coronavirus response
May 5, 2020

Had the U.S. been attacked by anthrax or weaponized smallpox, Robert Kadlec would have looked prescient. Instead, the U.S. and the world got a deadly new coronavirus, and the U.S. Strategic National Stockpile, which Kadlec oversees, was unprepared, The Washington Post reports.

Kadlec, a longtime biodefense expert, was confirmed as head of the Health and Human Service Department's Office of the Assistant Secretary for Preparedness and Response (ASPR) in August 2017. He immediately began shifting his office's focus to "biologic attacks, intentional attacks, terrorist attacks, and definitely away from natural disease outbreaks," a former official told the Post. HHS transferred control of the national stockpile to ASPR from the Centers for Disease Control and Prevention in 2018, over the objections of some national security and public health officials.

Kadlec streamlined the process for purchasing supplies for the stockpile, "diminishing the role of government experts and restricting decision-making to himself and a small circle of advisers," the Post reports. He oversaw a $2.8 billion, 10-year contract for smallpox vaccines, at double the cost per dose, with a former client, Emergent BioSolutions — a relationship he did not mention on his Senate disclosure forms — and ramped up purchases of anthrax vaccines.

At the same time, ASPR slashed planned funding for pandemic flu and infectious disease preparedness, including halting "an Obama-era initiative to spend $35 million to build a machine that could produce 1.5 million N95 masks per day," the Post reports. After HHS Secretary Alex Azar assigned him to lead the department's coronavirus response in March, Kadlec's office signed contracts for $2.3 billion worth of ventilators and $468 million for masks, including $62.3 million from O&M Halyard, the contractor whose rapid mask machine Kadlec axed in 2018.

Kadlec told the Post he's proud of his decades government service, including his efforts to centralize authority at ASPR. And his actions are consistent with his longtime views on biodefense.

"Quite frankly, Mother Nature is not a thinking enemy intent on inflicting grievous harm to our country, killing our citizens, undermining our government, or destroying our way of life," Kadlec told Congress in 2011. "Mother Nature doesn't develop highly virulent organisms that are resistant to our current stockpiles of antibiotics." In March, he told a House committee his office "did not consider a situation like this today," with "respirators being our first and only line of defense for health-care workers." Read more about his vision and business entanglements at The Washington Post. Peter Weber

March 19, 2020

President Trump announced Wednesday that he had signed an executive order claiming emergency powers under the 1950 Defense Production Act, allowing him to order U.S. manufacturers to increase production of dwindling medical supplies like masks and respirators, and had dispatched two Navy hospital ships to New York City and somewhere on the West Coast to help manage the COVID-19 coronavirus pandemic.

Trump clarified in a Wednesday night tweet that while he signed the executive order activating the Defense Production Act, he only did so "should we need to invoke it in a worst case scenario in the future," and "hopefully there will be no need." Defense Secretary Mark Esper also told CNN that the two ships — the USS Comfort and USS Mercy — won't deploy for at least 10 days. The Comfort, headed to New York, is undergoing maintenance in Virginia for "a couple weeks," he added, and neither ship will treat coronavirus patients.

"Again they're geared toward trauma, and what we can do is to create space in local hospitals by peeling off their trauma patients putting them through our field hospitals," Esper told CNN. Each ship has about 1,000 beds, and Esper also offered more than 1,000 beds in military field hospitals that will also not take coronavirus patients. New York Gov. Andrew Cuomo (D) said Wednesday his state will need an additional 50,000 beds to handle the coronavirus outbreak. Peter Weber

March 19, 2020

The U.S. and South Korea both confirmed their first cases of new coronavirus on Jan. 21. South Korea's epidemic seems to have already peaked, while the U.S. is girding for public health, financial, and social crises. The key to South Korea's relative success is testing, and South Korea's aggressive testing regime — "South Korea as of Tuesday was testing up to 20,000 patients a day, more than half the total of U.S. patients who have been tested since the outbreak began," The Wall Street Journal notes — was not an accident.

On Jan. 27, with four confirmed cases in the country, "South Korean health officials summoned representatives from more than 20 medical companies from their lunar New Year celebrations to a conference room tucked inside Seoul's busy train station," where a top infectious disease official "delivered an urgent message: South Korea needed an effective test immediately to detect the novel coronavirus," Reuters reports. "He promised the companies swift regulatory approval." A week later, South Korea's Centers for Disease Control and Prevention (CDC) approved one company's diagnostic test and gave the green light to another company's test on Feb. 12.

South Korea has tested more than 290,000 people; the U.S., with about 321 million more people, has tested just 71,000, according to the COVID Tracking Project. "South Korea took a risk, releasing briskly vetted tests, then circling back later to spot check their effectiveness," Reuters reports. "With many more tests in hand, health officials were well armed to attack a fast-moving virus and aggressively track down people who may have been exposed. This testing-backed offensive helped South Korea reduce the number of new cases over a matter of weeks, serving as a model for other countries grappling with the pandemic."

In the U.S., the CDC had the only tests approved by the Food and Drug Administration until the FDA loosened its criteria on Feb. 29, and the CDC's first test was faulty. The FDA is now considering approving the South Korean tests as the U.S. struggles to meet demand.

South Korea's response is a testament to leadership and foresight, but it was hard-won. South Korea was hit badly by MERS in 2015 — 186 cases, more than anywhere outside the Middle East — and the government was criticized for its slow, secretive response. "We can’t ever forget the incident," Lee Sang-won at South Korea's CDC told Reuters. "It is engraved in our mind." Peter Weber

March 16, 2020

The San Francisco Bay Area isn't quite going on total lockdown, but they'll be close to it as the region looks to curb the spread of the coronavirus pandemic.

A directive went out Monday to 6.7 million people in six counties — San Francisco, Santa Clara, San Mateo, Marin, Contra Costa, and Alameda — to "shelter in place" until at least April 7. That means people can only step outside their homes for essential purposes such as shopping for necessary supplies and groceries, accessing health care, providing aid to family members, or working in an essential service. People will be able to go outside for walks or exercise as long as they keep six feet of distance between themselves and others.

It's not yet clear how the policy will be enforced, the San Francisco Chronicle reports, although the order calls for sheriffs and chiefs of police to "ensure compliance." Read more at the San Francisco Chronicle. Tim O'Donnell

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