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U.S. Health Workers Responding to Coronavirus Lacked Training and Protective Gear, Whistle-Blower Says

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Team members were not properly trained, lacked necessary gear and moved freely around and off military bases where Americans were quarantined, a complaint says.

By Emily Cochrane, Noah Weiland and Margot Sanger-Katz
Published Feb. 27, 2020
Updated Feb. 28, 2020, 7:30 a.m. ET

WASHINGTON — Federal health employees interacted with Americans quarantined for possible exposure to the coronavirus without proper medical training or protective gear, then scattered into the general population, according to a government whistle-blower who lawmakers say faced retaliation for reporting concerns.

The team was “improperly deployed” to two military bases in California to assist the processing of Americans who had been evacuated from coronavirus hot zones in China and elsewhere, according to a portion of a narrative account shared with Congress and obtained by The New York Times ahead of a formal complaint to the Office of the Special Counsel, an independent government agency that handles federal whistle-blower complaints.

Staff members from the Department of Health and Human Services’ Administration for Children and Families were sent to Travis Air Force Base and March Air Reserve Base in late January and early February and were ordered to enter quarantined areas, including a hangar where coronavirus evacuees were being received, the complaint said. They were not provided safety-protocol training until five days into their assignment, said the whistle-blower, who is described as a senior leader at the health agency.

Without proper training or equipment, some of the exposed staff members moved freely around and off the bases, with at least one person staying in a nearby hotel and leaving California on a commercial flight. Many were unaware of the need to test their temperatures three times a day.

“I soon began to field panicked calls from my leadership team and deployed staff members expressing concerns with the lack of H.H.S. communication and coordination, staff being sent into quarantined areas without personal protective equipment, training or experience in managing public health emergencies, safety protocols and the potential danger to both themselves and members of the public they come into contact with,” the whistle-blower wrote. House Democrats said on Thursday that the official who voiced concerns to superiors about the situation was subjected to professional retaliation.

In a statement on Thursday, the Department of Health and Human Services acknowledged the complaint, which was first reported by The Washington Post, without elaborating.

“We take all whistle-blower complaints very seriously and are providing the complainant all appropriate protections under the Whistleblower Protection Act,” said Caitlin B. Oakley, a deputy assistant secretary and a national spokeswoman for the Office of the Assistant Secretary for Public Affairs. “We are evaluating the complaint and have nothing further to add at this time.”

A former department official who spoke on the condition of anonymity said that two senior officials there who were directly involved with the situation believed the whistle-blower was making the accusations in an effort to protect their job after being told they would be reassigned. The officials involved contended that the teams were not in any danger, the person said, and that testing was not done because none of the personnel showed symptoms of being sick.

The account surfaced as President Trump seeks to play down the danger of a domestic coronavirus outbreak amid bipartisan concern about a sluggish and disjointed response by the administration to an illness that public health officials have said is likely to spread across the United States. The first American case of coronavirus in a patient with no known contact with hot zones or other coronavirus patients emerged this week near Travis Air Force Base.

The complaint raised questions about whether the Trump administration had taken adequate precautions in its handling of the virus, and whether Mr. Trump’s minimization of the risks had been mirrored by other top officials when confronted with potentially disturbing developments.

The Coronavirus Outbreak
Answers to your most common questions:
Updated Feb. 26, 2020

What is a coronavirus?
It is a novel virus named for the crownlike spikes that protrude from its surface. The coronavirus can infect both animals and people and can cause a range of respiratory illnesses from the common cold to more dangerous conditions like Severe Acute Respiratory Syndrome, or SARS.
How worried should I be?
New outbreaks in Asia, Europe and the Middle East are renewing fears of a global pandemic. The Centers for Disease Control and Prevention warned this week that Americans should brace for the likelihood that the virus will spread to the United States.
How do I keep myself and others safe?
Washing your hands frequently is the most important thing you can do, along with staying at home when you’re sick.
What if I’m traveling?
The C.D.C. has warned older and at-risk travelers to avoid Japan, Italy and Iran. The agency also has advised against all nonessential travel to South Korea and China.
How can I prepare for a possible outbreak?
Keep a 30-day supply of essential medicines. Get a flu shot. Have essential household items on hand. Have a support system in place for elderly family members.
Where has the virus spread?
The virus, which originated in Wuhan, China, has sickened more than 80,000 people in at least 33 countries, including Italy, Iran and South Korea.
How contagious is the virus?
According to preliminary research, it seems moderately infectious, similar to SARS, and is probably transmitted through sneezes, coughs and contaminated surfaces. Scientists have estimated that each infected person could spread it to somewhere between 1.5 and 3.5 people without effective containment measures.
Who is working to contain the virus?
World Health Organization officials have been working with officials in China, where growth has slowed. But this week, as confirmed cases spiked on two continents, experts warned that the world was not ready for a major outbreak.
The workers who were sent to the scene were not medical professionals and usually help low-income Americans returning to the United States from foreign countries during crises.

THE LATEST Read our live coverage of coronavirus developments.

In a narrative prepared for Congress, the whistle-blower painted a grim portrait of staff members who found themselves suddenly thrust into a federal effort to confront the coronavirus in the United States. The whistle-blower said their own health concerns were dismissed by senior administration officials as detrimental to staff “morale.” They were “admonished,” the complainant said, and “accused of not being team players,” and had their “mental health and emotional stability questioned.”

After a phone call with health agency leaders to raise their fears about exposure to the virus, the staff members described a “whitewashing” of the situation, characterizing the response as “corrupt” and a “cover-up,” according to the narrative, and telling the whistle-blower that senior officials had treated them as a “nuisance” and did not want to hear their worries about health and safety.

A separate team not connected to the whistle-blower complaint was dispatched to Marine Corps Air Station Miramar in San Diego to help coronavirus evacuees from Wuhan, China, the center of the outbreak, according to two people with direct knowledge of the effort. One of those people said they also lacked protective gear.

At Miramar, one of the people said, guidelines were unclear and sometimes contradictory, and different teams appeared to be following different protocols. Professional cleaning crews in full protective gear — eye and respiratory protection and gloves — cleaned the quarantine area at the same time that Centers for Disease Control and Prevention doctors wearing business suits interacted with evacuees at close range.

Standards were lax at first, this person said, but once patients appeared to become sick, workers began wearing personal protective equipment. One member of the team is now back at work and has yet to be tested for coronavirus exposure, the person added, although the C.D.C. sends daily texts checking in on whether they have symptoms.

Representative Jimmy Gomez, Democrat of California, whose office received the whistle-blower complaint, appeared to allude to it on Thursday morning at a House Ways and Means Committee hearing with Alex M. Azar II, the secretary of health and human services.

Image“To your knowledge, were any of the A.C.F. employees exposed to high-risk evacuees from China?” Representative Jimmy Gomez, Democrat of California, asked Alex M. Azar II, the secretary of health and human services.
“To your knowledge, were any of the A.C.F. employees exposed to high-risk evacuees from China?” Representative Jimmy Gomez, Democrat of California, asked Alex M. Azar II, the secretary of health and human services.Credit...Anna Moneymaker/The New York Times
“To your knowledge, were any of the A.C.F. employees exposed to high-risk evacuees from China?” Mr. Gomez asked Mr. Azar.

“They should never have been,” Mr. Azar responded, unless they had special suits designed to protect against infection. “To maintain quarantine, that should be the case.”

Mr. Gomez said his understanding was that the teams sent to March and Travis air bases faced a “chaotic” situation.

“I would not accept your proposition that it was chaotic at all times,” Mr. Azar said. “I am not aware of any violation of quarantine or isolation protocols.”

March air base in Riverside, Calif., housed 195 people evacuated from Wuhan, China, for 14 days beginning in late January, while Travis in Northern California has housed a number of quarantined people in recent weeks, including some of the nearly 400 Americans on the Diamond Princess cruise ship that had docked in Japan.

At a hearing of the House Foreign Affairs Committee after the accusations surfaced, William A. Walters, a top medical official at the State Department, denied that any protocols had been broken.

“Every precaution has been taken,” said Dr. Walters, the head of operational medicine at the department’s Bureau of Medical Services. “I can say unequivocally that everyone involved with those evacuations were properly equipped and trained.”

Representative Richard E. Neal, Democrat of Massachusetts and the chairman of the Ways and Means Committee, said the complaint appeared to be part of a pattern of ineptitude and mistrust of civil servants by the Trump administration.

“The president has spent years assaulting our health care system, draining resources from key health programs, and showing utter disdain for career federal employees who are the backbone of our government,” Mr. Neal said in a statement provided to The Times. “It’s sadly no surprise we’re seeing this degree of ineptitude during a terrible crisis.”

Mr. Neal and Mr. Gomez requested additional information on Thursday evening from Mr. Azar, from the inspector general’s office at the Department of Health and Human Services and from the Government Accountability Office, a nonpartisan watchdog, citing the concerns raised in the whistle-blower report.

In a pair of letters, Mr. Neal and Mr. Gomez formally requested a briefing from Mr. Azar within a week, saying that they were “deeply troubled that H.H.S. seems to have ignored valid public health concerns” as well as reports that the agency had retaliated against the whistle-blower instead of taking action.

In the letter to the Government Accountability Office, they expressed concerns that “management decisions at H.H.S. could have contributed to the spread of the virus within the United States.”

Michael D. Shear and Catie Edmondson contributed reporting.



Florida declares public health emergency after two coronavirus cases

Two cases of the deadly coronavirus were identified in Florida late Sunday — prompting Gov. Ron DeSantis to declare a public health emergency.

The patients, both adults from the Sunshine State’s Gulf Coast, tested “presumptive positive” for COVID-19, Florida health officials said.

That means the cases were confirmed by a public health laboratory, but are awaiting confirmatory testing from the Centers for Disease Control and Prevention.

The first patient, from Manatee County, had no history of travel to a country identified for restricted travel by the CDC, which includes China, Iran, South Korea, Italy and Japan.

The other patient, a resident of Hillsborough County, has traveled to Italy, though health officials didn’t say when.

Both “are isolated and being appropriately cared for,” the state’s health department said.

Shortly after the announcement, Gov. DeSantis issued an executive order declaring a public health emergency, releasing resources to tackle the virus.

He said he’ll be in Tampa and Miami on Monday to speak with the state’s Surgeon General, Dr. Scott Rivkees, about the response to the outbreak.

The announcement of the Florida cases came after New York announced the first patient in the state to test positive for the flu-like illness.


From my inbox...OD Action

Today’s Action: Take action on Trump and Coronavirus, Part 1

As we prepare for the inevitability of coronavirus taking a pass in the United States, we also face a grim fact: Trump has done so much during his presidency to weaken our ability to keep the spread of this disease to a minimum.

In 2018, Trump first fired and then eliminated both the senior position and entire security team that oversees pandemics...right in the middle of the Ebola crisis. In the past few months of the coronavirus buildup, we have not had an expert at the National Security Council in charge of preventing spread to the United States.

He shut down Predict, a successful pandemic preparedness program. Predict, which ran under both Bush and Obama, was instituted in 2005 during the H5N1 bird flu crisis. Its goal: to collect samples from animals to better understand and identify potential life-threatening viruses to humans (the flu, Ebola, HIV, and coronavirus are just a few examples). Predict discovered more than 1,000new viruses before Trump shuttered the program this past fall.

Trump has attempted to sabotage the Center for Disease Control every year of his presidency. This includes his 2021 budget, which has a 16% reduction in the budget, released 11 days after the World Health Organization declared a public health emergency over coronavirus. Thankfully, Democrats have fought back each year and kept CDC funding intact – but we will need to fight again this year.

Call (202.224.3121) or email your Members of Congress and urge them to call for all of the following:

the reinstallation of an experienced senior director at the National Security Council dedicated to overseeing global health threats
the immediate re-opening of Predict
a boost, not a cut, to CDC funding in the 2021 budget

These are steps that fight the damage Trump has wrought in the past, which we need corrected ASAP. Trump and his administration are now taking action to combat the spread of the virus in the United States, but those steps also (big surprise) come with some serious flaws. Tomorrow, we’ll share how you can push for a better coronavirus plan than the one Trump has proposed.



Who Allowed 14 People with Coronavirus on a Plane to US with Uninfected Passengers?
The CDC had previously stated its intent to block anyone who tested positive for the disease caused by the new coronavirus from flying on an evacuation flight. Who overruled whom?
14 people coronavirus plane
Image via KAZUHIRO NOGI/AFP via Getty Images
On Feb. 3 2020, health officials announced that a new coronavirus-infected individual was a passenger on the luxury cruise liner Diamond Princess. At the time, the vessel was off the coast of Yokohama, Japan. In response, the Japanese government mandated a 14-day quarantine, forcing passengers to remain on the ship to avoid spreading the disease to the broader population. Among those passengers were 328 Americans.

The plan had been to send these Americans, by way of a chartered State Department jet, to containment facilities in the United States, following their Japanese quarantine. The condition that no one who tested positive should be a passenger on this flight was included in a Centers for Disease Control and Prevention (CDC) press release from Feb. 15:

All travelers from Japan will be screened before boarding the State Department-chartered aircraft to prevent symptomatic travelers from departing Japan. These planes will be met by a team of U.S. Government personnel deployed there to assess the health of the passengers. The passengers will be screened before leaving the ship and monitored and evaluated by medical and public health personnel every step of the way, including before takeoff, during the flight, and after arrival.

On the day of the flight, however, the government learned that 14 Americans had recently tested positive for COVID-19 (the disease caused by the virus), forcing a game-time decision on the tarmac by the U.S. government, as reported in The Washington Post:

As the buses [filled with quarantined Americans] idled, U.S. officials wrestled with troubling news. New test results showed that 14 passengers were infected with the virus. The U.S. State Department had promised that no one with the infection would be allowed to board the planes. A decision had to be made. Let them all fly? Or leave them behind in Japanese hospitals?

Ultimately, the State Department decided to allow these 14 individuals on the plane in an area separated from the rest of the passengers by plastic. According to The Washington Post, “The State Department and a top Trump administration health official wanted to forge ahead … But officials at the Centers for Disease Control and Prevention disagreed, contending they could still spread the virus.” A joint State Department and Health and Human Services notice explained the decision:

During the evacuation process, after passengers had disembarked the ship and initiated transport to the airport, U.S. officials received notice that 14 passengers, who had been tested 2-3 days earlier, had tested positive for COVID-19. These individuals were moved in the most expeditious and safe manner to a specialized containment area on the evacuation aircraft to isolate them in accordance with standard protocols. After consultation with HHS officials, including experts from the HHS Office of the Assistant Secretary for Preparedness and Response, the State Department made the decision to allow the 14 individuals, who were in isolation, separated from other passengers, and continued to be asymptomatic, to remain on the aircraft to complete the evacuation process.

This decision was so controversial that, according to the Post, “unhappy CDC officials demanded to be left out of the news release that explained that infected people were being flown back to the United States.”

While it is accurate to say that the Trump administration, via “the State Department and a top Trump administration health official,” overruled the CDC’s position and allowed these 14 individuals transport on a plane with uninfected individuals, it bears mentioning that the decision was reportedly made without Trump’s knowledge.

Trump was “briefed on the decision and agreed that healthy passengers should not be on the plane with sick ones,” according to three senior administration officials who spoke to The Washington Post. “The State Department and a top U.S. health official ultimately decided to bring back the 14 Americans who tested positive for the virus on the planes and place them in isolation — without informing the president first,” they said.





Coronavirus: Ten reasons why you ought not to panic

March 6, 2020 6.17pm EST

Regardless of whether we classify the new coronavirus as a pandemic, it is a serious issue. In less than two months, it has spread over several continents. Pandemic means sustained and continuous transmission of the disease, simultaneously in more than three different geographical regions. Pandemic does not refer to the lethality of a virus but to its transmissibility and geographical extension.

What we certainly have is a pandemic of fear. The entire planet’s media is gripped by coronavirus. It is right that there is deep concern and mass planning for worst-case scenarios. And, of course, the repercussions move from the global health sphere into business and politics.

But it is also right that we must not panic. It would be wrong to say there is good news coming out of COVID-19, but there are causes for optimism; reasons to think there may be ways to contain and defeat the virus. And lessons to learn for the future.

Sign up to The Conversation

1. We know what it is
The first cases of AIDS were described in June 1981 and it took more than two years to identify the virus (HIV) causing the disease. With COVID-19, the first cases of severe pneumonia were reported in China on December 31, 2019 and by January 7 the virus had already been identified. The genome was available on day 10.

We already know that it is a new coronavirus from group 2B, of the same family as SARS, which we have called SARSCoV2. The disease is called COVID-19. It is thought to be related to coronavirus from bats. Genetic analyses have confirmed it has a recent natural origin (between the end of November and the beginning of December) and that, although viruses live by mutating, its mutation rate may not be very high.

2. We know how to detect the virus
Since January 13, a test to detect the virus has been available.

3. The situation is improving in China
The strong control and isolation measures imposed by China are paying off. For several weeks now, the number of cases diagnosed every day is decreasing. A very detailed epidemiological follow-up is being carried out in other countries; outbreaks are very specific to areas, which can allow them to be controlled more easily.

4. 80% of cases are mild
The disease causes no symptoms or is mild in 81% of cases. Of course, in 14% it can cause severe pneumonia and in 5% it can become critical or even fatal. It is still unclear what the death rate may be. But it could be lower than some estimates so far.

5. People recover
Much of the reported data relates to the increase in the number of confirmed cases and the number of deaths, but most infected people are cured. There are 13 times more cured cases than deaths, and that proportion is increasing.

U.S. Health Workers Responding to Coronavirus Lacked Training and Protective Gear, Whistle-Blower Says File-20200301-166488-1muyflg.png?ixlib=rb-1.1
Recoveries per day. Coronavirus COVID-19 Global Cases by Johns Hopkins CSSE

6. Symptoms appear mild in children
Only 3% of cases occur in people under 20, and mortality under 40 is only 0.2%. Symptoms are so mild in children it can go unnoticed.

7. The virus can be wiped clean
The virus can be effectively inactivated from surfaces with a solution of ethanol (62-71% alcohol), hydrogen peroxide (0.5% hydrogen peroxide) or sodium hypochlorite (0.1% bleach), in just one minute. Frequent handwashing with soap and water is the most effective way to avoid contagion.

8. Science is on it, globally
It is the age of international science cooperation. After just over a month, 164 articles could be accessed in PubMed on COVID19 or SARSCov2, as well as many others available in repositories of articles not yet reviewed. They are preliminary works on vaccines, treatments, epidemiology, genetics and phylogeny, diagnosis, clinical aspects, etc.

These articles were written by some 700 authors, distributed throughout the planet. It is cooperative science, shared and open. In 2003, with the SARS epidemic, it took more than a year to reach less than half that number of articles. In addition, most scientific journals have left their publications as open access on the subject of coronaviruses.

9. There are already vaccine prototypes
Our ability to design new vaccines is spectacular. There are already more than eight projects underway seeking a vaccine against the new coronavirus. There are groups that work on vaccination projects against similar viruses.

The vaccine group of the University of Queensland, in Australia, has announced it is already working on a prototype using the technique called “molecular clamp”, a novel technology. This is just one example that could allow vaccine production in record time. Prototypes may soon be tested on humans.

10. Antiviral trials are underway
Vaccines are preventive. Right now, the treatment of people who are already sick is important. There are already more than 80 clinical trials analysing coronavirus treatments. These are antivirals that have been used for other infections, which are already approved and that we know are safe.

One of those that has already been tested in humans is remdesivir, a broad-spectrum antiviral still under study, which has been tested against Ebola and SARS/MERS.

Another candidate is chloroquine, an antimalarial that has also been seen to have potent antiviral activity. It is known that chloroquine blocks viral infection by increasing the pH of the endosome, which is needed for the fusion of the virus with the cell, thus inhibiting its entry. It has been demonstrated that this compound blocks the new coronavirus in vitro and it is already being used in patients with coronavirus pneumonia.

Other proposed trials are based on the use of oseltamivir (which is used against the influenza virus), interferon-1b (protein with antiviral function), antisera from people who recovered or monoclonal antibodies to neutralise the virus. New therapies have been proposed with inhibitory substances, such as baricitinibine, selected by artificial intelligence.

The 1918 flu pandemic caused more than 25 million deaths in less than 25 weeks. Could something similar happen now? Probably not; we have never been better prepared to fight a pandemic.

[For more articles from scientists and other experts, subscribe to The Conversation’s daily newsletter.]

Ignacio López-Goñi is a Professor of Microbiology at the University of Navarra (Spain).


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