Trump Said He Was the President of Manufacturing. Then Disaster Struck.

https://www.nytimes.com/2020/03/29/us/politics/coronavirus-trump-ventilators-manufacturing-gm.html

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When President Trump came to office, he promised a new day with America’s manufacturers, casting himself as the first president who understood their needs. He toured factory floors, often handing out his signature “Make America Great Again” hats.

Yet in the first national crisis that required harnessing American manufacturing ingenuity and ramping up production of ventilators, perhaps the most crucial piece of equipment for patients in crisis, the White House’s ability to gather the power of American industry crumpled.

It was unable to communicate how many ventilators it would need or how quickly it would need them. Mr. Trump set states off on a mad scramble to find their own, leading to bidding wars against one another. Even today it is unclear who is deciding where the new American production will be directed — to the highest bidders or to the cities that need them most.

A week after praising General Motors and a small ventilator manufacturer, Ventec Life Systems, for their voluntary efforts to combine cutting-edge technology with G.M.’s expertise at supply chains and mass production, the president blew up at the largest carmaker in America, accusing its chief executive, Mary T. Barra, of moving too slowly and trying to “rip off” the federal government. In fact, G.M. and Ventec had already signed a partnership — without government help — to ramp up production.

Interviews with White House officials, industry executives and outsiders who tried to intervene make two problems clear. Mr. Trump’s first mistake was recognizing the problem far too late, even though his own medical experts had identified a probable shortage of ventilators as a critical problem in late January, as panic set in that the virus was headed to the United States. Had the president acted sooner, thousands of new ventilators would probably be coming off production lines next month, when they are likely to be desperately needed.

And even after the problem was recognized, and the president’s son-in-law and senior adviser, Jared Kushner, took over the process, both the White House and the Federal Emergency Management Agency struggled to define what was needed, who would pay for it and how to solve the problem of supply chains that stretched across more than a dozen countries.

“We’re going to have plenty,” Mr. Trump said Friday afternoon, declaring that he was invoking the Defense Production Act, a Korean War-era law, to force the companies to make more. But he gave no numbers — and glided past the complexities of getting between 700 and 1,500 components from more than a dozen nations.

“It’s terrific that the administration is now beginning to use the D.P.A.,” said Joshua Gotbaum, a former defense official in the Clinton administration who often made use of the Defense Production Act. “Had they started two months ago, we would already have ventilators, masks and other critical equipment in mass production.”

“It is one thing to know that there should be a central national effort,” Mr. Gotbaum added. “It is quite another to accept the responsibility for the shortcomings and mistakes that will inevitably occur with it.”

“If we don’t flatten the curve, we’re on a trajectory currently to exceed our capacity in the New Orleans area for ventilators by about April the 4th, and all beds available in hospitals by about April the 10th,” Gov. John Bel Edwards, Democrat of Louisiana, said Sunday on “Meet the Press on NBC. “So we’re doing everything we can to surge capacity. It’s very difficult.”

Industry executives made the point that while the Defense Production Act enabled the White House to create the illusion of decisive executive action, it did not solve the nuts-and-bolts problem of gearing up scores of suppliers or creating Made-in-America production lines where few exist. That is the problem G.M. and Ventec, and other companies involved in the effort like Ford and Medtronic, are facing — often seeking parts from the same suppliers.

“We are moving full steam ahead on ventilators because they know there is an immediate need for increased production,” said Chris Brooks, Ventec’s chief strategy officer, even if it is still unclear whether the customers are hospitals, states or the Federal Emergency Management Agency, which the White House has delegated to take charge of the effort.

Mr. Trump came to this crisis belatedly, but once he did he has tried to portray himself as a wartime president, one who is making use of all of America’s talents to fight an invisible but devastating enemy. And in that regard, the best analogy may be Franklin D. Roosevelt’s “arsenal of democracy,” the phrase he used in a Dec. 29, 1940, fireside chat, as he tried to get American industry to support Britain in its fight with Nazi Germany, without getting the United States into the war.

It turned out to be prescient, because industry was already getting onto a wartime footing by the time Japan attacked Pearl Harbor a year later, plunging the United States into a manufacturing frenzy. That is when Ford began churning out B-24 bombers and Sherman tanks.

But in this case, Mr. Trump sought the language of wartime action without the responsibility for making it happen. He welcomed voluntary efforts that were already underway, as manufacturers like Medtronic and the Dutch manufacturing giant Philips promised to ramp up production. The problem was that it was uncoordinated — as if the Pentagon had announced it needed more missiles, more artillery shells and more nuclear weapons but left unclear how many or where they should be delivered.

That was the situation Mr. Kushner found when he entered the effort, at the request of Vice President Mike Pence. He moved the authority to deal with the issue from the Department of Health and Human Services to FEMA, saying that the latter agency knew how to act in a “battle rhythm.” But still, no one knew how many ventilators were already in the market, where they would be needed first or how many more companies could be expected to make. And it was complicated by the fact that many of the largest manufacturers had moved operations offshore, to Ireland, Switzerland and, of course, China.

Along came G.M. and Ventec, a partnership Mr. Trump celebrated in a tweet a week ago. But all week the details languished. Early hopes that the company could produce 20,000 ventilators quickly began to fade; in the first few weeks, the figure was more like 5,000. And that production would not begin until late April, if everything went perfectly.

Still, a small group of White House officials briefed on the discussion anticipated that it would go ahead, a welcome announcement after weeks of headlines about the administration’s halting response to the spread of the coronavirus.

Updated June 12, 2020

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.

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.

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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.

Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.

Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.

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.

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.)

Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.

The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

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.

One administration official said that Mr. Trump had not been briefed on the details of the G.M.-Ventec deal, and that he was caught by surprise when he read a New York Times article about how the announcement was being held up while FEMA examined competing offers.

Instead of focusing on why the deal had been abruptly stopped, officials said, the president was enraged about the prospect of G.M. — which was actually Ventec’s subcontractor — trying to get money upfront from the government to fund suppliers. And aides told him that the company’s estimates of how many ventilators could be made in a relatively short period of time had shifted when G.M. officials were pressed.

So the president posted a series of tweets denouncing the company and its chief executive, urging them to build ventilators at a Lordstown, Ohio, plant that had been closed. (G.M. sold the plant last year and will be making ventilators in Kokomo, Ind., an electronics plant that has the clean rooms needed for manufacturing medical parts.)

Mr. Trump decided to go ahead and compel G.M. to manufacture the ventilators, but far fewer than the original deal envisioned. His attitude, officials said, was that since reporters had been pushing him on deploying the Defense Production Act, he would give them what they wanted — without giving G.M. the full deal. And then he named other firms that would also be tapped by FEMA.

But by the end of the weekend, it was still unclear what the production targets were or even if FEMA had issued any contracts. The companies did not know if Washington would take responsibility for distributing the ventilators.

In the Rose Garden on Sunday afternoon, Mr. Trump for the first time began to acknowledge the complexity of the undertaking American industry was just now beginning. “They are very complex,” he said of the machines. “You know, this is like building a car.”