Categories
makes pandemic'

Pandemic makes flu shots vital this season. Health officials aim for easier, safer ways for you to get the vaccine. – The Washington Post

One idea gaining in popularity is to give the shots outdoors.

Bethesda, Md., internist Brent Berger, for example, hopes to “borrow” a nearby church parking lot and offer outdoor flu vaccinations, delivered either curbside or in the car. He’s even thinking about combining it with a canned food drive.

“We want patients who would rather not come into the office to have an alternative,” Berger says. “A food drive also allows us to give something back to the community. Most of all, we want to do everything we can to encourage patients to be immunized against the flu, especially against the backdrop of the covid-19 pandemic.”

“This fall we anticipate a double-barreled respiratory virus season,” says William Schaffner, professor of preventive medicine at Vanderbilt University, who points out that people can contract both influenza and covid-19 at the same time. “We expect the occurrence of severe disease and its impact on the health-care system to be substantial. It’s all the more important that everyone over the age of 6 months be vaccinated against influenza.”

The shot not only will prevent many cases of influenza but also increase the likelihood of a mild disease if a vaccinated person still develops flu.

“You’ll be less likely to end up in the emergency room or hospital, and less likely to die of influenza,” Schaffner says. “Most important, you’ll take weight off the medical care system so patients can be cared for more appropriately.”

Age can be a consideration in the timing of a flu shot. It takes two weeks after a shot to develop immunity, which wanes faster in older people than in younger people. Young people can get their shot as early as this month, but those over 65 might want to wait until October. The flu season begins that month and peaks between December and February.

(Experts say it’s better to get one too early or too late than not at all)

Older people also should ask about two flu vaccines associated with a higher immune response and approved for those 65 and older. Also, those over 65 are advised to get a pneumonia vaccination, which is also recommended for children under 2 and for those with certain medical conditions. Pneumonia can be a fatal complication of the flu, the Centers for Disease Control and Prevention says.

More than half of all American adults failed to get a flu vaccination last season, although compliance did inch up from the previous year, according to the CDC. Coverage was 45.3 percent during 2018-2019, an increase of 8.2 percentage points over the 2017-2018 season. The numbers were better for children; coverage was 62.6 percent last year, according to the CDC.

This year, the fear is that the pandemic could prompt the numbers to drop, either from fear of covid-19, or inconvenience. Many homebound employees, for example, won’t have access to flu shots in the workplace this year, as in previous years, and providers are trying to compensate by offering alternatives. “You can’t vaccinate by telemedicine, so we need ways to make it easy, quick and safe for people to come in, and we need to convince them to do it,” Schaffner says.

Berger, the Bethesda doctor, represents one example, but others, including clinics and medical centers, pharmacies and retailers, also have expanded their vaccination plans to the outdoors, which is considered safer than being indoors when it comes to covid-19 transmission.

“This season we will be setting up drive-through flu vaccination sites and clinics at many of our medical facilities to make the process easy and safe for people and maintain social distancing,” says Stephen Parodi, associate executive director of the Permanente Medical Group. “Also, in select Kaiser Permanente regions, we are piloting touch-free screening and check-in.”

Todd Prewitt, corporate medical director for population health for the insurance giant Humana, says the company is encouraging all of its members to get flu vaccinations, and will cover them. As part of its campaign, Humana sent two cloth masks to more than 7 million of its members.

Many pharmacies will offer drive-through vaccinations, says Mitchel Rothholz, chief of governance and state affiliates for the American Pharmacists Association. “We understand that people may hesitate about going into a doctor’s office, because that’s where the sick people are,” he says.

But consumers also can make appointments for shots inside drugstores, he says. “Patients can fill out paperwork before they come into a pharmacy,” he says. “Some pharmacies will have patients wait in their cars and will call them when it’s time to come in and get the shot. They are trying to streamline the process so you’re not having a lot of people standing around in the waiting area.”

Most people who feel comfortable going to their doctor’s office for a flu shot probably still can. Furthermore, if patients have an in-office appointment for another medical reason already scheduled, physicians recommend getting a flu shot at the same time. Regardless — inside or outside — consumers should be prepared for social distancing, temperature checks, screening questions and mask-wearing. They also should expect those giving the shots to be wearing personal protective gear, and to change gloves and disinfect areas between patients.

“Patients will be given a covid-19 screening questionnaire and have their temperature taken prior to any immunization,” says Matthew Blanchette, a spokesman for CVSHealth, which has 10,000 pharmacies nationwide. “They must also wear a face covering or mask, and one will be provided, if needed.”

Starting this month, CVS Pharmacy customers can make flu vaccination appointments at CVS.com, on the CVS app or by texting FLU to 287898, he says.

“They also will be able to complete a digital intake form prior to their visit to limit in-person contact at the time of vaccination,” Blanchette adds.

Some pediatricians also plan to offer outdoor flu vaccinations, although outside clinics present special challenges when dealing with children. Gary Bergman, a pediatrician who practices in Alexandria and Fairfax, Va., decided against vaccinating outdoors. He plans to hold indoor flu shot clinics during hours when the pediatricians aren’t treating sick children.

“Some practices are setting up tents and vaccinating outside, but what if it’s cold and rainy, and kids are crying, and you have to undress a 9-month-old to give a shot in the thigh?” referring to the site for vaccinating children before they are walking, he says. “We just didn’t want to go that route.”

Last year, the pediatricians in his practice delivered more than 8,000 flu shots to their pediatric patients, as well as occasionally to their parents, he says. This year, the practice ordered 12,000 doses, “figuring with the situation, parents who can’t get their flu shots at work might want to get them here,” he says. With social distancing, however, they expect to reduce the number of shots they give during each shift from 225 to 175, but plan to add several evening flu shot clinics.

Experts say that it is important to be protected against influenza before a coronavirus vaccine becomes available, which could happen early next year. If that is the case, “we want to make sure we get as many people protected from flu [first],” says Rebecca Snead, executive vice president and chief executive of the National Alliance of State Pharmacy Associations.

Meanwhile, vaccine manufacturers have boosted production of the influenza vaccine this year. And because routine childhood immunizations for other infectious diseases have fallen behind, federal health officials recently announced they will allow pharmacists in every state to administer childhood vaccinations, including for flu.

Vaccine manufacturer Sanofi Pasteur, for example, has produced nearly 80 million doses of influenza vaccine for this season, a 15 percent increase over last year, and the company has developed a “road map” to help providers prepare to deliver flu vaccines at alternative sites, including outdoors.

“The same people who were told to shelter in place, are also the same ones we must ensure get their flu shots,” says Elaine O’Hara, who heads Sanofi’s North America vaccine program. “Trying to overcome the limitations is very important. There’s no point in producing 80 million doses of influenza vaccine if they don’t end up in someone’s arm.”

Read More

Categories
pandemic' Times

How to Stop the Next Pandemic – The New York Times

This graph can tell you a lot about your future. Each bar shows how many new infectious diseases emerged in a year. In 1944, there was one. In ’48, three. We have no immunity to new pathogens. Each disease on this list posed a new pandemic threat. It was around 1960 when the number began to rise. By the time 1990 rolled around, it wasn’t just two or three new diseases that year — there were 18. Soon after, the trend became so clear, a scientist appeared on TV with a warning. “What worries me the most is that we’re going to miss the next emerging disease, that we’re going to suddenly find a SARS virus that moves from one part of the planet to another, wiping out people as it moves along.” That was 17 years ago. And today, stuck at home in a seemingly never-ending pandemic purgatory, it appears that we did not heed his warning. Covid-19 has opened our eyes to the danger. But has it opened them enough to look past this pandemic to what our future holds? We tracked down that same scientist today to ask him: How do you stop the next pandemic? He said the trend isn’t looking good. “We see an increased frequency of emerging pandemics. We also still have the ones that emerged recently. We still have H.I.V. We still have Ebola. We still have H1N1. So we’re adding to the stock of known pandemic pathogens with new ones at an increasing rate. That’s not a good place for us as a species right now.” If you want to know how to stop the next pandemic, you first need to know why they’re happening. “We humans are an ecological anomaly. There have never been 7.7 billion large-body vertebrates of one species on this planet before in the history of earth.” This is David Quammen. He’s a — “— a very unmystical, black-hole Darwinian materialist.” Well, David’s a storyteller. He’s been writing about the origin of infectious diseases for decades. “So we are unprecedented, and we’re causing ecological wreckage that’s unprecedented, and there are consequences of that.” [explosions] “Pandemics emerge due to our ecological footprint. And our cultural footprint is accelerating exponentially.” Remember this guy? That’s Peter Daszak, the scientist who warned us in 2003. He’s sometimes referred to as a virus hunter. He goes out to preemptively find viruses before they find us. “It’s the connection between humans and animals that’s driving this. And that connection happens where people move into a new region through things like road building and deforestation, mining, palm oil production, timber and livestock production. People move into new areas. They come across wildlife that we’ve not really had much contact with. The pathogens spill over into them, and then can spread through that connectivity.” [birds squawking] “We’re encroaching on their habitats. And just many, many more opportunities for spillover events to occur.” Christian Walzer is a global veterinarian and executive director for the Wildlife Conservation Society. “The destruction happening at the edge of forests is one of the areas where we’re very concerned. Changing the trees that bats, for example, would roost on, they may be driven to an edge. They may be driven into an area where there’s more human population. And suddenly, you create a contact area which didn’t exist before.” So what do these new contact areas look like? In this video, we’re going to show you three ways in which our changing relationship with wildlife is increasingly creating dangerous pandemic possibilities. So let’s say you want to sell toothpaste. No, peanut butter. Wait, wait shampoo. Never mind, it doesn’t matter. In all of those cases, you need palm oil. So you burn down a forest in Malaysia to grow palm trees. But that forest was home to some bats. So the bats find a new home, near some fruit trees on a pig farm. But soon, a virus from those bats makes its way into the farmers who own the property. This isn’t science fiction. This is how the Nipah virus came to humans. “Why was it getting from the fruit bats to the people? Because of habitat destruction. Most of the forest in northern Malaysia, where the bats would ordinarily be living wild and feeding on wild fruit, most of that forest had been destroyed. In place of the forest, among other human enterprises, were giant pig farms, piggeries, where thousands of pigs were kept in a single corral, being raised for meat. Some of those corrals were shaded by domestic fruit trees that were planted to grow mangoes or to grow starfruit for another revenue stream for these pig farms. So the bats, having lost their wild habitat, are attracted to the domestic fruit trees. They come in, they eat the mango, they eat the starfruit, they drop the pulp into the pig corrals. And with it, they drop their feces and their urine and their virus. It gets into the pigs, spreads through the pigs, then gets in the pig farmers, pork sellers, and other people.” Land use change is one big reason more infectious diseases are making their way into humans. However, it’s not just animal habitat we need to worry about. Animal diversity can be just as important. “Loss of biodiversity itself has led to emergence of disease. When you lose species, you tend to be left with certain groups. And if they happen to carry viruses, and if they dominate the landscape, you will be exposed to those viruses more than others.” This story doesn’t begin in the jungles of Africa or forests of Southeast Asia. We begin in the American suburbs. “If humans cut down the forest and turn it into a suburb, like those beautiful suburbs we know in semi-rural Connecticut, where there are great big lawns in front of nice houses, and there are hedges, and then there’s somebody else’s house with a great big lawn in front of it, that’s really good habitat for white-footed mice, and also for white-tailed deer. Not so good for larger mammals, like foxes, like weasels, or for birds of prey. So the hawks and the owls tend to disappear, the foxes and the weasels tend to disappear from this environment. What happens then? You get more white-footed mice. You get an abundance of white-footed mice because their predators are not suppressing them.” Having an abundance of white-footed mice wouldn’t be so bad, except they are the natural reservoir host of Lyme disease. This means they harbor the bacteria, but it doesn’t make them sick. So if there was a biological diverse landscape, well, then — “The pathogen is shared amongst the various hosts that are in that landscape. Many of these hosts are incompetent and are unable to actually transmit the disease. And so it becomes a dilution effect.” “The net result of this reduction in biological diversity, changing the landscape, making it more fragmented, less forested, is more ticks infecting more little kids when they go out to roll around in the grass and bust through the hedges. So there is more Lyme disease.” And yet, Covid-19 may not have started this way at all. “In view of the ongoing outbreak, if you create a completely artificial interface where you go and capture animals regionally, globally, and bring them together at one place, like at a wildlife trading market, then you’re obviously creating fantastic opportunities for viruses to spill over.” A pathogen from an animal might not be able to spill over directly into humans, but it could spill over into another animal, evolve or adapt, and then infect humans. With a rotating variety of animals stacked on top of each other, the pandemic possibilities are significant. This is one theory of how the coronavirus may have started in China. The thing is, in the past, a spillover event from this wildlife market may not have affected you. “We also have to take one step back from the sort of very romantic idea that these are isolated communities living in central Africa. You know, I always point out that a rat which you capture somewhere in northern Congo now, within 12 hours, you’re in Brazzaville.” “The Republic of the Congo now has a new modern highway and economic artery thanks to Chinese assistance.” See, just 10 years ago, that would have been impossible. But then, well, China — “The national highway was complete —” China wanted access to minerals to mine. In exchange, they helped with infrastructure. Now, there’s a road. They’ve created accessways, not only for the rare earths which are so important for your mobile phone, but for viruses as well. “If you catch the plane that evening and you take your rat with you because you want to bring it to your family in Paris, it’s less than 24 hours from a very, very remote community all the way to Paris.” But luggage is screened, you say. The rat would get caught. Maybe. But really, the rat isn’t the biggest threat. It’s you. Your bag gets screened. Your blood does not. “We all have a share of the responsibility. It’s not just people in China who want to eat bats or who want to eat pangolins. That may be the immediate cause of this spillover, but in terms of the initiation of these things, generally, there is also enough blame, enough responsibility to go around.” The three ways in which a pandemic could start shown in this video all have one thing in common — us. “Here’s what we did. We changed the planet so significantly and so fundamentally that we dominate every ecosystem on earth, right now. We are the dominant vertebrate species. Our livestock are the dominant biomass on the planet. And that’s the issue. What we’ve done is we’ve created this pathway through our consumption habits by which viruses can get from wildlife into people and then infect us. And our response is we blame one country versus another, we blame people who eat one species over people who don’t eat another and we blame nature. Well, no. We need to point the finger directly at ourselves. This is not a whiny argument that the world’s falling apart and it’s our fault, this is an argument that says we are the reason why this happens. We, therefore, have the power to change it.” So how do you stop the next pandemic? “Well, this is what you do. No. 1, you find out what viruses there are in wildlife. We estimate 1.7 million unknown viruses. Let’s go and discover them. Let’s get the viral sequences. Let’s get them into the hands of vaccine and drug developers, and get them to design vaccines and drugs that are broadly effective — not just against one pathogen, but against a number of pathogens. But No. 2, and critically, we need to work with the communities that are on the front line of this. And that’s a solution that the public are less excited by. It’s old-fashioned. It’s working in foreign countries with different communities that do different things. It’s hard work, and it’s less attractive to the voting public. We’ve got to do all of the above. High-tech, low-tech, but focused on prevention. It’s possible and it’s doable. Let’s get on and do it.” Great. Let’s do it. No more pandemics. There’s just one problem — money. “Please, in the back.” “Thank you, Mr. President. U.S. intelligence is saying this week that the N.I.H., under the Obama administration in 2015, gave that lab $3.7 million in a grant. Why would the U.S. give a grant like that to China?” “We will end that grant very quickly, but —” That’s Donald Trump canceling a grant that was funding research to stop pandemics, including studying coronaviruses in bats. But the grant wasn’t going to China. It was going to — you guessed it — Peter Daszak. That grant started in 2015. “2015? Who was president then, I wonder?” “We have to put in place an infrastructure, not just here at home, but globally that allows us to see it quickly, isolate it quickly, respond to it quickly.” This is not a new fight. “But if we wait for a pandemic to appear, it will be too late to prepare.” What is new is our reaction to it. “It’s nobody’s fault — it’s not like — who could have ever predicted anything like this?” “What worries me the most is that we’re going to miss the next emerging disease.” If we don’t want more Covid-19-like events in the future, we need to stop pandemics before they happen. That means depoliticizing pandemics and investing in prevention. “I think we need to wake up. There’s a certain moment right now where the public around the world, because this pandemic has got to every country on the planet, the public now see their own health as intimately connected to why these pandemics emerge through the wildlife trade or deforestation. So we need to really drive that message home that producing a healthier planet will actually save our own lives and improve our own healths.”

Read More

Categories
Adapting pandemic'

Adapting To A Pandemic, GOP Confab Sets Tone For Trump Re-Election Campaign – NPR

President Trump speaks from the South Lawn of the White House on Thursday night, the last day of the Republican National Convention.

Evan Vucci/AP


hide caption

toggle caption

Evan Vucci/AP

President Trump speaks from the South Lawn of the White House on Thursday night, the last day of the Republican National Convention.

Evan Vucci/AP

The 2020 Republican National Convention this week began and ended with two performances by the man who designed it all, President Donald J. Trump.

Most of the attention went, of course, to the final night’s event, when a live audience saw him “profoundly accept” his re-nomination in an hourlong speech delivered on the South Lawn of the White House. Backed by a forest of American flags, the president looked out upon members of his family and staff, members of his Cabinet and members of his party in Congress.

They sat side by side in close rows of chairs. Few wore masks. There was little sign of the pandemic that had cost the president the big show he had originally planned for Charlotte, N.C., or in his backup venue in Jacksonville, Fla.

Unlike most of the speakers during the week, Trump did not ignore the disease that has killed 180,000 Americans or speak of it in the past tense. But he cast it as less than central to the moment, a kind of speed bump for his parade of triumphs: “We are meeting this challenge,” he said proudly, “delivering lifesaving therapies and we will produce a vaccine before the end of the year or maybe even sooner.”

Fact Check: Trump's Address To The Republican Convention, Annotated

Few experts have seen a realistic possibility of a vaccine that would be regarded as safe by year’s end, let alone sooner. But in recent weeks the White House has barred TV appearances by such figures as Dr. Anthony Fauci, the nation’s longtime leading immunologist, who has contradicted the president without criticizing him.

Trump displayed a portrait of three presidencies – his own, his predecessor’s and the one he said Democratic nominee Joe Biden would create if elected. Most of the attention focused on Trump’s own four years, which he sketched as a montage of success upon success. He spoke of having conquered the vexing issues of taxes and trade, European allies and Middle East rivals, refugees and immigrants and most notably – the pandemic itself.

Uplifting or unloading?

The White House had promised a speech that would be “uplifting,” unbowed by the virus, the consequent recession or the widespread racial unrest following multiple killings of Black people by police. The speech was defiant, to be sure, but the inspirational elements were less salient than Trump’s relentless attack on his Democratic foe.

“Joe Biden is not a savior of America’s soul,” the president said. “He is the destroyer of America’s jobs, and if given the chance, he will be the destroyer of America’s greatness.”

Overall, the speech sounded a great deal like an earlier acceptance speech by an angry outsider running for president four years ago at the Republican convention in Cleveland. That night, candidate Trump railed against the work of Democrats and Washington insiders, whom he would displace.

“Only I can fix it,” he said then. And four years later, the message was much the same, although he had been working for most of that time inside the building that served as the backdrop for his speech on Thursday.

[Throughout the week, government watchdogs and other critics of the administration noted the wanton disregard being shown for previous norms and regulations regarding the use of government officials or taxpayer property to promote a campaign for office. The Hatch Act, an 81-year-old law, prohibits such uses but has not been used to send anyone to jail. When asked about this during the week, White House Chief of Staff Mark Meadows said: “No one outside of the Beltway really cares.”]

Calling Protesters 'Thugs' And Biden Extreme, Trump's Bombastic Campaign Returns

Trump’s case for himself may have been even sharper on Monday, when he made an unscheduled appearance in Charlotte. Here, instead of the 50,000 attendees originally anticipated, a remnant of 336 delegates had done the official business of renominating the incumbent. The unopposed incumbent had won every state, and in fact every vote from every state. Many states had canceled their primaries or caucuses on the Republican side.

As he followed Vice President Pence onstage in Charlotte, Trump was greeted with chants of “four more years.” He replied: “If you want to really drive them crazy you say: ‘Twelve more years.’ ”

The president did not explain how a four-term presidency might happen, given the constitutional limit of two terms set by the 22nd Amendment to the Constitution halfway through the 20th century.

But the president did offer an hour’s worth of free-form, wide-ranging ruminations on everything from the state of the national economy to trade deals with China and South Korea and the kinds of people most likely to die from COVID-19 (“It affects older people, the elderly, people with problems, with heart, diabetes, other problems.”) By Friday, two attendees at the Charlotte event and two support staff had tested positive for the virus.

But in that hour in Charlotte, the president was loose and very much among friends. His language veered beyond informal to crude at times, but no one in the hall seemed to mind. The shouts of “we love you” and “thank you, Mr. President,” were recurrent, persistent and well-amplified to be clearly audible on TV.

Monday’s midday walk-on was not widely seen, but clips were great fodder for cable TV. And the prime-time TV audience began tuning in that same night, when Trump was not featured but did make a cameo appearance. The same happened on the second and third nights, posing the president for pictures with Melania, his wife, or Pence, his vice president, just as the TV anchors were signing off.

A creature unto itself

This Republican gathering was sui generis, a creature unto itself, unlike any preceding convention any party held since such gatherings began in the 1830s. The Democrats the week before had met almost entirely online, but the Republicans managed to perform before live audiences that were small but vocal and highly enthusiastic.

The overnight reviews split along partisan lines as sharply, and predictably, as the votes on impeachment in Congress last winter. It is hard to remember now that President Trump is the only president ever to face the voters after being impeached (or forced from office under threat of impeachment).

But if that was any inhibition for him, it did not show. It was not in his prepared remarks, but he again asserted in his concluding speech that “Obama and Biden spied on me and got caught” – an allusion to his explanation for the investigation of his ties to Russian interference in the 2016 election. Multiple investigations have yet to find evidence to prove this accusation.

Trump did not mention his actual impeachment, but several other speakers from his retinue did during the week. It was noted that the Democrats, who impeached Trump in the House and pressed for his removal from office in the Senate, did not mention impeachment in their prime-time speeches the previous week.

But sadly for the president, impeachment was only the first dire challenge to face in his reelection year. And it has proven more difficult to elide the facts and consequences of the others.

Despite the president’s assertions, the crisis over the COVID-19 pandemic rages on, with more than 180,000 dead and still nearly a thousand dying each day. The U.S. also adds thousands of new infections each day (leading the world with 5.9 million as of Saturday), while the administration responds by trying to limit the number of people getting tested and promoting various therapies that have not been shown to be helpful.

The president has repeatedly blamed the testing for the high numbers of new cases. He and others in his orbit have suggested only people showing symptoms of the disease should be tested at all. Still, flashing the bravado that characterized his business career, Trump has insisted his handling of the virus has been not only defensible but exemplary.

Recession the larger threat?

What has seemed to concern the president more is the dislocation the pandemic has caused in the economy, which crashed in March. The gross domestic product for the second quarter fell by nearly a third (on an annualized basis), and unemployment soared to nearly 15%. Both measures were the worst since the Great Depression. Aggrieved by the shutdown of schools and workplaces, Trump began saying, “The cure cannot be worse than the disease.”

Today, Trump can point to some bright spots. The stock market has rebounded to regain its previous highs. Partial reopening of many businesses has allowed many laid-off workers to return to work. But the positive jobs trend at mid-summer has since reversed itself, and a million or more people are again filing for unemployment compensation each week.

At the scaled-down RNC this week, all talk of the economy was spun to highlight the happier times of last winter and look forward to a snapback next winter. As he usually does, Trump took credit for the “strongest economy in history” and a record number of people with jobs. But both claims, while often repeated, are shaky. As was noted the previous week by the Democrats, there were more jobs created in the U.S. in the last three years under Obama than in the first three under Trump. More than a million more.

But whatever the validity of of Trump’s claims about the past, current reality for millions of the unemployed is dire. With the virus still far from controlled, the economic climb could get steeper as well.

Given all the strange and strained circumstances, no one can be surprised that this convention seemed so different from all its historic analogs. But the starkest contrast was with those past conventions staged by incumbent presidents seeing a second term — especially those in the era of TV coverage.

Looking just at GOP conventions renominating incumbents, the record is impressive. Four of the five incumbents in this era went on to win a second term (George W. Bush, Ronald Reagan, Richard Nixon and Dwight Eisenhower). The latter three won reelection in landslides: Ike carried 41 of 48 states, Nixon and Reagan each carried 49 of 50.

7 Takeaways From The Republican National Convention

Conventions Bring Sharper Faith Appeals From Both Parties

Those campaigns featured supremely confident conventions with little or no controversy touching the candidate (other than health concerns following Eisenhower’s 1955 heart attack).

George W. Bush was renominated in 2004 in New York City to celebrate that city’s comeback from the Sept. 11 attacks of 2001. The stars of that show were the city’s former mayor Rudy Giuliani (also on the program Thursday night, although with far less starpower impact) and the movie star Arnold Schwarzenegger, then a newly elected governor of California, who has since disappeared from Republican politics.

The one renominating GOP convention in these five that presaged a losing November was the 1992 event on behalf of President George H.W. Bush in his hometown of Houston. And a review of that episode turns up some similarities in rhetoric to what we heard this week. Rich Bond, the party’s national chairman, told the convention hall “We are America, they [the Democrats] are not America.” This week, Pence told the crowd at Fort McHenry that “America is on the ballot.”

It has often been said that the elder Bush’s show fell flat for two reasons. First, it failed to address the big negative story hanging over the country – lagging recovery from a recession that had lingered in some swing states. But the other problem for the incumbent nominee was one Trump did not have: speakers whose performance overshadowed the nominee’s own. One was Reagan, then just four years out of office and still immensely popular. In the last major address of his career, Reagan reminded the audience he had chosen Bush as his vice president; but many in the audience were reminded how much they preferred Reagan.

A speech sets campaign tone

A larger problem was the indelible opening night speech by Patrick Buchanan, a former journalist and speechwriter both for Reagan and the previous Republican president Richard Nixon. Buchanan had run against Bush, his party’s incumbent president, in the GOP primaries that year. While he had just 18 delegates, the Bush team wanted his help with the party’s more populist, nationalist wing. (Buchanan would later run for president as a third-party candidate on the campaign slogan “America First.”)

Buchanan’s outsider campaign had been about reducing immigration and resisting social changes such as abortion rights, gay rights, women in combat units and multicultural education. In Houston, he said these were “not the kind of change America wants and not the kind of change we can abide in a nation we still call God’s country.” He spoke of “a cultural war” in America and said that summer’s Democratic Convention had featured “20,000 radicals and liberals dressed up as moderates and centrists.”

Buchanan closed by paying tribute to National Guard troops sent to Los Angeles that summer to quell street riots after a jury acquitted police officers videotaped beating Rodney King, a black man. Buchanan said the soldiers, with bayonets fixed, were “taking back America, block by block.”

The speech lit up the Astrodome, unleashing a roar from the crowd that seemed to reverberate throughout the week and beyond. It would be widely criticized as incendiary and contradictory of Bush’s “kinder, gentler” conservatism. But it overshadowed the incumbent president’s own speech at week’s end, which lacked the force of his first acceptance speech four years earlier.

All conventions have their memorable moments, positive or otherwise, and their connection to either victory or defeat will always be subject to debate. This year’s versions, one online and one largely a hybrid, were both scaled way back from historic expectations. Their actual effect on the campaign’s outcome may be similarly reduced, perhaps even marginal.

In 2024, we may be eager to hold traditional conventions again, or we may have come to regard them as an anachronism. Much may depend on who is in the White House at that time, and on how much of a contribution that person believes the 2020 convention made to the November outcome.

Read More

Categories
handling pandemic'

‘Not handling the pandemic well’: Man fires at officers with AK-47 after refusing to wear a mask, police say – The Washington Post

When a cigar shop clerk told Adam Zaborowski on Friday he had to wear a mask in the shop, the 35-year-old angrily refused. Instead, he grabbed two stogies, stormed outside — and then pulled a handgun and shot at the clerk, Bethlehem Township, Pa., police said.

The next day, cornered near his home, Zaborowski allegedly fired at police with an AK-47, sparking a wild shootout with at least seven officers that ended with him shot multiple times and under arrest.

The case is the latest violent incident tied to arguments over mandatory mask orders. But Zaborowski’s reaction was driven by his own intense difficulty with the pandemic, his attorney claimed; before the shootout, Zaborowski had lost his job and had also recently lost custody of his child.

“He just wasn’t dealing well with the loss of his job, the loss of his child, just not handling the pandemic well,” John Waldron told the Express-Times on Sunday, while noting those factors didn’t justify his violent conduct. “I think he was getting stretched too tight.”

Zaborowski’s alleged rampage started Friday morning at Cigars International in Bethlehem Township, where he adamantly argued he didn’t have to wear a mask, even after a clerk offered to serve him curbside.

“It’s crazy,” said Tom Gallagher, who was shopping in the store at the time. “It’s the mask. The guy was obviously anti-mask.”

After Zaborowski walked out without paying for his cigars, police say he fired his gun once in the air and twice at a clerk who confronted him outside. Multiple customers were also sitting outside the shop in the direction he fired.

The next morning, police and state troopers were waiting to arrest Zaborowski outside his home in Slatington, Pa., when he hopped in a truck and drove off, police told the Express-Times. When they stopped him nearby, he jumped out of the vehicle and started firing at police with the AK-47 and a semiautomatic handgun.

“Both the Slatington Borough officer and troopers returned fire and struck Zaborowski,” State Trooper Nathan Branosky said in a news release.

Zaborowski was hit in the buttocks and leg, Waldron said, and is expected to recover.

“The fact that he got shot twice with non-life-threatening injures when he had an AK-47 and another handgun, Adam is very fortunate he ended up the way he did,” Waldron told the Express-Times.

He is now charged with 22 counts including attempted homicide, aggravated assault and robbery, the Express-Times reported, and is being held on $1 million bail.

Read More

Categories
Coronavirus pandemic'

Coronavirus pandemic causes another health concern — closed public restrooms – The Washington Post

SEATTLE — When courier Brent Williams makes his daily deliveries around the city here, he runs into one persistent problem: There’s almost nowhere to use the restroom. Most public buildings are closed under the pandemic, and restaurants and coffee shops that have shifted to carryout service won’t let him use their facilities.

“It’s hard to find any place where I can use the restroom,” said Williams, speaking outside a ­library in Seattle’s Ballard neighborhood that has reopened its ­restrooms to the public.

The library is one of five citywide to have opened their doors, and other parts of the city have almost no options for those who need to relieve themselves or wash their hands.

“I understand why some people downtown will duck into an alleyway,” he said. “There’s nowhere else to go, and I’m not going to do it in my pants.”

The lack of restrooms has become an issue for delivery workers, taxi and ride-hailing drivers and others who make their living outside of a fixed office building. For the city’s homeless, it’s part of an ongoing problem that preceded covid-19.

“It’s gone from bad to worse,” said Eric, who lives in an encampment near Interstate 5. (Eric asked to be identified by only his first name.) “It’s definitely much, much harder.”

A nearby pet supply store used to let homeless people use the restroom, but that changed during the pandemic. Conditions improved markedly when the city placed a portable restroom and handwashing station near the camp, but Eric said many more parts of town still lack similar amenities.

“It doesn’t smell like urine out here anymore,” he said. “Forty to 50 people having to [urinate] and [defecate] every day, what do you expect? I’m surprised we don’t see these [portable stations] all over the place.”

Seattle officials say the city has set up 32 portable toilets during the pandemic, bringing the total to 114 citywide. Another 107 restrooms are available at city parks. At the five reopened library restrooms, nearly 6,000 patrons have taken advantage of the facilities, according to the library system, which has been tracking usage.

But advocates for the homeless say the city has come nowhere close to meeting the need.

“All the public libraries, all the public buildings, all the coffee shops — we’re probably down thousands of restrooms,” said Alison Eisinger, executive director of the Seattle/King County Coalition on Homelessness. “There’s no way to make up for that with handwashing stations and a few port-a-potties.”

Eisinger’s group has asked throughout the pandemic for Seattle to reopen all public buildings for restroom use. Sabrina Register, spokeswoman for Seattle Public Utilities, did not answer emailed questions about reopening public buildings, or whether the city thinks its restroom supply is adequate.

She did note that Seattle has erected nearly 100 new shelter spaces in tiny house villages for the homeless, but added that “the need outweighs our available resources” during the pandemic.

Eisinger said some homeless people in the city have resorted to wearing adult diapers or using five-gallon buckets filled with cat litter. She pointed to the city’s recent hepatitis A outbreak — as well as that covid-19 can live in feces — as evidence that the city’s restroom shortage is a public health failure.

“This is a government responsibility, an obligation to the public to protect people’s health and safety,” she said. “This is a rich city in a rich county, and we still haven’t made available to people regular, dignified simple basics. It is better to meet folks’ needs on a regular basis than to wait until there is a public health crisis.”

The public restroom crisis is not limited to Seattle, nor did it begin during the pandemic. Those who study the issue say American cities have spent decades divesting from such facilities, leaving private businesses such as Starbucks and McDonald’s to pick up the slack.

“The government has basically given up on installing public toilets,” said Steven Soifer, a social work professor at the University of Mississippi who leads the American Restroom Association, which advocates for better public infrastructure. “It took something like the coronavirus to bring it out in the open.”

Private companies might require guests to buy something before using the restroom, advocates said, creating a barrier for homeless or otherwise marginalized people. In places where public urination laws are enforced, those who can’t pay may face repercussions.

“You’re criminalizing having a bladder,” said Taunya Lovell Banks, a professor at the University of Maryland School of Law who recently wrote a law review article about the lack of public toilets. “If you’re caught by the police and ticketed, you have to register as a sex offender. It’s beyond the pale.”

Banks noted that businesses may be less likely to allow homeless people to use their facilities, and people of color also are less assured of gaining access. For female-bodied people, urinating discreetly in the absence of restrooms is not always possible.

“It’s a class issue, it’s a race issue, it’s a gender issue,” she said. “[During the pandemic,] middle-class white people who normally have greater access to toilets in public spaces are all of a sudden being denied access. Now they’re woke to it.”

Covid-19 has made things much worse. Market reports show that sales of urine funnels, external catheters and other restroom substitutes have skyrocketed during the pandemic.

Public urination is on the rise in New York City, and leaders in Montpelier, Vt., fear that closures have left the city without an adequate restroom supply. In Chicago, delivery drivers can’t use the restrooms at restaurants when they pick up food, leaving some to resort to urinating in alleys.

Governments and businesses alike are justifiably concerned about the risk of covid-19 transmission in restrooms. Research has found that flushing creates “toilet plumes” that can spread particles carrying the coronavirus.

Places that do have open restrooms often need to limit occupancy and clean them frequently. Soifer said some restrooms have blocked off every other urinal.

But closing restrooms is its own public health risk. If delivery drivers, for instance, don’t have a place to safely relieve themselves and wash their hands, they risk spreading infection via the food and packages they drop off. Waste that ends up in the streets also could contribute to the spread of covid-19 or other diseases.

Ben Valdez, a Los Angeles-based ride-hailing driver and an organizer with Rideshare Drivers United, said he carries an empty bottle in the car in case of emergency — along with lots of disinfectant wipes and hand sanitizer.

“I literally have to plan my evening around being near a restroom,” he said “If I know I have no restroom available to me, I can’t drink anything or eat anything. I’ve had numerous occasions where I’ve had to decline a ride because I’ve been in that situation.”

Valdez said many gas stations now have “out of order” signs on their restrooms — likely an effort to limit transmission risk rather than an actual plumbing issue. Some hotels have limited access to lobby restrooms as well. With a driving radius that often reaches 100 miles, Valdez has found no institutions he can consistently count on to find a facility.

In San Francisco, officials have expanded the city’s Pit Stop program, which they think is a leading model for providing restroom access. The city set up 37 toilets to bolster the 24 already in place before the pandemic. The toilets are staffed by nonprofit partners, who clean them between each use and monitor for drug use and overdoses.

Since the city began staffing toilets, said Beth Rubenstein, spokeswoman for the San Francisco Public Works Department, the number of flushes per day went up “exponentially.” In neighborhoods where the Pit Stop toilets have been installed, the city has seen fewer calls for waste cleanup on the streets.

“It ensures cleanliness and safety,” Rubenstein said. “I know that the increased number of toilets [during the pandemic] has been very much used. Our essential workers use them as well, including our Public Works staff.”

Stateline is an initiative of the Pew Charitable Trusts.

Read More

Categories
pandemic' SpaceX

Even amid a pandemic, SpaceX is launching more than ever – Ars Technica

Halfway to 2021 —

SpaceX’s 11 launches match the total this year by Russia, Europe, and Japan combined.


  • Falcon 9 leaps off SLC-40 Tuesday with the 3rd GPS-III satellite for the United States Space Force / Air Force.


    Trevor Mahlmann

  • This is the first time the United States Space Force logo has graced the SpaceX Falcon 9 payload fairing.


    Trevor Mahlmann

  • The gray stripe at the bottom of the second stage is to keep the RP-1 fuel warm enough during longer coast periods.


    Trevor Mahlmann

  • Falcon 9 B1060.1 standing vertically on LC-40 at Cape Canaveral Air Force Station in advance of the GPS-III SV03 launch for the United States Air Force.


    Trevor Mahlmann

  • A close-up of the number “60” atop the first stage of Falcon 9.


    Trevor Mahlmann

  • The number 60 also graces the bottom of the first stage, but this is much more challenging to see on subsequent flights due to the soot buildup.


    Trevor Mahlmann

  • This new booster, 1060, will add to the fleet of used rockets SpaceX has available.


    Trevor Mahlmann

  • Clouds make for a nice launch.


    Trevor Mahlmann

  • The Falcon 9 rocket’s performance was nominal.


    Trevor Mahlmann

  • How many more launches will this first stage make?


    Trevor Mahlmann

  • SpaceX has launched the Falcon 9 rocket 88 times, including 11 times in 2020.

On Tuesday, SpaceX launched its 11th Falcon 9 rocket of the year—with a brand-new first stage delivering a 3.7-ton GPS III satellite into orbit for improved navigation services. The mission’s customer, the US Space Force, was happy.

“The successful GPS III SV03 launch and recovery serves as another step in our journey with industry partners to create innovative, flexible, and affordable services to meet NSSL mission objectives and propel US dominance in space,” said Col. Robert Bongiovi, Launch Enterprise director.

Tuesday afternoon’s launch puts the company on pace for 22 missions in this calendar year, which would break the company’s previous record of 21 launches set in 2018. What seems more remarkable about this pace is that it has occurred amid a global pandemic that has slowed operations in many other countries.

For example, SpaceX’s 11 launches match the total so far this year by Russia, Europe, and Japan combined. Globally, the company ranks second only to China’s state enterprise, which has attempted 15 orbital launches in 2020, two of which have been failures.

Much of the company’s activity during the pandemic has been driven by its own payloads. SpaceX has launched seven Starlink missions during the first half of this year, putting nearly 420 of its own satellites into low-Earth orbit. The company is moving forward with efforts to begin offering limited commercial Internet service by late this year or early 2021.

Barring a catastrophe, it seems likely that SpaceX will easily launch a dozen or more Falcon 9 rockets between now and the end of this year. The company has as many as 18 launches on its manifest, including half a dozen Starlink missions, a second Crew Dragon mission, a supply mission to the International Space Station, and several commercial missions. Its next launch may occur in a week, with the Starlink-9 mission, on July 8.

Thanks to the successful recovery of the first stage from Tuesday’s launch, SpaceX now has five first stage boosters at its disposal for future missions. Of those, it will be most interesting to see if, or when, Booster 1049 flies again. This first stage has already flown five flights dating back to September 2018 and could be ready for its sixth mission by the end of July—if engineers deem it safe to fly again.

Listing image by Trevor Mahlmann

Read More

Categories
Brutal pandemic'

‘Brutal Pandemic Reality Check’: Top CDC Official Gives Grim Assessment on Coronavirus Containment – Common Dreams

Dr. Anne Schuchat, principal deputy director of the Centers for Disease Control and Prevention, testifies before the Senate Health, Education, Labor and Pensions Committee during a hearing on “An Emerging Disease Threat: How the U.S. Is Responding to COVID-19, the Novel Coronavirus” on March 3, 2020 in Washington, D.C. (Photo: Sarah Silbiger/Getty Images)

The number two official at the Centers for Disease Control and Prevention gave a grim assessment Monday about the spread of the coronavirus in the U.S., warning the country is “not even beginning to be over this” and “clearly not at a point where there’s so little virus being spread that it’s going to be easy to snuff out.”

The comments from CDC principal deputy director Dr. Anne Schuchat came in a live-streamed Q&A session with The Journal of the American Medical Association.

Schuchat contrasted the situation in the U.S. with that of New Zealand or Singapore, “where a new case is rapidly identified and all the contacts are traced and people are isolated who are sick and people who are exposed are quarantined and they can keep things under control.”

“We have way too much virus across the country for that right now, so it’s very discouraging,” she said.

The new surge of Covid-19 cases in the U.S., warned Schuchat, is “really the beginning.”

“I think there was a lot of wishful thinking around the country that, ‘Hey it’s summer. Everything’s going to be fine. We’re over this,’ and we are not even beginning to be over this,” said Schuchat, adding, “There are a lot of worrisome factors about the last week or so.”

“As much as we’ve studied [the 1918 flu pandemic], I think what we’re experiencing as a global community is really bad and it’s similar to that 1918 transformational experience,” she said.

PBS Newshour‘s William Brangham tweeted Schuchat’s comments served as a “brutal pandemic reality check.”

SCROLL TO CONTINUE WITH CONTENT

The nonprofit, independent journalism of Common Dreams needs your help. Our journalists are working harder than ever to bring you journalism that is essential to the survival of our democracy. But we can’t do it without you. Please support our 2020 Mid-Year Campaign today:

Public health experts weighed in on the interview as well.

Forthright, important comments on seriousness of US COVID situation from Anne Schuchat principal deputy @cdcgov. The country should hear more from Dr Schuchat who has led through big epidemics in past, planned for years, and speaks directly and factually https://t.co/ieNJzfWWlK

— Tom Inglesby (@T_Inglesby) June 30, 2020

Seeing Dr. Anne Schuchat speaking out and getting quoted in the press is the most encouraging COVID development in a long time, notwithstanding that she is bringing bad news = truth, a scarce commodity from USG recently. https://t.co/KrG6jBWfuB

— Marc Lipsitch (@mlipsitch) June 30, 2020

I listen to every word Dr. Schuchat says on @COVID19. She’s worked on this for 20+ years. Brilliant, thoughtful, effective. This is ESSENTIAL listening. Virus is “incredibly infectious.” More masks, less chance for virus to spread. Pearls of wisdom. Professional epidemiology. https://t.co/r4hzJWZJrr

— Dr. Tom Frieden (@DrTomFrieden) June 30, 2020

Schuchat’s interview took place the same day World Health Organization Director-General Dr. Tedros Adhanom Ghebreyesus gave a similarly sobering assessment of progress to contain the coronavirus, saying that “this is not even close to being over.”

“Although many countries have made some progress,” he said, “globally the pandemic is actually speeding up.”

As of press time there were over 10.4 million confirmed cases of the coronavirus, including over 2.6 million in the U.S., according to Johns Hopkins.

The university’s tracker also showed that Covid-19 has led to 509,706 deaths, 129, 545 of which were in the U.S.

Read More

Categories
latest pandemic'

The Latest Pandemic Shortage: Coins Are The New Toilet Paper – NPR

Banks around the U.S. are running low on nickels, dimes, quarters and even pennies because of problems with production and distribution caused by coronavirus pandemic.

Bloomberg/Bloomberg via Getty Images


hide caption

toggle caption

Bloomberg/Bloomberg via Getty Images

Banks around the U.S. are running low on nickels, dimes, quarters and even pennies because of problems with production and distribution caused by coronavirus pandemic.

Bloomberg/Bloomberg via Getty Images

Just as supplies of toilet paper are finally getting back to normal, the coronavirus has triggered another shortage of something we typically take for granted: pocket change.

Banks around the U.S. are running low on nickels, dimes, quarters and even pennies. And the Federal Reserve, which supplies banks, has been forced to ration scarce supplies.

“It was just a surprise,” said Gay Dempsey, who runs the Bank of Lincoln County in Tennessee, when she learned of the rationing order. “Nobody was expecting it.”

Dempsey’s bank typically dispenses 400 to 500 rolls of pennies each week. Under the rationing order, her allotment was cut down to just 100 rolls, with similar cutbacks in nickels, dimes and quarters.

That spells trouble for Dempsey’s business customers, who need the coins to stock cash registers all around Lincoln County, Tenn.

“You think about all your grocery stores and convenience stores and a lot of people that still operate with cash,” Dempsey said. “They have to have that just to make change.”

Rural banks in particular seem to be getting shortchanged, according to Colin Barrett, CEO of the Tennessee Bankers Association.

Rep. John Rose, R-Tenn., sounded the alarm last week during a hearing before the House Financial Services Committee.

“My fear is that customers who use these banks will react very poorly,” Rose said. “And I know that we all don’t want to wake up to headlines in the near future such as ‘Banks Out of Money.’ ”

The congressman warned that if businesses are unable to make exact change, they’ll be forced to round up or round down, “in a time when pennies are the difference between profitability and loss.”

Federal Reserve Chair Jerome Powell assured Rose that the central bank is monitoring the situation closely.

“We’re working with the mint to increase supply, and we’re working with the reserve banks to get that supply where it needs to be,” Powell said. “So we think it’s a temporary situation.”

The U.S. Mint produced fewer coins than usual this spring in an effort to protect employees from infection. But the larger problem — as with many other pandemic shortages — is distribution.

During the lockdown, many automatic coin-sorting machines that people typically use to cash in loose change were off-limits. And with many businesses closed, unused coins piled up in darkened cash drawers, in pants pockets and on nightstands, even as banks went begging.

“The flow of coins through the economy … kind of stopped,” Powell said.

The Fed chairman stressed that this clog in the financial plumbing should clear quickly, now that businesses are reopening, and that supplies of coins should soon be back to normal.

In the meantime, Dempsey, the banker, has secured an emergency stash of coins from some of her business customers who run vending machines and laundromats.

While a growing number of people rely on credit cards or smartphone apps for many transactions today, the coin crunch is a reminder that sometimes you just need change.

“Cash is still king, I guess,” Dempsey mused.

Read More

Categories
pandemic' Since

Since the pandemic, 39 percent of Americans use cleansers and disinfectants in risky ways – The Washington Post

People have been amping up their use of cleansers and disinfectants in their homes to guard against the novel coronavirus. But 39 percent of U.S. adults are doing so in risky ways, according to a new report from the Centers for Disease Control and Prevention. Nearly 20 percent say they have washed fruits and vegetables with bleach or used household cleansers or disinfectants on their hands. Other reported risky practices included misting the body with a household cleaning or disinfectant spray and drinking or gargling with bleach solutions, soapy water or other cleaning and disinfectant solutions. Based on survey data from a panel of 502 adults, determined to be a representative sampling of the U.S. population, the CDC says that people who used at least one of these unsafe practices were more than twice as likely to have a subsequent health issue — irritation of the nose, sinuses, skin or eyes, nausea or an upset stomach, dizziness, headaches or breathing problems — than were those who did none of these things (39 percent vs. 16 percent). The CDC says that calls to poison centers from January, just before covid-19 began to spread, through March about exposure to cleaning products and disinfectants increased 20 percent compared with the same period last year. Although the agency says that “transmission of coronavirus occurs much more commonly through respiratory droplets than through objects and surfaces,” hence the importance of social distancing and wearing masks, studies have found that the virus can remain viable for hours or days on surfaces. For that reason, health experts recommend disinfecting frequently touched surfaces where covid-19 transmission is a risk. People should wear disposable gloves and possibly eye protection, use no more than the amount recommended on a product’s label and avoid mixing chemical products. Health experts also say never eat, drink, breathe or inject a household cleanser or disinfectant into your body or apply it on your skin.

Read More

Categories
pandemic' Russia

In Russia’s pandemic struggles, even Putin couldn’t speed bonuses to health workers – The Washington Post

MOSCOW — It was mid-March, and Russia had reported just 114 covid-19 cases, but President Vladimir Putin wanted to make a grand gesture: bonus payments for medical workers “who are performing their duties with honor.”

But weeks rolled on, and Russia’s pandemic numbers ballooned past 250,000 and then 350,000 — now at more than 370,000, the world’s third-largest number of confirmed cases after the United States and Brazil.

Medical workers were dying in their hundreds — 308 according to an unofficial count by medics. Many who kept working were not getting paid long-promised bonuses until recently. Some were even earning less money because the pay rate for working with covid-19 patients was lower than for their pre-pandemic jobs, such as surgeons.

The snags in delivering Putin’s bonus promise is more than just one bureaucratic glitch. It’s about a top-down governance system with underlings terrified to act. It also helps inform some of the larger truths in Russia’s struggle to control the pandemic even as countries to the west in Europe begin to lift their lockdowns.

Putin’s centralized power structure cannot handle the crisis alone. The president delegated much of the burden to regional officials, who were frightened of drawing attention to local problems and risking Moscow’s wrath.

One way to stay under the radar could be to understate cases or deaths, analysts say. With Putin’s promised bonuses, the instinct by regional leaders — ingrained over decades — was to minimize payments, fearing trouble from Moscow if they spent too much or paid people not entitled to bonuses.

Some regional officials have even counted the minutes that medical workers spent with infected patients.

“For Putin it’s a very uncomfortable position,” said Tatiana Stanovaya, director of Moscow political think tank R. Politik. “In fact, he turns out to be dependent on regional governors. Putin asks for something, and the government is not able to implement it in the way Putin intended.”

Low official figures

It has left Russia on the defensive on many fronts, including with regard to its official figures indicating an unusually low mortality rate. Authorities have vigorously denied accusations that statistics are being manipulated, claiming that Russia’s low rate is a sign the government is doing a good job. But it also could be Russia’s conservative counting method.

Infected patients who die in hospitals undergo autopsies. If there are no signs of lung infection, alternative causes are listed as the cause of death.

But regional statistics on cases and deaths were unreliable, Stanovaya said.

“For example, in the Caucasus region it’s just a total mess,” she added. “The numbers they give are like a fake, nothing to do with reality. In other regions, they’re not very careful with statistics and with these tests.”

There is no hiding the strains on Russia’s health system, though.

Svetlana Munirova, a surgeon of 20 years experience at Pokrovskaya hospital in St. Petersburg, was shocked to find her April pay dropped from 50,336 rubles (around $708) to 43,996 rubles ($619) as a result of being deployed to covid-19 treatment.

She did not get her bonuses until mid-May, she said in an interview, but her basic salary is lower because an infectious-disease doctor is paid less than a surgeon.

A cardiology surgeon in the same hospital told the Novaya Gazeta newspaper last month that he was normally paid the equivalent of $1,158 a month but received half as much in April because he was treating covid-19 patients.

“I don’t know why it was so hard to pay doctors and medics despite the fact that the authorities repeatedly ordered it,” said Munirova. “All my reflections on this issue will hardly change anything. Probably, like in most cases, the money ‘got lost’ on the way.”

At government meetings, Putin has grown testier by the day.

“Listen to me. Listen carefully. We have agreed, and it was clearly and unambiguously stated, that this money should be paid for working with patients with the coronavirus infection, not for some hours or minutes they are putting in,” he said at a televised May 15 meeting with government health, defense and regional officials.

Four days later, he was nagging again. “Back in March, we made provisions for incentive payments,” he complained in a televised meeting, adding that almost all of the allocated 51 billion rubles ($720 million) had been sent to regions.

“To my knowledge, far from all those who were entitled to these payments received them,” he snapped.

On Monday, health authorities finally reported that all necessary bonuses had been paid to 153,373 medical workers.

‘Very confusing’

Stanovaya said regional officials interpreted the bonus payment order as narrowly as they could: Regional governors are under pressure to prove they are doing a good job fighting the virus, so they tend to minimize the reported infections.

“Either they declare a lot of covid-19 patients, and they receive more money — but in this case, the Kremlin can interpret it as a failure in fighting this coronavirus — or you will have to decrease these numbers and receive less money,” she said.

One problem is that doctors are paid bonuses only for the exact time worked with patients who tested positive — but many infected patients are asymptomatic, and tests are unreliable in up to 30 percent of cases, Andrei Konoval co-chairman of the Action union of health workers, told Echo of Moscow radio last week.

“The regulations on payments are very confusing. . . . As a result, we have chaos that may lead to more protests among medics,” he said.

In the impoverished Dagestan region in the Caucasus — a region with shortages of ventilators and protective gear — the regional health minister, Dzmaludin Gadzhiibragimov, acknowledged in an interview with local blogger Ruslan Kurbanov that more than 40 doctors in the republic had died of covid-19.

That is a major embarrassment to federal government leaders, with official statistics claiming only 27 covid-19 deaths in the entire republic.

He said the republic had recorded 13,697 cases of covid-19 and community-acquired pneumonia — although the official covid-19 count was just 3,280.

“This is why we don’t trust the statistics,” said Stanovaya.

Putin asserted Tuesday that Russia had passed the peak of covid-19 cases. The daily increase has declined from around 18 percent a day in early April to 2.3 percent Wednesday. Some regions are beginning to open up.

But a spike in new cases in St. Petersburg after holidays in early May, when many people ignored isolation and social distancing rules, indicated potential dangers.

St. Petersburg health committee deputy chairman Andrei Sarana said Wednesday that covid-19 hospitalizations jumped recently from around 200 a day to 670 a day, putting doctors and hospitals under “colossal pressure.”

Natasha Abbakumova contributed to this report.

Read More