Washington: For several months, President Donald Trump and his officials have cast a fog of promises meant to reassure a country in the throes of the coronavirus pandemic. Trump and his team haven't delivered on critical ones.
They talk numbers. Bewildering numbers about masks on the way. About tests being taken. About ships sailing to the rescue, breathing machines being built and shipped, field hospitals popping up, aircraft laden with supplies from abroad, dollars flowing to crippled businesses.
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Piercing that fog is the bottom-line reality that Americans are going without the medical supplies and much of the financial help they most need from the government at the very time they need it most — and were told they would have it.
The US now is at or near the height of COVID-19 sickness and death, experts believe.
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There's no question that on major fronts — masks, gowns, diagnostic tests, ventilators and more —- the federal government is pushing hard now to get up to speed. Impressive numbers are being floated for equipment and testing procedures in the pipeline.
But in large measure they will arrive on the downslope of the pandemic, putting the U.S. in a better position should the same virus strike again but landing too late for this outbreak's lethal curve.
Concerning ventilators, for example, Trump recently allowed: "A lot of them will be coming at a time when we won't need them as badly."
Two weeks ago, Trump brought word of an innovative diagnostic test that can produce results in minutes instead of days or a week. The US testing system, the key to containing the spread of infection, has been a failure in the crunch, as public health authorities (but never Trump) acknowledged in March. The rapid test could help change that.
Like other glimmers of hope that may or may not come to something, Trump held out these tests as a "whole new ballgame." The new machines and testing cartridges are being sent across the country, and may well hold promise. But they are not ready for actual use in large numbers.
New Hampshire, for one, received 15 rapid-test machines but 120 cartridges instead of the 1,500 expected. Only two machines can be used. "I'm banging my head against the wall, I really am," Republican Gov. Chris Sununu said Wednesday. "We're going to keep pushing on Washington multiple times a day to get what we need."
False starts and dead ends are inevitable in any crisis, especially one driven by a virus never seen before. By its nature, a crisis means we're not on top of it. Desperation is the mother of invention here and officials worldwide are winging it, much more successfully than in the U.S.
But bold promises and florid assurances were made, day after day, from the White House and a zigzagging president who minimized the danger for months and systematically exaggerates what Washington is doing about it.
"We're getting them tremendous amounts of supplies," he said of health care workers. "Incredible. It's a beautiful thing to watch." This was when Americans were watching something else entirely — doctors wearing garbage bags for makeshift protection.
MASKS, GLOVES, GOWNS
In hospitals, masks, gloves and other protective garb come with the territory. But doctors, nurses, flight attendants and other front-line workers have had to go begging for such basics, even before public health leaders flipped and recommended facial coverings for everyone outside the home.
The mere scale of the pandemic stretched supplies even in better prepared countries. Yet the enduring shortages in the U.S. are not just from a lack of foresight, but also from hesitancy as the pandemic started to sicken and kill Americans.
It was not until mid-March, when some hospitals were already treating thousands of infected patients without enough equipment and pleading for help, that the government placed bulk orders for N95 masks and other basic necessities of medical care for its stockpile, The Associated Press reported. Washington dithered on supplies for two months after global alarm bells rang about a coming pandemic in January.
And the Strategic National Stockpile, it turns out, is not the supply fortress you might have thought from its formidable name.
It maxed out days ago, before the pandemic's peak in the U.S., and never filled its purpose of plugging the most essential and immediate gaps in supplies, though it helped. This past week officials said the stockpile was 90% depleted of its protective equipment, with the remainder to be held back for federal employees only.
Some shipments to states were deficient. The wrong masks were sent to Illinois in a load of 300,000. Michigan got only half of the number that was supposed to be in a shipment of 450,000. When he was trying to get 10,000 ventilators in late March, Democratic Gov. Gavin Newsom of California said he received 170 broken ones from the national stockpile as well as good ones.
When officials in Alabama opened a shipment of medical masks from the stockpile, they found more than 5,000 with rot. They had expired in 2010, officials in the state said, yet been left in place first by the Obama administration and then the Trump administration.
When it became clear that critical shortages weren't being solved, the self-styled "wartime president," who had gone to Norfolk, Virginia, to send off the USS Comfort Navy hospital ship to New York City, blamed the states and declared the federal government isn't a "shipping clerk."
TESTS
"Anybody that needs a test, gets a test," Trump said on March 6. "They have the tests. And the tests are beautiful." He said the same day: "Anybody that wants a test can get a test."
Whether it's a case of needing a test or only wanting one, his assurance was not true then, it's not true now and it won't be true any time soon.
The greatly expanding but still vastly insufficient capacity to test people is steered mostly to those who are already sick or to essential workers at the most risk of exposure.
If you're sick with presumed COVID-19 but riding it out at home, chances are you haven't been tested. If you worry that you've been exposed and might be carrying and spreading the virus but so far feel fine, you're generally off the radar as well.
Trump tries to assure people who need to fly that passengers are tested getting on and off flights. He is wrong. Instead, some major airports do screenings, which means asking passengers questions and checking their temperature, not swabbing their nasal passages to find out for sure.
Many people with the virus will never get sick from it. Others who have it will get sick eventually. Both groups are contagious. But there is no capacity in the days of greatest danger to test apparently healthy people in large numbers, so precautionary distancing remains the best defense, like in ancient times.
Within three weeks of China's New Year's Eve notification to global health authorities about a mysterious cluster of pneumonia cases, China had sequenced the genetic makeup of the virus, German scientists had developed a test for detecting it and the World Health Organization had adopted the test and was moving toward global distribution.
Ten days behind, officials at the Centers for Disease Control and Prevention bypassed the WHO test and sponsored their own, which was flawed out of the gate. Trump said the WHO test was flawed, but it wasn't.
Precious time was lost as the U.S. test was corrected, distributed narrowly, then more broadly but still not up to par with the countries most on top of the crisis. Testing most lagged during the critical month of February as the virus took root in the U.S. population.
Germany, in contrast, raced ahead with aggressive testing of a broad segment of the population when it had fewer than 10 cases in January. It has experienced far fewer deaths proportionally than the United States.
"There were many, many opportunities not to end up where we are," Dr. Ashish K. Jha, director of the Global Health Institute at Harvard, told AP.
Trump told Americans on March 13 that a division of Google's parent company was coming out with a website that would let people determine online if they should get a test and, if so, swing by a nearby place to get one, a notable shortcut in theory. But a game-changer in practice?
"It's going to be very quickly done," he said. The website is up but operational in just four California counties. Drive-through sites that he promised would expedite testing were plagued with shortages and delays in state after state, such that many people with symptoms and a doctor's order were turned away.
VENTILATORS
Trump dusted off the Defense Production Act, empowering him to order manufacturers and shippers to make and deliver what the country needs in the crisis. His move raised expectations that a new wave of emergency supplies generally and ventilators in particular could come to the aid of patients and the people looking after them. He and his advisers inflated those hopes.
Under the president's "vigorous, swift" order to General Motors, said Peter Navarro, White House point man on the emergency supply chain, new ventilators would be ready in "Trump time, which is to say as fast as possible."
Yet Trump has held off on using his full powers under the act to command production from private companies. A presidential directive to GM on ventilator manufacturing essentially told the company to do what it was already doing.
While most people get better from COVID-19 without needing medical care, the sickest cannot breathe without a ventilator bridging them to recovery. The ventilator shortfall has been the most frightening deficiency as more people get infected and die by the hour. In the current chaos, the size of the shortfall nationally is not known.
In the absence of what they regard as dependable federal leadership, several states formed a supply consortium to coordinate purchases and boost their buying power. The federal government has pitched in with states and private companies to spur supplies, though not exactly in an atmosphere of trust.
Governors accuse Washington of shortchanging states on machines. Washington accuses some of them of trying to build an unreasonable cushion that deprives other, more desperate states.
According to the scientific model most favored by federal authorities, the country probably needs nearly 17,000 ventilators to be operating for COVID-19 patients alone at the pandemic's peak, right about now, a figure that exceeds 35,000 under a worst-case scenario.
"We have over 1,00,000 being built right now or soon to be started," Trump said a week ago. He acknowledged they won't come in time.
WHERE'S THE MONEY?
"This will deliver urgently needed relief," Trump said in signing an economic rescue package into law. The need may be urgent but the delivery hasn't been.
More than two weeks later, Senate Majority Leader Mitch McConnell, R-Ky., said with some exaggeration, but not much, that "no money has gone out the door yet."
Because of the bureaucracy.
Because of website glitches.
Because of confusion among lenders with the money to farm out and among those who need it to keep their businesses afloat.
So much for Treasury Secretary Steven Mnuchin's prediction that loans could be turned around and money transferred to businesses' bank accounts the same day applications were received.
Yet because of the flood of pending loans, Congress is already having to find more money for subsidies to help businesses cover payroll. Only a tiny fraction of loans has been released.
Meantime state officials are slammed as they try to administer jobless benefits that Washington expanded and is paying for but having states try to manage.
Frustration with the virus package is going viral.
In Portland, Maine, a furloughed orthopedic medical assistant, Margaret Heath Carignan, called the unemployment office on a day set aside for people with surnames starting with A through H. And called and called. Altogether, she said. 291 times before she gave up.
AP
