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Coronavirus Pandemic in U.S. Fueled by Stunted CDC Budget & Lack of Access to Healthcare, Insurance

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The coronavirus pandemic has now infected more than 113,000 people worldwide, and killed more than 4,000. We are joined by two epidemiologists to examine the response so far around the world and in the United States. Thomas Bollyky is director of the global health program, senior fellow at the Council on Foreign Relations and author of the book “Plagues and the Paradox of Progress: Why the World Is Getting Healthier in Worrisome Ways.” We’re also joined by Alfredo Morabia, professor of epidemiology at the Barry Commoner Center for Health and the Environment at Queens College, City University of New York, and editor-in-chief of the American Journal of Public Health.

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This is a rush transcript. Copy may not be in its final form.

JUAN GONZÁLEZ: Today we spend the hour looking at the coronavirus pandemic that has now infected more than 113,000 people globally and killed more than 4,000. Italy is under a nationwide lockdown, with all 60 million residents now facing travel checks, school closures and bans on public events. This comes as Chinese President Xi Jinping visited the virus epicenter of Wuhan for the first time since the outbreak. China recorded just 19 new cases of the virus over the previous 24 hours, the lowest update since it began reporting national figures. In the United States, officials report 26 deaths of people infected with coronavirus, most of them in Washington state. The number of confirmed cases in New York has grown to 143, making it the state with the largest number of confirmed cases.

AMY GOODMAN: Meanwhile, Wall Street suffered its worst day in more than a decade Monday. The Dow Jones Industrial Average fell more than 2,000 points, or nearly 8%, based largely on concern over the coronavirus and oil prices. This brings losses in recent weeks to more than $5 trillion in stock market wealth. President Donald Trump announced Monday he will take, quote, “major steps” to minimize the economic impact.

PRESIDENT DONALD TRUMP: We are going to be asking tomorrow — we’re seeing the Senate. We’re going to be meeting with House Republicans, Mitch McConnell, everybody, and discussing a possible payroll tax cut or relief, substantial relief, very substantial relief. That’s a big — that’s a big number. We’re also going to be talking about hourly wage earners getting help, so that they can be in a position where they’re not going to ever miss a paycheck. We’re going to be working with companies and small companies, large companies, a lot of companies, so that they don’t get penalized for something that’s not their fault. It’s not their fault. It’s not our country’s fault. This was something that we were thrown into, and we’re going to handle it, and we have been handling it.

JUAN GONZÁLEZ: This comes as five congressmen have self-quarantined, including Florida Republican Congressman Matt Gaetz, who announced on Twitter Monday he will self-quarantine, after learning he had contact with an attendee at the Conservative Political Action Conference who has been diagnosed with coronavirus. Gaetz reportedly received the news while aboard Air Force One with Donald Trump. Just last week, he appeared to mock the coronavirus scare, showing up in Congress wearing a gas mask as the House passed emergency funding to combat the disease. Republican Congressman Doug Collins of Georgia also came in contact with the CPAC attendee at the end of February. Collins joined Trump on his visit to the Centers for Disease Control and Prevention in Atlanta last week and shook his hand. Collins also is in self-quarantine. Gaetz and Collins join lawmakers Senator Ted Cruz and Arizona Congressmember Paul Gosar in self-quarantine after interacting with the individual at the conference.

AMY GOODMAN: Meanwhile, more than 40 U.S. colleges have canceled in-person classes, including Columbia, Princeton, Rice University, Stanford, Hofstra, the University of Southern California, Ohio State, the University of Washington. Meanwhile, Detroit Mayor Mike Duggan announced Monday the city will restore service to thousands of households whose water was shut off.

For more, we’re joined by two guests. In Washington, D.C., Thomas Bollyky is with us, director of the global health program, senior fellow at the Council on Foreign relations, author of the book Plagues and the Paradox of Progress: Why the World Is Getting Healthier in Worrisome Ways. Here in New York, Dr. Alfredo Morabia is with us, professor of epidemiology at the Barry Commoner Center for Health and the Environment at Queens College, City University of New York, editor-in-chief of the American Journal of Public Health.

We welcome you both of you to Democracy Now! Thomas Bollyky, let’s begin with you. Why has the U.S. mismanaged this so severely, at a time when time is of critical importance, at the beginning of a pandemic? For example, the number of tests, the lack of testing that’s available in this country, compared to China, compared to South Korea. Can you explain what happened?

THOMAS BOLLYKY: So, on the testing side, it seems that what happened was, is that our Center for Disease Control and Prevention developed a test in real time. That’s great. In most of the former outbreaks we’ve seen, the CDC has led the world. They did so under emergency use authorization from the FDA. It became clear pretty quickly that there was something wrong with that test. We’re still investigating what was the cause of that error. The challenge was, from the FDA perspective, when they started to get requests from state labs to make their own version of the test, the FDA refused to grant that authorization for five days. That’s a little ironic because the Trump administration itself has been reluctant to regulate laboratory tests overall. It’s really only during an emergency that FDA even has this role. So we were very slow to respond. The broader issue here, though, is that we’re dealing with a path —

AMY GOODMAN: And the fact is the World Health Organization had a test that the CDC rejected. Is that right? That everyone else is using.

THOMAS BOLLYKY: That’s right. So, it was developed in Germany, adopted by the World Health Organization. As you said, most countries are using it. South Korea, as you pointed out, has done at least 190,000 of these tests. As of last week, we had just done a little under 2,000 tests. So we’re greatly behind on that. But some of it really does seem to be, in the U.S. context, a focus on the threat from abroad as opposed to recognizing that, to some degree, the burglar was in the house, the pathogen was spreading domestically, and we had to shift tactics.

JUAN GONZÁLEZ: And I’d like to ask Dr. Alfredo Morabia: What about the status of the CDC? There have been numerous cutbacks in recent years to the CDC. Talk about its preparedness for this pandemic.

DR. ALFREDO MORABIA: Yeah, the CDC budget has been cut for at least 12 years now, I mean, following the recession in 2008. I think that was the peak. And since then, it has been declining about 10%, I think. It’s clear that the budget is not what it should be. It’s clear that we don’t have a healthcare system that is as good as it could be.

But I think the problem — and this is what the Journal has been raising and our authors have been writing — is that we have a social problem that is much more important and which makes us vulnerable for the progression of the epidemic, because if people have access to care, have insurance, you know, we can manage it. We can slow down the progression. It’s clear we have a pandemic. We’re going to have the epidemic curve. It’s going to rise until enough people are infected. It’s going to disappear when maybe 40 or 70% of the people are infected. So, if it all occurs quickly, we are in trouble, because our system is going to be overwhelmed. It’s going to be a health crisis. We have to slow it down. We have to stretch it.

And if people are insured, if people have access to care, we can deal with that, even with the limitation of the budget that CDC have had to endure over the last years. But the question is that the lack of access for poor people that have been increasing lately — I mean, the ACA, the Affordable Care Act, had reduced to 10% the proportion of people who are not covered with insurance in this country. It’s up again 5%. The fact that people, to have access to Medicaid, have to work, will push them to go to work even if they are sick. The fact that immigrants who are undocumented are scared to go to get healthcare, get tested, treated, vaccine when we’ll get it, you know? This —

AMY GOODMAN: And explain public charge, what President Trump has done.

DR. ALFREDO MORABIA: This is about the risk of being deported for undocumented immigrants, but for the ones that are legally here, the public charge rule says that if they use welfare, they cannot be admissible to get a green card.

AMY GOODMAN: Even though it’s legal to use welfare.

DR. ALFREDO MORABIA: Exactly. And so they won’t be considered for green card, and so these immigrants are also deterred from using healthcare, from going and get a test to know whether they are infected. So what does this create? It creates a zone of the country, large sector of the population, in which the progression of the epidemic and the virus can go very fast, like wildfire. We cannot contain it there. And this is what makes us today very vulnerable. And I think this should be rescinded immediately. I mean, all those — the public charge rule, the fact that people have to work for Medicare, the attacks on the Affordable Care Act, which the Supreme Court is going to look at very soon — all these issues needs to be changed in order to be able to—

AMY GOODMAN: Do you see it as “Medicare or coronavirus for all”?

DR. ALFREDO MORABIA: That’s a good way of saying it. In some ways, it’s true. In some ways, it’s true. And this is why European countries are better prepared than us. Universal access to healthcare is key for the protection of the whole population here.

JUAN GONZÁLEZ: Yeah, I wanted to ask Thomas Bollyky, this whole issue of the federal government pursuing one strategy and various states pursuing more stringent strategies — you have Oregon, Washington, California, Maryland, New York declaring states of emergency, while from the White House we’re getting this message from President Trump that is quite different.

THOMAS BOLLYKY: Yeah. So, to some degree, it’s appropriate that states and localities tailor their response to what they’re seeing at their communities. That’s both what their legal authorities are, and that’s what we should see from a medical and ethical standpoint. The challenge that we have is they’re being undermined to some degree by the mixed messages that are coming out from the White House.

This is an environment where it’s really important to be clear to the public what the risks are, the importance of taking that threat seriously and to adopting the good measures that one can have to reduce the spread of infection. And they’re not getting that support from the White House. State and local officials need guidance on when they should be adopting social distancing policies, what are the criteria, what are the indicia they should they be looking at. And by all reports, they’re not getting it from the federal government. And that’s unusual in comparison to past outbreaks.

AMY GOODMAN: Do you think, Thomas Bollyky, that not only are these massive cutbacks to the CDC, but in 2018, President Trump disbanding the White House’s pandemic response team within the National Security Council so that when he’s talking about, to his NSC, “We gotta get billions for the wall,” there isn’t a group pushing back in December saying, “Wait, we’re looking at what’s happening in China, and we have to have a serious uptick now in dealing with what could be a pandemic”?

THOMAS BOLLYKY: Yeah. So, I think there are a lot of lessons that no one should take from China. China did many draconian things. They had censorship. They were slow to respond to the early days of the outbreak. There are two lessons that are important to take — three lessons, really, that are important to take from China. First is that speed matters. Second is the disproportionate effect of the elderly. And third is the importance to shore up medical care for when the cases start to surge, and to be able to do that safely.

Dismantling the NSC directorate on global health reduced our ability to respond quickly. The argument from the administration is there are other officials that were taking this on. The secretary of health and human services had the lead on this issue. But it reduced the ability and the bench of people that really knew how to respond to an outbreak, and that’s really important for speed. And at the end of the day, as my colleague was saying, that’s the important part about responding to an epidemic, is doing so effectively, reducing the spread, and doing so in a timely way.

AMY GOODMAN: This issue of dealing with the poor, Detroit Mayor Mike Duggan announced Monday that the city would restore service to thousands of households whose water was shut off.

MAYOR MIKE DUGGAN: The governor and I sat down and said, “We’re going to have a solution that no resident of the city of Detroit has their water shut off for lack of funds.” … If you receive a shutoff notice — it’s come in the mail, or it’s hung on your door — you can avoid your water shutoff by paying $25. And we will keep your rates at $25 a month as long as COVID-19 remains a health threat in this community.

AMY GOODMAN: So that’s the Detroit mayor announcing — making this announcement after the city and state of Michigan came under fire last week for declining to restore service. Congressmember Rashida Tlaib, who represents a part of Detroit, tweeted the Michigan governor and lieutenant governor on Saturday, quote, “No disrespect, but I am still waiting to hear the plan that includes getting people’s water back on as this disease spreads. Please don’t forget poor families. They deserve protection and with no access to water we are putting them in jeopardy.”

This is a critical point, Dr. Morabia. I mean, for years, activists in Detroit have been saying, “This is an outrage you’re cutting off people’s water. You keep it on for the corporations even when they don’t pay their taxes, but you cut it off to the individual people.” Now they’re talking about turning it back on. Can you talk about the significance of this and once again how it highlights how different people are treated but how these health issues threaten everyone?

DR. ALFREDO MORABIA: Yeah, absolutely. Absolutely. And I think that this pandemic shows that the idea that reducing access to welfare to the poor in order to stimulate them to get jobs or to get the immigrants to become self-sufficient, etc., in order to reduce public expenses, this thing don’t work. But in addition, they make us more vulnerable, because the problem of access to care, access to hygiene, access to sanitation. You mentioned water. But are we going to have access to tests now? And if we have a treatment by the end of the year, access to treatment, and next year, very important, if we have a vaccine, people must have access to the vaccine, too. And all these issues are key.

We are like a single organism, you know, like a collective individual. And this is how we have to consider ourselves. All these anti-poor, anti-immigrant and, I would say also, anti-science, because there has been his tendency to deemphasize the role of science. I mean, in reducing the budget of CDC, that’s what’s happening. When they dismantled the global health security team at the National Security Council, in some ways they reduced the influence of scientists on the executive. And this has been really a very serious component of those last years of policies, yes.

JUAN GONZÁLEZ: I wanted to ask you about — President Trump has said on several occasions, made comparisons to the regular flu season and the number of people who die from the flu. Could you talk about this whole issue of the mortality rate and also the rate of people who, with the coronavirus, are getting seriously ill or — I think it’s about 10% are seriously ill, and about 4 to 5%, the mortality rate, how that compares to the normal flu?

DR. ALFREDO MORABIA: So, this is not exactly my expertise, but I think that the president had a point to raise the issue of the flu, because he mentioned the vaccine. I mean, the vaccine against the flu won’t protect you against the coronavirus, but it would protect you against the flu, and we don’t have to have the two. We don’t want to have the two epidemics together. So, reminding people that they need to get their flu shot, even under a coronavirus epidemic, that’s very important, I think. And it will be true also next year. There are two epidemics, and one is a pandemic, you know, and we want people to be protected from both, because both pandemics are likely to stress our healthcare system in an extremely strong way.

AMY GOODMAN: It was astounding to hear him say he had no idea people died of the flu. He was trying to minimize the coronavirus by saying, you know, tens of thousands of people die a result of the flu. Astounding because his own father — his own grandfather, Friedrich Trump, died of the flu in this country.

DR. ALFREDO MORABIA: Yeah. But you see, Amy, the role of the Journal, our mission, is to bring —

AMY GOODMAN: Of the American Journal of Public Health.

DR. ALFREDO MORABIA: Of the American Journal of Public Health — is to bring the science, to bring the history and to support policy. We’re not watchdogs. We’re not judging or giving awards or points, anything like that. What we do is this. And already, you know, in November of 2018, we had this issue on the 1918 flu, the great flu pandemic.

AMY GOODMAN: The Spanish flu.

DR. ALFREDO MORABIA: The Spanish one. I mean, the so-called Spanish one that killed 20 million people. But all these issues, we raised them. And now we are stressing the fact — our authors, not myself — but our authors are stressing the fact that we have to be prepared for the vaccine. And it won’t happen if we are still letting anti-vax ideology spread on media.

AMY GOODMAN: We have to break. And when we come back, our scientists are going to stay with us, but we’re going to go to a college student in Milan. The entire country of Italy is locked down. Stay with us. We’ll ask her about life in the red zone.

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