2020 coronavirus in the United States.
The ongoing pandemic of coronavirus disease 2019 (COVID-19), a new infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), spread to the United States in January 2020. Cases have occurred in all fifty U.S. states, the District of Columbia, and all inhabited U.S. territories except American Samoa. As of April 11, 2020, the U.S. has the most confirmed active cases and deaths in the world.
The first known case of COVID-19 in the U.S. was confirmed on January 20, 2020, in a 35-year-old returnee from Wuhan, China, five days earlier.The White House Coronavirus Task Force was established on January 29. Two days later, the Trump administration declared a public health emergency and announced restrictions on travelers arriving from China. On February 26, a person with “no known exposure to the virus through travel or close contact with a known infected individual” was confirmed by the Centers for Disease Control and Prevention (CDC) in northern California.
The federal government’s response to the pandemic was initially slow; a manufacturing defect rendered a supply of CDC-developed test kits unusable, regulatory rules prevented academic laboratories and hospitals from using their own tests, while President Donald Trump also dismissed the threat that COVID-19 posed (repeatedly making optimistic statements and claiming the outbreak was under control). By the start of March, the government began to heighten its response; the Food and Drug Administration (FDA) began allowing public health agencies, hospitals, and private companies to develop tests and perform testing, and loosened its requirements to allow anyone with a doctor’s order to be tested. As of March 25, at least 418,000 tests had been conducted, and by April 2 the number had reached 1,280,000. Although it has surpassed South Korea in the total number of tests performed, it has still performed fewer tests per capita than South Korea.
The CDC warned that widespread transmission of the disease may force large numbers of people to seek healthcare, which may overload healthcare systems and lead to otherwise preventable deaths. Since March 19, 2020, the U.S. Department of State has advised U.S. citizens to avoid all international travel. On March 16, the White House advised against any gatherings of more than 10 people. In mid-March 2020, the Federal Emergency Management Agency (FEMA) told the United States Army Corps of Engineers (USACE) to plan to construct new facilities, including leased hotels and other buildings, and to convert them for use as hospitals and intensive care units. State and local responses to the outbreak have included prohibitions and cancellation of large-scale gatherings (including cultural events, exhibitions, and sporting events), and the closure of schools and other educational institutions. There have been incidents of xenophobia and racism against Chinese Americans and other Asian Americans. On April 11, 2020, Wyoming became the 50th state to declare a disaster, thus for the first time in history, all 50 U.S. states have simultaneously been under emergency declarations. The same day, the United States became the country with the most confirmed COVID-19 deaths…. (Sources) wikipedia.
Research into vaccine and drug therapies
There is currently no drug approved for treating COVID-19 either as a therapy or a vaccine, nor is there any clear evidence that COVID-19 infection leads to immunity (experts assume it does for some period). As of late March 2020, more than a hundred drugs are in testing. In April 2020, the CDC began testing blood samples to determine if a person has been exposed to the virus, even without showing symptoms, which could provide information about immunity.
While most common viruses provide diverse degrees of immunity, with this new virus it is not yet known for certain whether there is absolute immunity, how long that immunity would last or whether certain people can still be reinfected even after recovering. There is also concern that if this virus mutates as does the yearly influenza, there could be a new strain each year. In any case, learning who is protected against the disease’s spread is a primary factor in deciding when people can fully return to society. Until then, physical distancing is required as it has shown to slow the spread of the disease to manageable levels.
Among the labs working on a vaccine is the Walter Reed Army Institute of Research, which has previously studied other infectious diseases, such as HIV/AIDS, Ebola, and MERS. Speed in developing a vaccine is a key element in the midst of the pandemic, as physical distancing, self-isolating, and closures will have to be maintained until a vaccine is developed, which could take 12 to 18 months at best, or else transmission will quickly rebound. By March 18, tests had begun with a few dozen volunteers in Seattle, Washington, which was sponsored by the U.S. government. Similar safety trials of other coronavirus vaccines will begin soon in the U.S. Trials are also underway in China and Europe. This search for a vaccine has taken on aspects of national security and global competition.
The FDA has sent warning letters to at least seven retailers selling essential oils, nasal sprays, herbal remedies, and other products claiming to test for, treat, or prevent COVID-19. This is in violation of federal law, since none have been determined to be safe and effective by the FDA.
By March 19, President Trump directed the FDA to accelerate the testing and possible use of certain medications to discover if they would help treat patients who already have COVID-19. Among potential drugs are chloroquine and hydroxychloroquine, which have long been used successfully to treat malaria. In March, both hydroxychloroquine and chloroquine were already being used to treat coronavirus patients by a number of physicians under the limited compassionate use approval of the FDA or as an off-label prescription, while trials and analysis are still ongoing. On March 29, the FDA issued an Emergency Use Authorization, allowing the drugs as treatments for hospitalized coronavirus patients when clinical trials are not available for them to join. Fauci and other public health officials stress hydroxychloroquine is unproven for efficacy against COVID-19, as of early April 2020. (Sources) wikipedia
On March 6, 2020, the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 provided $8.3 billion to fight the pandemic. The deal includes “more than $3 billion for the research and development of vaccines, therapeutics and diagnostics, as well as $2.2 billion for the CDC, and $950 million to support state and local health agencies”.Another bill, the Families First Coronavirus Response Act was approved on March 18. It provides paid emergency leave and food assistance be provided to affected employees, along with free testing.
The U.S. House Committee on Financial Services, chaired by Representative Maxine Waters, released a stimulus proposal on March 18 in which the Federal Reserve would fund monthly payments of “at least $2,000 for every adult and an additional $1000 for every child for each month of the crisis”. Other elements include suspending all consumer and small business credit payments. On March 18, Representative Rashida Tlaib proposed the similar “Automatic BOOST to Communities Act”, which would involve sending pre-loaded $2,000 debit cards to every American, with $1,000 monthly payments thereafter until the economy recovers. This would be funded by the U.S. Treasury minting two trillion-dollar coins. According to Tlaib, the Treasury has this authority, and it would not increase the national debt.
With guidance from the White House, Senate Majority Leader Mitch McConnell proposed a third stimulus package amounting to over $1 trillion. On March 22 and 23, the $1.4 trillion package, known as the Coronavirus Aid, Relief, and Economic Security Act (or CARES Act), failed to pass in the Senate. The act was revised in the Senate, coming to $2 trillion, including $500 billion for loans to larger businesses such as airlines, $350 billion for small business loans, $250 billion for individuals, $250 billion for unemployment insurance, $150 billion for state and municipal governments, and $130 billion for hospitals. It passed unanimously in the Senate late the night of March 25. On March 27, the House approved the stimulus bill, and it was signed into law by President Trump.
President Trump has floated using the low interest rates to invest in infrastructure, including roads, bridges, and tunnels, but specifically excluding the initiatives of the Democrats’ Green New Deal. Nancy Pelosi has made similar proposals, suggesting that broadband and water projects be included. Although the Senate will not reconvene until at least April 20,McConnell has indicated that a fourth bill related to the virus would prioritize health care. Senator Bernie Sanders has called for a monthly basic income to help “every person in the United States, including the undocumented, the homeless, the unbanked, and young adults excluded from the CARES Act”. (Sources) wikipedia
U.S. military response
After mid-March 2020, the federal government made a major move to use the U.S. military to add health care capacity to impacted areas. The United States Army Corps of Engineers (USACE), under existing statutory authority that comes from authorizations and powers of the Federal Emergency Management Agency (FEMA), is leasing a large number of buildings nationwide such as hotels, college dormitories, and larger open buildings to immediately convert them into hospital facilities. To assist USACE and FEMA efforts, the United States Army are dispatching medical soldiers to set up field hospitals in cities widely affected by the pandemic. Some of these facilities will have ICU capability for patients of the 2020 coronavirus pandemic, while others will serve non-coronavirus patients to allow established hospitals to concentrate on the pandemic. A public briefing of the plan was given by Army General Todd Semonite on March 20, 2020. USACE will handle leasing and engineering, with contracts for rapid facility modification and setup issued to local contractors. The plan envisions that the operation of the facilities and the provision of medical staff would be entirely handled by the various U.S. states rather than the Federal government. One of the early and largest buildings to be converted is the Jacob K. Javits Convention Center in New York City, which was quickly being transformed into a 2,000-bed care facility on March 23, 2020. (Sources) wikipedia
In addition to the many popup hospitals nationwide, the United States Navy on March 18 prepared to deploy two hospital ships, USNS Mercy and USNS Comfort, to affected areas. The ships will take in non-coronavirus patients transferred from land-based hospitals, so those hospitals can concentrate on virus cases. On March 22, Trump announced that Comfort would go to the East Coast and Mercy to the West Coast. He added the government may be using cruise ships. Mercy arrived in Los Angeles on March 27, and Comfort arrived in New York City on March 30. On April 1, it was reported that the United States Department of Defense was working to provide 100,000 military-style nylon body bags to fulfill a request from FEMA. Only half this number was already kept in stock by the military.
On March 29, citing reduction in on-shore medical capabilities and the closure of facilities at the Port of Miami to new patients, the U.S. Coast Guard required ships in the Seventh District (southeast and Atlantic territories) carrying more than fifty people to prepare to care for sick people onboard indefinitely, for vessels requesting medical evacuation to make arrangements with an on-shore hospital, and for foreign vessels to seek medical assistance from their country of registration. Despite earlier opposition from the governor of Florida, arrangements were made allowing MS Zaandam and MS Rotterdam to dock at Port Everglades on April 2 after nearly two hundred people became ill with COVID-19 and four passengers died.