States plead for help as White House touts success in curbing virus


Participants in the weekly calls say federal officials, a rotating cast led by Pence that often includes task force coordinator Deborah Birx and test czar Brett Giroir, rarely deviate from Trump’s view that the response to the pandemic is a success. The tone is usually optimistic, with Pence highlighting governors who are reopening their economies and officials making it clear that, while they share their ideas, it is up to governors to make their own decisions.

“What we have heard in the last two calls is that they adhere to this message that the president continues to raise,” said a state official, who requested anonymity to describe the private discussions. “That is, there are no outbreaks, there are no increases in cases, you only see more cases because we are doing more tests.”

The officials’ stance on the calls is consistent with Trump’s telegraphed desire to transfer responsibility for managing the outbreaks to the states. But it has caused mounting frustration among state officials and the public health experts who advise them. They expressed a desire for broader federal guidance on how to identify hot spots and reduce infections, along with better data tools and more on-the-ground resources to track cases.

“There must be much more support from the federal government,” said Richard Besser, CEO of the Robert Wood Johnson Foundation and one of the advisers to the New Jersey reopening effort. “It is very difficult to predict how long this will continue and what that trajectory will look like.”

Although Pence has kept in close contact with the governors and Birx will sometimes call state health officials, the task force has offered few new tips to combat new outbreaks, largely based on the recommendation that states intensify testing in places like nursing homes and meat packers. plants that can quickly become ground zero for new coronavirus groups, according to participants in the calls.

And despite mounting evidence that the virus is spreading across the country at a rapid rate, the White House has shown no appetite to regain control of the response, insisting that states and localities are capable of handle the pandemic, with the federal government playing a prop. paper.

“We are confident that the state-run and locally implemented response effort is going to be the model to follow,” said the task force official, noting the downward trend in Covid-19 deaths across the country, “especially when” I’m just seeing so many positive and encouraging data signs on the coronavirus front. “

However, on the front line, many state and local officials say the rising rate of hospitalizations and rising positive test rates make clear that a resurgence is underway. the The administration’s non-intervention approach has forced them to wage a county-by-county war against a virus that doesn’t respect borders, sparking a disjointed response that constantly follows the spread of the disease.

There is no comprehensive national coronavirus testing strategy, which has largely left local officials and healthcare providers to decide where to offer the tests, and led to slashes in high-demand areas, even when other parts of the country they have a lot of capacity.

Similarly, there is no national apparatus for contact tracing, making it more difficult for states and localities to coordinate efforts to discover the disease on the ground and gain a broader picture of how the virus travels in some parts of the country.

While the administration has distributed $ 14 billion in Congress-approved funds to state and local departments for testing and tracing, another $ 8 billion approved in April for federal efforts remains unspent, a delay that the Department of Health and Human Services has blamed legislators for lack of clarity.

On Tuesday, the Director of the Centers for Disease Control and Prevention, Robert Redfield, told a House of Representatives panel that agencies across the country have signed up only 28,000 contact trackers to date, well below of the 100,000 who anticipate that they need to keep the virus under control.

In some major metropolitan areas, such as Kansas City, Missouri, funds for testing and contact tracing that were approved by Congress in April are only just beginning to come in. Kansas City was slated to receive its share of federal aid, about $ 4 million, for the first time on Thursday.

Patty Hayes, director of public health for King County and Seattle, Washington, said states and counties continue to compete with each other to buy enough test supplies and protective equipment.

“We are still struggling,” he said. “We have to find our own way many times.”

State officials and public health experts have wondered why the Trump administration has not developed more extensive data tools that can help them identify burgeoning outbreaks and direct resources. Instead, many states have chosen to build their own public health surveillance systems to gain a better understanding of the evolving situation on the ground than they can get from the federal government.

CDC’s data systems are isolated and based on a mix of information sources that are incomplete or duplicated and have also frustrated Trump’s top health officials. At the height of the initial wave of the pandemic in April, and amid irritation over the quality of the information produced by the CDC, health officials awarded a $ 10.2 million contract to healthcare technology firm TeleTracking Technologies to Collect hospital data, even though CDC already collects a lot of that information.

“There have been discussions about what we need to do to get better data and more consistent data,” said the working group official. “Especially in 2020, where data has become increasingly important in a pandemic response like this.”