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Top Coronavirus Official for U.S. Has Fought an Epidemic Before Top Coronavirus Official for U.S. Has Fought an Epidemic Before
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WASHINGTON — In the spring of 1983, even before the virus that causes AIDS had a name, a young Army doctor named Deborah L. Birx suffered excessive bleeding while giving birth. Moments before she passed out from pain, she screamed an order at her husband: “Do not let them give me blood!”WASHINGTON — In the spring of 1983, even before the virus that causes AIDS had a name, a young Army doctor named Deborah L. Birx suffered excessive bleeding while giving birth. Moments before she passed out from pain, she screamed an order at her husband: “Do not let them give me blood!”
She may have saved her own life. The blood she would have received was later discovered to be contaminated with H.I.V.She may have saved her own life. The blood she would have received was later discovered to be contaminated with H.I.V.
“That was Debbie’s first brush with AIDS, and it literally changed her,” John Kerry, then the secretary of state, said in 2014, after President Barack Obama put Dr. Birx in charge of addressing the global AIDS epidemic. “It made her think hard not just about the perils of this new disease, but about her responsibility to fight it.”“That was Debbie’s first brush with AIDS, and it literally changed her,” John Kerry, then the secretary of state, said in 2014, after President Barack Obama put Dr. Birx in charge of addressing the global AIDS epidemic. “It made her think hard not just about the perils of this new disease, but about her responsibility to fight it.”
Now, after researching H.I.V. and devising public health strategies to combat it for more than three decades, Dr. Birx has a new virus to fight. As President Trump’s newly named White House coronavirus response coordinator, she has the difficult task of tracking and orchestrating the government’s effort to contain the outbreak, while projecting a calm, authoritative presence to counter the mixed messages from Mr. Trump.Now, after researching H.I.V. and devising public health strategies to combat it for more than three decades, Dr. Birx has a new virus to fight. As President Trump’s newly named White House coronavirus response coordinator, she has the difficult task of tracking and orchestrating the government’s effort to contain the outbreak, while projecting a calm, authoritative presence to counter the mixed messages from Mr. Trump.
Vice President Mike Pence, who is overseeing the government’s response, introduced her as “my right arm.”Vice President Mike Pence, who is overseeing the government’s response, introduced her as “my right arm.”
Public health experts say her task is immense.Public health experts say her task is immense.
“There are lots of things that can go wrong here,” said Dr. Thomas Frieden, who worked with Dr. Birx when he ran the Centers for Disease Control and Prevention, and she oversaw the C.D.C.’s division of global AIDS. “It’s possible that we’ll look back in six months and say, ‘It’s not so bad, we overreacted.’ We just don’t know. But we wouldn’t want to look back in six months and say we underreacted.”“There are lots of things that can go wrong here,” said Dr. Thomas Frieden, who worked with Dr. Birx when he ran the Centers for Disease Control and Prevention, and she oversaw the C.D.C.’s division of global AIDS. “It’s possible that we’ll look back in six months and say, ‘It’s not so bad, we overreacted.’ We just don’t know. But we wouldn’t want to look back in six months and say we underreacted.”
Unlike Dr. Anthony S. Fauci, another member of the coronavirus task force and the oft-quoted director of the National Institute of Allergy and Infectious Diseases, Dr. Birx — who carried the rank of ambassador at the State Department — is stepping gingerly into the public eye. She has taken pains not to contradict the president, praising the White House for its “energy and efficiency.”Unlike Dr. Anthony S. Fauci, another member of the coronavirus task force and the oft-quoted director of the National Institute of Allergy and Infectious Diseases, Dr. Birx — who carried the rank of ambassador at the State Department — is stepping gingerly into the public eye. She has taken pains not to contradict the president, praising the White House for its “energy and efficiency.”
That kind of political savvy helps explain why Dr. Birx is one of only a handful of Obama political appointees who is still working for the Trump administration. (Another is Dr. Francis S. Collins, the director of the National Institutes of Health.)That kind of political savvy helps explain why Dr. Birx is one of only a handful of Obama political appointees who is still working for the Trump administration. (Another is Dr. Francis S. Collins, the director of the National Institutes of Health.)
“Thank God she’s in charge,” said Katy Talento, a former health policy adviser to Mr. Trump.“Thank God she’s in charge,” said Katy Talento, a former health policy adviser to Mr. Trump.
Dr. Birx faces multiple challenges, Dr. Frieden said. She must quickly gather information about the virus and how it is spreading to adjust the government’s response. She must ensure that decisions are “based on science rather than on political considerations,” he said. And she must “engage globally,” he said, “so we can tamp down the size of the pandemic in other countries.”Dr. Birx faces multiple challenges, Dr. Frieden said. She must quickly gather information about the virus and how it is spreading to adjust the government’s response. She must ensure that decisions are “based on science rather than on political considerations,” he said. And she must “engage globally,” he said, “so we can tamp down the size of the pandemic in other countries.”
She has deep relationships with health officials around the world, Dr. Frieden said, but she is less familiar with the public health system in this country.She has deep relationships with health officials around the world, Dr. Frieden said, but she is less familiar with the public health system in this country.
Tough and disciplined — she walks several miles to work each day to “clear her head,” one associate said — Dr. Birx is most often described as “data driven.” She is running what amounts to a coronavirus war room from the vice president’s office, meeting with government and public health officials and pharmaceutical industry executives to shore up beleaguered local health departments, scale up the production of coronavirus test kits and encourage research into antiviral medicines and vaccines.Tough and disciplined — she walks several miles to work each day to “clear her head,” one associate said — Dr. Birx is most often described as “data driven.” She is running what amounts to a coronavirus war room from the vice president’s office, meeting with government and public health officials and pharmaceutical industry executives to shore up beleaguered local health departments, scale up the production of coronavirus test kits and encourage research into antiviral medicines and vaccines.
“I think this administration is realizing that her credibility and the years of sweat equity and trust she has built up working with people on both sides of the aisle is arguably her best asset,” said Senator Ron Wyden, Democrat of Oregon.“I think this administration is realizing that her credibility and the years of sweat equity and trust she has built up working with people on both sides of the aisle is arguably her best asset,” said Senator Ron Wyden, Democrat of Oregon.
For the past six years at the State Department, Dr. Birx has, among her responsibilities, overseen the Presidents’s Emergency Plan for AIDS Relief, or PEPFAR, created in 2003 by President George W. Bush when antiretroviral drugs saving lives in developed countries were not available in other nations.For the past six years at the State Department, Dr. Birx has, among her responsibilities, overseen the Presidents’s Emergency Plan for AIDS Relief, or PEPFAR, created in 2003 by President George W. Bush when antiretroviral drugs saving lives in developed countries were not available in other nations.
In its first decade, the initiative focused on “priority countries,” offering broad public health programs to slow the spread of H.I.V., said Paul Zeitz, who worked for Dr. Birx for three years.In its first decade, the initiative focused on “priority countries,” offering broad public health programs to slow the spread of H.I.V., said Paul Zeitz, who worked for Dr. Birx for three years.
Dr. Birx, he said, concluded that it would be more effective to concentrate specifically on H.I.V. prevention and the treatment of infected people in areas where the epidemic was disseminating swiftly. She made difficult decisions to take money from “low transmission zones” and beef up spending in areas where the disease was spreading rapidly, using statistics as a guide.Dr. Birx, he said, concluded that it would be more effective to concentrate specifically on H.I.V. prevention and the treatment of infected people in areas where the epidemic was disseminating swiftly. She made difficult decisions to take money from “low transmission zones” and beef up spending in areas where the disease was spreading rapidly, using statistics as a guide.
“I saw her be very tough with country teams,” Dr. Zeitz said. “She wanted the facts about exactly what was happening with their epidemic, and if people did not have data in a way that it could be used, where it could be disaggregated by gender, by geography — and then she got all the way down to statistics for each medical clinic — they would have to go back to the drawing board.”“I saw her be very tough with country teams,” Dr. Zeitz said. “She wanted the facts about exactly what was happening with their epidemic, and if people did not have data in a way that it could be used, where it could be disaggregated by gender, by geography — and then she got all the way down to statistics for each medical clinic — they would have to go back to the drawing board.”
Dr. Birx also created a program known as DREAMS, a public-private partnership to reduce rates of H.I.V. among adolescent girls and young women. That demographic accounts for 74 percent of new H.I.V. infections among adolescents in sub-Saharan Africa, where the disease is most prevalent.Dr. Birx also created a program known as DREAMS, a public-private partnership to reduce rates of H.I.V. among adolescent girls and young women. That demographic accounts for 74 percent of new H.I.V. infections among adolescents in sub-Saharan Africa, where the disease is most prevalent.
Updated June 22, 2020 Updated June 24, 2020
Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
She was particularly outraged at the high rates of infections resulting from sexual assault, which was rarely reported, Ms. Talento said. She started working with churches to encourage young women to speak up.She was particularly outraged at the high rates of infections resulting from sexual assault, which was rarely reported, Ms. Talento said. She started working with churches to encourage young women to speak up.
“She was jumping around, waving her arms, ‘Listen, young women are suffering scandalously high rates of sexual assault,’” Ms. Talento said. “She would brainstorm and kick things around: What if we started ranking countries on how well they prosecute this, and tie the money to those rankings?”“She was jumping around, waving her arms, ‘Listen, young women are suffering scandalously high rates of sexual assault,’” Ms. Talento said. “She would brainstorm and kick things around: What if we started ranking countries on how well they prosecute this, and tie the money to those rankings?”
Dr. Birx, a colonel in the Army, began her career in the early 1980s as an immunologist at the Walter Reed Army Medical Center. She spent part of her training as a fellow in Dr. Fauci’s lab, and “was a star then,” he recently told reporters, adding, “and what has happened over the years, she’s become a superstar.”Dr. Birx, a colonel in the Army, began her career in the early 1980s as an immunologist at the Walter Reed Army Medical Center. She spent part of her training as a fellow in Dr. Fauci’s lab, and “was a star then,” he recently told reporters, adding, “and what has happened over the years, she’s become a superstar.”
With the military committed to reducing the spread of H.I.V. in its own ranks, Dr. Birx was on the cutting edge of research. Shepherd Smith, an evangelical Christian leader and a founder of Children’s AIDS Fund International, said Dr. Birx and her colleagues at the Defense Department sometimes spotted epidemiological trends even before the Centers for Disease Control and Prevention.With the military committed to reducing the spread of H.I.V. in its own ranks, Dr. Birx was on the cutting edge of research. Shepherd Smith, an evangelical Christian leader and a founder of Children’s AIDS Fund International, said Dr. Birx and her colleagues at the Defense Department sometimes spotted epidemiological trends even before the Centers for Disease Control and Prevention.
“She had an early view of the epidemic that a lot of people in the AIDS issue didn’t have,” he said. “Between 1985 and 1988, the number of H.I.V.-positive African-American women in the military was greater than white men, so there were indicators where this epidemic was going.”“She had an early view of the epidemic that a lot of people in the AIDS issue didn’t have,” he said. “Between 1985 and 1988, the number of H.I.V.-positive African-American women in the military was greater than white men, so there were indicators where this epidemic was going.”
In 2005, Dr. Birx moved to the C.D.C., where she remained until Mr. Obama appointed her to the State Department. Eric Goosby, Dr. Birx’s predecessor at the State Department, said she was somewhat reluctant to leave her diplomatic post. The two spoke before she accepted Mr. Pence’s offer.In 2005, Dr. Birx moved to the C.D.C., where she remained until Mr. Obama appointed her to the State Department. Eric Goosby, Dr. Birx’s predecessor at the State Department, said she was somewhat reluctant to leave her diplomatic post. The two spoke before she accepted Mr. Pence’s offer.
”The responsibility she carried involves hundreds of thousands of lives,” he said, adding that for Dr. Birx, it was a question of whether to “move away from something where you know you are dropping suffering and dropping death, to work on something that has the potential to be devastating but isn’t there yet.””The responsibility she carried involves hundreds of thousands of lives,” he said, adding that for Dr. Birx, it was a question of whether to “move away from something where you know you are dropping suffering and dropping death, to work on something that has the potential to be devastating but isn’t there yet.”