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| The ‘Red Dawn’ Emails: 8 Key Exchanges on the Faltering Response to the Coronavirus | The ‘Red Dawn’ Emails: 8 Key Exchanges on the Faltering Response to the Coronavirus |
| (6 days later) | |
| WASHINGTON — As the coronavirus emerged and headed toward the United States, an extraordinary conversation was hatched among an elite group of infectious disease doctors and medical experts in the federal government and academic institutions around the nation. | WASHINGTON — As the coronavirus emerged and headed toward the United States, an extraordinary conversation was hatched among an elite group of infectious disease doctors and medical experts in the federal government and academic institutions around the nation. |
| Red Dawn — a nod to the 1984 film with Patrick Swayze and Charlie Sheen — was the nickname for the email chain they built. Different threads in the chain were named Red Dawn Breaking, Red Dawn Rising, Red Dawn Breaking Bad and, as the situation grew more dire, Red Dawn Raging. It was hosted by the chief medical officer at the Department of Homeland Security, Dr. Duane C. Caneva, starting in January with a small core of medical experts and friends that gradually grew to dozens. | Red Dawn — a nod to the 1984 film with Patrick Swayze and Charlie Sheen — was the nickname for the email chain they built. Different threads in the chain were named Red Dawn Breaking, Red Dawn Rising, Red Dawn Breaking Bad and, as the situation grew more dire, Red Dawn Raging. It was hosted by the chief medical officer at the Department of Homeland Security, Dr. Duane C. Caneva, starting in January with a small core of medical experts and friends that gradually grew to dozens. |
| The “Red Dawn String,” Dr. Caneva said, was intended “to provide thoughts, concerns, raise issues, share information across various colleagues responding to Covid-19,” including medical experts and doctors from the Health and Human Services Department, the Centers for Disease Control and Prevention, the Homeland Security Department, the Veterans Affairs Department, the Pentagon and other federal agencies tracking the historic health emergency. | The “Red Dawn String,” Dr. Caneva said, was intended “to provide thoughts, concerns, raise issues, share information across various colleagues responding to Covid-19,” including medical experts and doctors from the Health and Human Services Department, the Centers for Disease Control and Prevention, the Homeland Security Department, the Veterans Affairs Department, the Pentagon and other federal agencies tracking the historic health emergency. |
| Here are key exchanges from the emails, with context and analysis, that show the experts’ rising sense of frustration and then anger as their advice seemingly failed to break through to the administration, raising the odds that more people would likely die. | Here are key exchanges from the emails, with context and analysis, that show the experts’ rising sense of frustration and then anger as their advice seemingly failed to break through to the administration, raising the odds that more people would likely die. |
| One of the most active participants in the group was Dr. Carter E. Mecher, a senior medical adviser at the Veterans Affairs Department who helped write a key Bush-era pandemic plan. That document focused in particular on what to do if the government was unable to contain a contagious disease and there was no available vaccine, like with the coronavirus. | One of the most active participants in the group was Dr. Carter E. Mecher, a senior medical adviser at the Veterans Affairs Department who helped write a key Bush-era pandemic plan. That document focused in particular on what to do if the government was unable to contain a contagious disease and there was no available vaccine, like with the coronavirus. |
| The next step is called mitigation, and it relies on unsophisticated steps such as closing schools, businesses, shutting down sporting events or large public gatherings, to try to slow the spread by keeping people away from one another. As of late January, Dr. Mecher was already discussing the likelihood that the United States would soon need to turn to mitigation efforts, including perhaps to “close the colleges and universities.” | The next step is called mitigation, and it relies on unsophisticated steps such as closing schools, businesses, shutting down sporting events or large public gatherings, to try to slow the spread by keeping people away from one another. As of late January, Dr. Mecher was already discussing the likelihood that the United States would soon need to turn to mitigation efforts, including perhaps to “close the colleges and universities.” |
| Dr. James Lawler, an infectious disease doctor at the University of Nebraska who served in the White House under President George W. Bush and as an adviser to President Barack Obama, was also a regular participant in the email chain. He stayed in regular communication with federal officials as the United States attempted to figure out how to respond to the virus. From the beginning he predicted this would be a major public health event. | Dr. James Lawler, an infectious disease doctor at the University of Nebraska who served in the White House under President George W. Bush and as an adviser to President Barack Obama, was also a regular participant in the email chain. He stayed in regular communication with federal officials as the United States attempted to figure out how to respond to the virus. From the beginning he predicted this would be a major public health event. |
| Convincing governors and mayors to intentionally cause economic harm by ordering or promoting mitigation efforts — such as closing businesses — is always a difficult task. That is why it is so important, these medical experts said, for the federal government to take the lead, providing cover for the local officials to kick off the so-called Nonpharmaceutical Interventions, such as school and business closures. Again, this group of doctors and medical experts recognized from early on that this step was all but inevitable, even if the administration was slow to recognize the need. | Convincing governors and mayors to intentionally cause economic harm by ordering or promoting mitigation efforts — such as closing businesses — is always a difficult task. That is why it is so important, these medical experts said, for the federal government to take the lead, providing cover for the local officials to kick off the so-called Nonpharmaceutical Interventions, such as school and business closures. Again, this group of doctors and medical experts recognized from early on that this step was all but inevitable, even if the administration was slow to recognize the need. |
| Strong evidence was emerging as of mid-February — with the first cases of Covid-19 already in the United States — that the nation was about to be hit hard. These doctors and medical experts researched how quickly the virus spread on the Diamond Princess cruise ship, which was quarantined in the port of Yokohama, Japan, on Feb. 3 before hundreds of United States citizens on the ship returned home. | Strong evidence was emerging as of mid-February — with the first cases of Covid-19 already in the United States — that the nation was about to be hit hard. These doctors and medical experts researched how quickly the virus spread on the Diamond Princess cruise ship, which was quarantined in the port of Yokohama, Japan, on Feb. 3 before hundreds of United States citizens on the ship returned home. |
| Dr. Eva Lee, a researcher at Georgia Institute of Technology who has frequently worked with the federal government to create infectious disease projections, helped the Red Dawn group do modeling, based on the virus spread on the cruise ship. (Dr. Lee is facing sentencing on federal charges that she falsified the membership certificate behind a $40,000 National Science Foundation grant for unrelated research.) | Dr. Eva Lee, a researcher at Georgia Institute of Technology who has frequently worked with the federal government to create infectious disease projections, helped the Red Dawn group do modeling, based on the virus spread on the cruise ship. (Dr. Lee is facing sentencing on federal charges that she falsified the membership certificate behind a $40,000 National Science Foundation grant for unrelated research.) |
| The concern these medical experts had been raising in late January and early February turned to alarm by the third week in February. That was when they effectively concluded that the United States had already lost the fight to contain the virus, and that it needed to switch to mitigation. One critical element in that shift was the realization that many people in the country were likely already infected and capable of spreading the virus, but not showing any symptoms. Here Dr. Lee discusses this conclusion with Dr. Robert Kadlec, the head of the virus response effort at the Department of Health and Human Services and a key White House adviser. | The concern these medical experts had been raising in late January and early February turned to alarm by the third week in February. That was when they effectively concluded that the United States had already lost the fight to contain the virus, and that it needed to switch to mitigation. One critical element in that shift was the realization that many people in the country were likely already infected and capable of spreading the virus, but not showing any symptoms. Here Dr. Lee discusses this conclusion with Dr. Robert Kadlec, the head of the virus response effort at the Department of Health and Human Services and a key White House adviser. |
| Dr. Kadlec and other administration officials decided the next day to recommend to Mr. Trump that he publicly support the start of these mitigation efforts, such as school closings. But before they could discuss it with the president, who was returning from India, another official went public with a warning, sending the stock market down sharply and angering Mr. Trump. The meeting to brief him on the recommendation was canceled and it was three weeks before Mr. Trump would reluctantly come around to the need for mitigation. | Dr. Kadlec and other administration officials decided the next day to recommend to Mr. Trump that he publicly support the start of these mitigation efforts, such as school closings. But before they could discuss it with the president, who was returning from India, another official went public with a warning, sending the stock market down sharply and angering Mr. Trump. The meeting to brief him on the recommendation was canceled and it was three weeks before Mr. Trump would reluctantly come around to the need for mitigation. |
| Updated June 30, 2020 | |
| 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. | |
| 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. | 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. |
| 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. |
| This slow pace of action was confusing to the medical experts on the Red Dawn email chain, who were increasingly alarmed that cities and states that were getting hit hard by the virus needed to move faster to take aggressive steps. | This slow pace of action was confusing to the medical experts on the Red Dawn email chain, who were increasingly alarmed that cities and states that were getting hit hard by the virus needed to move faster to take aggressive steps. |
| When Mr. Trump gave a speech to the nation on March 11 in which he announced limits on flights from Europe to the United States — but still no move to curb gatherings in cities where the virus had spread — the experts on the email chain grew angry and fearful. Among those questioning Mr. Trump’s decision was Tom Bossert, who had previously served as Mr. Trump’s homeland security adviser. | When Mr. Trump gave a speech to the nation on March 11 in which he announced limits on flights from Europe to the United States — but still no move to curb gatherings in cities where the virus had spread — the experts on the email chain grew angry and fearful. Among those questioning Mr. Trump’s decision was Tom Bossert, who had previously served as Mr. Trump’s homeland security adviser. |
| The Red Dawn participants were even more upset when the Centers for Disease Control and Prevention, in mid-March, questioned the value of closing schools, at least for short periods of time. Soon enough, governors ignored this advice, and most schools in the United States were shut. But it happened largely without federal leadership. | The Red Dawn participants were even more upset when the Centers for Disease Control and Prevention, in mid-March, questioned the value of closing schools, at least for short periods of time. Soon enough, governors ignored this advice, and most schools in the United States were shut. But it happened largely without federal leadership. |
| The New York Times has collected more than 80 pages of these emails, from January through March, based in part on Freedom of Information Act requests to local government officials. Some of the emails were reported on last month by Kaiser Health News. Here is a fuller collection, arranged by The Times in chronological order. This file includes a list of many of the medical experts on the email chains. It also contains related emails from certain state government medical experts who were reaching out to the federal government during the same time period. | The New York Times has collected more than 80 pages of these emails, from January through March, based in part on Freedom of Information Act requests to local government officials. Some of the emails were reported on last month by Kaiser Health News. Here is a fuller collection, arranged by The Times in chronological order. This file includes a list of many of the medical experts on the email chains. It also contains related emails from certain state government medical experts who were reaching out to the federal government during the same time period. |