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In Congress, Doctors Are Pressing for a More Aggressive Coronavirus Response In Congress, Doctors Are Pressing for a More Aggressive Coronavirus Response
(7 days later)
WASHINGTON — There were just 160 documented cases of the coronavirus in the United States when Representative Raul Ruiz, Democrat of California, told Vice President Mike Pence in a closed-door meeting that President Trump needed to “think about declaring a national emergency.” It took nine more days for Mr. Trump to do so.WASHINGTON — There were just 160 documented cases of the coronavirus in the United States when Representative Raul Ruiz, Democrat of California, told Vice President Mike Pence in a closed-door meeting that President Trump needed to “think about declaring a national emergency.” It took nine more days for Mr. Trump to do so.
That was in early March. A month earlier, Representative Phil Roe, Republican of Tennessee, concluded that the Diamond Princess, a cruise ship, was a “viral petri dish” for the coronavirus. He badgered top federal health officials until the Trump administration eventually evacuated Americans from the ship.That was in early March. A month earlier, Representative Phil Roe, Republican of Tennessee, concluded that the Diamond Princess, a cruise ship, was a “viral petri dish” for the coronavirus. He badgered top federal health officials until the Trump administration eventually evacuated Americans from the ship.
Senator Bill Cassidy, Republican of Louisiana, also watched the spread of coronavirus with alarm. He is now seeking an audience with Mr. Pence to push several ideas, including the creation of a national “immunity registry” for Covid-19, the disease caused by the coronavirus, that would collect data from widespread blood testing to determine who could safely return to work.Senator Bill Cassidy, Republican of Louisiana, also watched the spread of coronavirus with alarm. He is now seeking an audience with Mr. Pence to push several ideas, including the creation of a national “immunity registry” for Covid-19, the disease caused by the coronavirus, that would collect data from widespread blood testing to determine who could safely return to work.
The senator and the congressmen share a common background: all are medical doctors, part of a small corps of roughly two dozen health professionals in Congress, many of whom were sounding the alarm about the coming pandemic back when Mr. Trump was still calling criticism of his administration’s response a “hoax.” Now, with more than 275,000 Americans infected and 7,000 dead from Covid-19, the doctors of Congress are drawing on their expertise to push for more aggressive federal measures to cope with the disease.The senator and the congressmen share a common background: all are medical doctors, part of a small corps of roughly two dozen health professionals in Congress, many of whom were sounding the alarm about the coming pandemic back when Mr. Trump was still calling criticism of his administration’s response a “hoax.” Now, with more than 275,000 Americans infected and 7,000 dead from Covid-19, the doctors of Congress are drawing on their expertise to push for more aggressive federal measures to cope with the disease.
The doctor-turned-lawmaker who garnered the most attention in recent weeks was Senator Rand Paul, Republican of Kentucky and an eye surgeon, who drew widespread derision for going about his business — including exercising in a shuttered Senate gym — while quietly awaiting test results for Covid-19 after having been exposed to someone who was infected. He later learned he was positive, which sent some of his colleagues, including Dr. Cassidy, into quarantine.The doctor-turned-lawmaker who garnered the most attention in recent weeks was Senator Rand Paul, Republican of Kentucky and an eye surgeon, who drew widespread derision for going about his business — including exercising in a shuttered Senate gym — while quietly awaiting test results for Covid-19 after having been exposed to someone who was infected. He later learned he was positive, which sent some of his colleagues, including Dr. Cassidy, into quarantine.
But others have been trying — sometimes in vain — to put their training to use. The first coronavirus hearing in Congress was convened by a Democratic doctor from California, Representative Ami Bera, on Feb. 5, before the disease it caused even had a name.But others have been trying — sometimes in vain — to put their training to use. The first coronavirus hearing in Congress was convened by a Democratic doctor from California, Representative Ami Bera, on Feb. 5, before the disease it caused even had a name.
Mr. Trump had imposed a ban on travel from China just days earlier. But Dr. Bera, the former chief medical officer for Sacramento County, said he was concerned at the time about the lack of “a clear command control structure” inside the White House, and felt the travel ban was an inadequate response.Mr. Trump had imposed a ban on travel from China just days earlier. But Dr. Bera, the former chief medical officer for Sacramento County, said he was concerned at the time about the lack of “a clear command control structure” inside the White House, and felt the travel ban was an inadequate response.
“We were sounding the alarms,” he said, recounting his message: “The travel ban on China wasn’t going to stop this virus. It was going to buy us time, but this virus is coming to the United States.”“We were sounding the alarms,” he said, recounting his message: “The travel ban on China wasn’t going to stop this virus. It was going to buy us time, but this virus is coming to the United States.”
Now that it is here in full force, a bipartisan trio of doctors — Dr. Cassidy, a gastroenterologist with expertise in immunization; Dr. Ruiz, an emergency room doctor with a master’s degree in public health; and Representative Kim Schrier, Democrat of Washington and a pediatrician — are collaborating on what Dr. Ruiz called “a three-point immediate triage response for mass production and restocking” of medical supplies and equipment, including much-needed masks and ventilators.Now that it is here in full force, a bipartisan trio of doctors — Dr. Cassidy, a gastroenterologist with expertise in immunization; Dr. Ruiz, an emergency room doctor with a master’s degree in public health; and Representative Kim Schrier, Democrat of Washington and a pediatrician — are collaborating on what Dr. Ruiz called “a three-point immediate triage response for mass production and restocking” of medical supplies and equipment, including much-needed masks and ventilators.
The idea, all three said in interviews, is to have a centralized command structure, anchored inside the White House, to manage production and distribution. Ventilators and other equipment would be shipped across the country based on data about where outbreaks were emerging. If, for example, Des Moines had 5,000 ventilators but few cases of coronavirus, those machines could be sent to New York, with the promise that New York or other cities would supply Des Moines when that city was in need.The idea, all three said in interviews, is to have a centralized command structure, anchored inside the White House, to manage production and distribution. Ventilators and other equipment would be shipped across the country based on data about where outbreaks were emerging. If, for example, Des Moines had 5,000 ventilators but few cases of coronavirus, those machines could be sent to New York, with the promise that New York or other cities would supply Des Moines when that city was in need.
“We need a way to get out of the mess we’re currently in, and I think this is part of the solution,” Dr. Cassidy said in an interview. He also outlined his idea for the immunity registry, which he said would be akin to “vaccine registries” maintained by schools.“We need a way to get out of the mess we’re currently in, and I think this is part of the solution,” Dr. Cassidy said in an interview. He also outlined his idea for the immunity registry, which he said would be akin to “vaccine registries” maintained by schools.
Not all of Congress’ doctors, however, are so actively engaged. In a brief interview in the Capitol before his diagnosis became public, Mr. Paul insisted that he had little relevant expertise: “I am a physician,” he said. “I’m aware of science, I’m able to read scientific papers and I think, make judgments. But I don’t put myself out as an expert.”Not all of Congress’ doctors, however, are so actively engaged. In a brief interview in the Capitol before his diagnosis became public, Mr. Paul insisted that he had little relevant expertise: “I am a physician,” he said. “I’m aware of science, I’m able to read scientific papers and I think, make judgments. But I don’t put myself out as an expert.”
Others, like Dr. Schrier, the only female doctor in Congress, have simply been trying to keep their colleagues and constituents well. Dr. Schrier recounted how, after coronavirus cases first appeared in the United States but before social distancing became a household phrase, she watched in horror as her colleagues were still coughing into their hands and sharing fruit and other food, including with Representative John Lewis, the civil rights icon who is batting pancreatic cancer.Others, like Dr. Schrier, the only female doctor in Congress, have simply been trying to keep their colleagues and constituents well. Dr. Schrier recounted how, after coronavirus cases first appeared in the United States but before social distancing became a household phrase, she watched in horror as her colleagues were still coughing into their hands and sharing fruit and other food, including with Representative John Lewis, the civil rights icon who is batting pancreatic cancer.
“They did a birthday party for John Lewis with a cake,” she said, sounding incredulous. “I pulled my friends aside and said, ‘You can’t do this with an 80-year-old whose immune system is already compromised.’”“They did a birthday party for John Lewis with a cake,” she said, sounding incredulous. “I pulled my friends aside and said, ‘You can’t do this with an 80-year-old whose immune system is already compromised.’”
There are 17 doctors in Congress — 14 in the House and three in the Senate — as well as three dentists, two nurses, a pharmacist and a former health secretary, Representative Donna E. Shalala, Democrat of Florida, who served under President Bill Clinton. The group is overwhelmingly white, male and Republican. Only the two nurses and three of the doctors are Democrats. The Republican doctors have their own group, the G.O.P. Doctors Caucus.There are 17 doctors in Congress — 14 in the House and three in the Senate — as well as three dentists, two nurses, a pharmacist and a former health secretary, Representative Donna E. Shalala, Democrat of Florida, who served under President Bill Clinton. The group is overwhelmingly white, male and Republican. Only the two nurses and three of the doctors are Democrats. The Republican doctors have their own group, the G.O.P. Doctors Caucus.
This being Washington, party affiliation tends to color their views of how the president has handled the crisis. Representative Neal Dunn, Republican of Florida and a urologist, organized a classified briefing for members of the doctors caucus in early February, he said, to dispel conspiracy theories that coronavirus was a biological weapon. Dr. Dunn, who also served as a surgeon in the military, said he was not troubled by Mr. Trump’s early attempts to play down the disease.This being Washington, party affiliation tends to color their views of how the president has handled the crisis. Representative Neal Dunn, Republican of Florida and a urologist, organized a classified briefing for members of the doctors caucus in early February, he said, to dispel conspiracy theories that coronavirus was a biological weapon. Dr. Dunn, who also served as a surgeon in the military, said he was not troubled by Mr. Trump’s early attempts to play down the disease.
“I think what he was saying is, ‘Don’t panic, this is a flu, Americans are largely not at risk,’” Dr. Neal said, echoing Mr. Trump’s language as he deemed the federal response “unprecedented, unlike any response in history.”“I think what he was saying is, ‘Don’t panic, this is a flu, Americans are largely not at risk,’” Dr. Neal said, echoing Mr. Trump’s language as he deemed the federal response “unprecedented, unlike any response in history.”
Updated June 16, 2020 Updated June 22, 2020
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.
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.
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.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.)
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’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.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.
Representative Mark E. Green, Republican of Tennessee and a retired Army flight surgeon, said much the same: “The president, I admit, was trying to create calm as a leader should — he was saying it’s like flu.”Representative Mark E. Green, Republican of Tennessee and a retired Army flight surgeon, said much the same: “The president, I admit, was trying to create calm as a leader should — he was saying it’s like flu.”
The Democrats, not surprisingly, have been far more critical. Dr. Ruiz was one of four Democrats selected by leadership to question Mr. Pence when the vice president came to the Capitol on March 4 to brief lawmakers privately. The congressman said he had been frustrated to see Mr. Trump “downplay and deny” the emerging threat, and that Mr. Pence offered no response to the suggestion that the president declare a national emergency.The Democrats, not surprisingly, have been far more critical. Dr. Ruiz was one of four Democrats selected by leadership to question Mr. Pence when the vice president came to the Capitol on March 4 to brief lawmakers privately. The congressman said he had been frustrated to see Mr. Trump “downplay and deny” the emerging threat, and that Mr. Pence offered no response to the suggestion that the president declare a national emergency.
And Dr. Ruiz was so irked by the administration’s early failure to put out public service announcements that he donned a white lab coat and made his own. They are posted on his website.And Dr. Ruiz was so irked by the administration’s early failure to put out public service announcements that he donned a white lab coat and made his own. They are posted on his website.
Representative Lauren Underwood, Democrat of Illinois and a nurse who worked in pandemic preparedness for the Obama administration, said she drew on her knowledge of federal laws and rules to feed information about free government testing to Representative Katie Porter, Democrat of California. Ms. Porter used it to confront the director of the Centers for Disease Control and Prevention in a moment that went viral on Twitter.Representative Lauren Underwood, Democrat of Illinois and a nurse who worked in pandemic preparedness for the Obama administration, said she drew on her knowledge of federal laws and rules to feed information about free government testing to Representative Katie Porter, Democrat of California. Ms. Porter used it to confront the director of the Centers for Disease Control and Prevention in a moment that went viral on Twitter.
Ms. Shalala, who at 79 is the oldest freshman in Congress, lacks a medical degree but has deep experience in managing epidemics. She is on a first-name basis with the nation’s senior health officials, including Dr. Anthony S. Fauci, the government’s top infectious disease expert, from their work together fighting AIDS.Ms. Shalala, who at 79 is the oldest freshman in Congress, lacks a medical degree but has deep experience in managing epidemics. She is on a first-name basis with the nation’s senior health officials, including Dr. Anthony S. Fauci, the government’s top infectious disease expert, from their work together fighting AIDS.
Ms. Shalala has been warning about the nation’s lack of pandemic preparedness for years, and says Congress bears some responsibility for the nation’s flat-footed response.Ms. Shalala has been warning about the nation’s lack of pandemic preparedness for years, and says Congress bears some responsibility for the nation’s flat-footed response.
“Every time I said ‘public health infrastructure’ to Congress, their eyes glazed over,” she said. “So I blame both parties for not paying attention.”“Every time I said ‘public health infrastructure’ to Congress, their eyes glazed over,” she said. “So I blame both parties for not paying attention.”
Dr. Roe, the chairman of the G.O.P. Doctors Caucus, agreed that this is no time for politics: “I spent a career and a lifetime taking care of patients,” he said. “This ought to be all hands on deck. This is ‘Butch Cassidy and the Sundance Kid,’ where we both hold hands and jump off together.”Dr. Roe, the chairman of the G.O.P. Doctors Caucus, agreed that this is no time for politics: “I spent a career and a lifetime taking care of patients,” he said. “This ought to be all hands on deck. This is ‘Butch Cassidy and the Sundance Kid,’ where we both hold hands and jump off together.”
Emily Cochrane contributed reporting.Emily Cochrane contributed reporting.