With half of a terrible ’20 now done, can federal torpor on pandemic change?

The nation shudders into the second half of 2020, months deep into an unchecked Covid-19 pandemic that has infected 2.8 million Americans and killed roughly 130,000 of us.

America has become the coronavirus’s outbreak epicenter, its would-be travelers shunned by leading nations around the world as too risky to allow without quarantines or outright bans.

Five states set new infection records, and 40 of the 50 states report worrisome spikes in detected coronavirus cases (see New York Times graphic, above, of newly reported U.S. Covid-19 cases).

Although some reckless optimists find solace in a slightly dipping Covid-19 fatality curve, death persists as the disease’s U.S. calling card:

• Congressional Democrats’ say their research finds at least 7,000 patient deaths in assisted living facilities — separate and atop the 50,000 or so lives lost in nursing home infections. The new death toll may be much higher and the situation in the facilities far worse because assisted living centers, unlike nursing homes, are not subject to federal oversight, including now required reporting of Covid-19 infections and deaths among residents and staff, the members of Congress say. “We are simply not doing enough to protect our seniors or workers in assisted living homes from this deadly virus,” U.S. Senator Ed Markey (D-Mass.), said of the findings put out by his office and by his colleague U.S. Senator Elizabeth Warren, and U.S. Rep. Carolyn Maloney (D-NY).
• The Washington Post reported that expert analyses detect the likelihood “thousands more deaths than would have been expected from heart disease and a handful of other medical conditions.” These “excess deaths” are tied to the pandemic but may not be recorded in its toll. As the newspaper noted: “While several experts said some of the excess deaths in the analysis were almost certainly unrecognized fatalities from Covid-19, the review suggests that many patients suffering from serious conditions died as a result of delaying or not seeking care as the outbreak progressed and swamped some hospitals.”

President Trump, golfing, Tweeting, and focusing on his re-election campaign, keeps steering his administration far from important federal leadership in a pandemic response. Instead, the reported reset of the official administration stance will revolve around this concept of how Americans should view the coronavirus, the economic collapse it has caused, including record joblessness, and the disease’s death and infections: Live with it.

The shifting and shambolic federal inaction, however, leaves Americans in the throes of an unprecedented uncertainty. It is taking a visible toll on how they live and their frightened efforts to restore normality. Without leadership from the top:

• Families are stuck and growing angry, frustrated, and disconsolate as educators try to weigh health concerns to determine whether to reopen nursery, elementary, middle, and high schools, and colleges and universities. Working parents, even as many say they feel fortunate that they can keep their jobs through remote labor, are melting down without desperately needed childcare. Concerns grow by the instant, including by respected groups like the pediatricians’ academy, about the harms to the nation’s young by school closures and the inequitable and less effective education offered, so far, online. Yes, medical scientists learn more by the day about Covid-19 and alter their guidance accordingly, including about the coronavirus risks to the young, teens and children But pray tell, what would the public say has been the out front work of the president’s Education Secretary in getting parents, teachers, and institutions together to deal with worries and determine a path forward?
• Airlines and others in the travel industry continue to bleat about their beleaguered finances, need for federal assistance, and their difficult path to getting their business back. But absent a strong federal presence, news reporting has made clear that individual airlines are setting health and safety standards for their passengers. Some airlines insist their cleaning and existing systems mean that packed jets are just fine, while others have reduced loads and kept middle seats open to expand travelers’ distance between each other. Airlines, which are suspending the rare services they had offered like onboard food, insist that passengers keep their faces covered. But is this putting the enforcement burden on already over-worked and harried flight crews? How are they supposed to handle infractions en route? And, by the way, individual airports also were setting their own health rules, too, including with dubious measures like passenger temperature checks. Federal officials just before the July 4^th holiday issued a national guidance. Meantime, railroads, buses, and mass transit systems not only are determining their own safety standards, many are slashing routes and services citing coronavirus exigencies. Will these return ever, or will distant and undeserved areas find vital ways of transportation were yet another Covid-19 victim? Where, pray tell, is the president’s Transportation Secretary, leading, coordinating, cajoling, and supporting businesses, travelers, and commuters?
• Federal prisoners have been slammed by coronavirus infections, which are raging in prisons from coast to coast. Sure, inmates committed crimes and society has doled them out punishments. Those did not include for most the risk of sustained debilitation or death. Incarceration also is a burgeoning industry in this nation like no other. Which means that sickness and death among the imprisoned puts at risk significant numbers of others — notably guards and administrators who go in and out of facilities, moving around in their off work time in communities and putting others at heightened risk. Extra points for taxpayers who can point to leadership by the Attorney General or any others in the federal government for great leadership in dealing with this major coronavirus nightmare.
• Athletes — prep, collegiate, and pro — as well as artists and entertainers have seen their livelihoods walloped by the coronavirus. So, too, has the struggle been great for museums, symphony orchestras, as well as the food and restaurant industry. The individuals in these pursuits and their enterprises hold a unique spot in American life, adding in big ways not only to public diversion but also huge sums in economic activity. Besides an occasional gathering of fast-food CEOs and others in that trade, what leadership at the top has the public seen with national pasttimes? It makes some sense to leave many health concerns with public gatherings, hygiene, and other such measures to states, counties, cities, and other local jurisdictions. But Vice President Pence could spend tens of thousands of taxpayer dollars on a sham counter-protest at an NFL game but how has the coronavirus task force he leads been out and up front with guidance for sports, arts and cultural institutions, and to deal with food insecurity? Heard a lot from the Agriculture Secretary? The First Lady often bolsters the nation’s arts, cultural, and family friendly enterprises, especially in troubled times — as did the spouses of JFK, Obama, and the Bushes. Melania, anyone?

In my practice, I see not only the harms that patients suffer while seeking medical services, but also the high value in their staying healthy and away from the U.S. health care system. Until medical science comes up with a way to prevent or better treat it, the coronavirus will continue to pose the possibility of swamping our health resources. In their better times, they already had notable problems with infections acquired in hospitals, nursing homes, and other medical care giving facilities, as well as major challenges with medical error and misdiagnoses.

That said, the system and the providers in it need our support. As recent experiences with the coronavirus have amply shown, dire consequences result when doctors, first responders, clinics, nursing homes, and hospitals get overwhelmed by serious infections. The trend lines look terrible in Florida, Texas, and Arizona. We need to heed the evidence- and science-based guidance of medical and public health experts, not hip-shooting, loud-mouthed political partisans pushing bunk for their own gain. It looks as if, more than ever, we need to research information carefully, make good choices based on the best available evidence and science, and protect ourselves and our own with less support than usual from our government and officials.

That is turning into a tragic reality. But what’s next? Are current circumstances really the argument that advocates want for the philosophy that the government that governs least governs best? Starve the beast and keep the federal government out of Americans’ lives and especially their health care? Maybe not. The rest of us have lots of work to do to defeat the coronavirus and move the country to a far better place than it is now.