Climate Accord , and demand cuts to federal programs .
It also $ 1.5 trillion in tax cuts as part of President Donald Trump ’ s 2017 tax overhaul .
Experts around the country have for shelter-in-place policies for nonessential businesses , arguing that social isolation can drastically curb the spread of the coronavirus .
Slowing the pandemic , they say , can save lives by lowering the demand for medical supplies and limited hospital beds .
Despite their medical necessity , these policies are being rejected by @ @ @ @ @ @ @ leaders , including Mississippi Gov .
Tate Reeves and Florida Gov .
Ron DeSantis , have balked at shutdown requests .
On Tuesday , Reeves Dr. Anthony Fauci , the federal government ’ s top infectious disease expert and a member of the White House coronavirus task force , he has “ emphasized very emphatically ” that bars , restaurants , and other nonessential businesses close and that those who may work from home do so .
The Intercept asked AFP if the group had consulted any public health officials before beginning the @ @ @ @ @ @ @ the group continues to support steep cuts to the CDC .
The group did not respond to the inquiry regarding the CDC and did not name any public health experts .
A spokesperson for AFP noted in an email that they are “ encouraging every public official dealing with these incredible challenges to consider how communities and businesses are adapting to meet critical needs as they make these difficult decisions ” and that the group believes that there is “ value in businesses and government working together to stop the spread of this @ @ @ @ @ @ @ it.
” The Koch network , while pushing for businesses to stay open , is taking the opposite approach for its lobbying apparatus .
AFP and its affiliates , including LIBRE Initiative and Concerned Veterans for America , are now working from home .
“ Out of an abundance of caution and to ensure the health and safety of our activists , staff , and voters , our staff are working from home and are utilizing digital organizing as one way to continue their grassroots engagement , ” a spokesperson from AFP told @

Americans for Prosperity , the pro-corporate pressure group founded and funded by billionaire industrialist Charles Koch, wants employees to return to work despite desperate pleas from public health officials that people should stay home as much as possible to help contain the spread of the coronavirus.
As states began to order nonessential businesses to shut down last week, AFP released a statement calling for all businesses to remain open.
“Rather than blanket shutdowns, the government should allow businesses to continue to adapt and innovate to produce the goods and services Americans need, while continuing to do everything they can to protect the public health,” said Emily Seidel, chief executive of AFP, in a press release.
Join Our Newsletter Original reporting. Fearless journalism. Delivered to you. I'm in
Some of the group’s state chapters have taken a similar tone. AFP Pennsylvania’s state director, as well as a regional director with the group, have taken to Twitter to lambast shelter-in-place policies. The Michigan chapter of AFP on Monday slammed Democratic Gov. Gretchen Whitmer’s stay-at-home order, which closed down fitness centers, nail salons, amusement parks, casinos, and other businesses deemed nonessential, calling it the “wrong approach for our state.”
Whitmer’s order, variations of which are being implemented by state and local governments nationwide, contains exceptions for critical industries such as grocery stores, pharmacies, health care providers, financial services, transportation, child care, hazardous materials, and energy.
“All businesses are essential — to the people who own them, the people who work in them, and the communities they serve,” said Annie Patnaude, the Michigan state director for AFP, in a statement responding to the order.
If you are wondering where #DonaldTrump got the idea to end the #CoronavirusPandemic quarantines, stay at home orders. It came from the #KochNetwork These are 2 staffers of the network agitating for businesses to reopen.
They will be safe working at home. pic.twitter.com/CVXjhCKVrz — Laura Goldman (@laurasgoldman) March 23, 2020
AFP’s position, which directly contradicts the advice of medical experts who say that social isolation is essential to curbing the spread of the coronavirus, comes after the group lobbied the Trump administration in 2018 to rescind $1 billion from the Centers for Disease Control and Prevention.
Much of AFP’s recommended cuts to government programs, which included CDC money for infectious disease control and global health, became part of the official White House budget request, though most were not adopted by Congress.
The cuts, AFP argued, would “relieve the burden overspending is placing on all taxpayers.” The CDC is now one of the front-line organizations dealing with the coronavirus pandemic, which has impacted nearly 70,000 people in the United States and has claimed over 1,000 lives.
The libertarian advocacy network has spent tens of millions of dollars lobbying for corporate tax cuts, deregulation, and reductions to social welfare programs, particularly state Medicaid programs. This aggressive advocacy record has come into focus in recent days as Americans confront the coronavirus pandemic. Medicaid funding is seen as a critical tool for treating sick patients, and many are now questioning the wisdom of reductions to the CDC’s funding and staff.
Read Our Complete Coverage The Coronavirus Crisis
Internal memos from AFP reveal the size and scope of the organization, which employed 650 staff members during the 2016 election and has successfully worked to block Medicaid expansion in at least four states. During the 2016 election, the group also aired negative advertising sharply criticizing Hillary Clinton and Senate Democrats, an electioneering push that dramatically shaped the current balance of power in Washington, D.C.
The group has since used its government influence to slash environmental rules, retreat from the Paris Climate Accord, and demand cuts to federal programs. It also helped secure $1.5 trillion in tax cuts as part of President Donald Trump’s 2017 tax overhaul.
Experts around the country have called for shelter-in-place policies for nonessential businesses, arguing that social isolation can drastically curb the spread of the coronavirus. Slowing the pandemic, they say, can save lives by lowering the demand for medical supplies and limited hospital beds. Despite their medical necessity, these policies are being rejected by conservatives around the country. Republican state leaders, including Mississippi Gov. Tate Reeves and Florida Gov. Ron DeSantis, have balked at shutdown requests. On Tuesday, Reeves signed an executive order superseding local bans on public gatherings.
Dr. Anthony Fauci, the federal government’s top infectious disease expert and a member of the White House coronavirus task force, has said he has “emphasized very emphatically” that bars, restaurants, and other nonessential businesses close and that those who may work from home do so.
The Intercept asked AFP if the group had consulted any public health officials before beginning the push against shelter-in-place policies, and whether the group continues to support steep cuts to the CDC.
The group did not respond to the inquiry regarding the CDC and did not name any public health experts.
A spokesperson for AFP noted in an email that they are “encouraging every public official dealing with these incredible challenges to consider how communities and businesses are adapting to meet critical needs as they make these difficult decisions” and that the group believes that there is “value in businesses and government working together to stop the spread of this virus and help the people who need it.”