Roundup: Without Federal Coordination, Many States See Rising COVID-19 Cases

July 8, 2020 | 5:58 pm
Louisiana National Guard member prepares to do COVID-19 screeningLouisiana National Guard
UCS Science Network

This post is part of a series of quarterly roundups on scientific integrity.

The second three months of 2020 saw some progress in the fight to control the COVID-19 crisis, but with a vacuum of consistent, science-informed federal leadership the US became one of the few countries to see its case numbers plateau rather than drop—and case counts are now growing with alarming speed in states that relaxed standards too quickly. While COVID-19 continued to take an inequitable toll on Black communities, the police murders of Breonna Taylor, George Floyd, and many others highlighted the multiple ways that structural racism endangers Black lives, and protesters across the country took to the streets (wearing protective masks) to demand change. Rather than taking meaningful steps to address these crises, the Trump administration largely left states to respond on their own, and instead focused energy on damaging actions like purging inspectors general. Moves by Congress and courts, however, provided signs of hope that the executive branch won’t be able to continue to ignore evidence with impunity.

Without federal leadership, great sacrifices bring limited returns

As the nature and reach of COVID-19 became clearer, states and local areas responded by reallocating healthcare resources, ramping up testing, encouraging or requiring mask use, and instituting stay-at-home orders to limit coronavirus transmission. Countless people sacrificed economic and mental health to stay home, while workers performing essential functions in healthcare, food production, transportation, and other sectors braved the risk of COVID exposure with inadequate safeguards and insufficient support from federal occupational health authorities. These shared sacrifices allowed most healthcare systems to avoid complete overwhelm and gave scientists time to research treatments and advance vaccines. But some states began relaxing physical distancing requirements in May, and by late June several began to see rising case counts and intensive-care units nearing capacity. Thousands of families—a disproportionate share of them Black—are grieving loved ones lost to COVID-19, and the inadequate responses mean this toll will grow quickly.

Insufficient guidance and coordination from the federal government made it hard for states to use resources efficiently and plan appropriately. Former assistant secretary for health Howard K. Koh pointed out that “only the federal government can establish standards for the country to synchronize state surveillance, establish benchmarks, monitor outcomes, disseminate best practices, and offer consistent health messages that can lead to a healthier and more informed populace.” CDC’s collection and reporting of data improved, but the federal government has done too little on consistent messaging, benchmarks, and best practices for states, communities, and workplaces. In mid-April, the White House released criteria for determining when and how to move between reopening phases; the plan won praise for its overall approach but criticism for missing details on testing and what constitutes a “downward trajectory” in cases.

CDC created detailed guidelines for reopening schools, businesses, and other organizations, but the administration initially shelved them, and then released a less-complete version after news reports of the guidelines’ suppression. Most states had not met the White House criteria when they began to reopen, and some appeared to be manipulating the data to make conditions appear more favorable than they were.

In addition to delaying and watering down CDC guidance, the administration reportedly instituted airport temperature screenings over the objections of CDC scientists who warned that they are a poor strategy for detecting COVID-19 cases in arriving passengers. In another example of sidelining scientists’ advice, President Trump repeatedly touted the anti-malaria drug hydroxychloroquine despite an absence of strong evidence of effectiveness. HHS scientist Rick Bright testified to the House Energy & Commerce Committee’s Subcommittee on Health that he was reassigned after working against “misguided directives” to allow broad use of hydroxychloroquine; the federal office investigating his whistleblower complaint determined there is sufficient evidence to believe he was the subject of retaliation, and FDA has now revoked hydroxychloroquine’s emergency use authorization. The administration also abruptly terminated a National Institutes of Health grant for ongoing research into how coronaviruses move from bats to humans after unfounded accusations about an involved Wuhan laboratory circulated online.

President Trump has failed to fully support CDC advice to wear masks in public by refusing to wear one himself when in view of cameras and downplaying their importance. (The government initially advised against routine mask-wearing because limited supplies of masks were needed for front-line workers and evidence that masks protected wearers was lacking; in early April, CDC advised mask-wearing based on accumulating evidence that masks could limit the spread of the virus from infected individuals to others.) Although the majority of US adults report wearing masks regularly, President Trump’s apparent distaste for them may be contributing to politicization of mask-wearing. Some individuals angry about mask requirements and business closures have harassed and threatened public health officials, several of whom have resigned.

Although high-profile news stories chronicled missteps in CDC’s early handling of the COVID-19 crisis, public trust in the agency remains much higher than trust in President Trump. CDC resumed holding briefings in late May after an 11-week hiatus; they were halted after Nancy Messonnier, director of CDC’s National Center for Immunization and Respiratory Diseases, warned the virus would spread widely and cause severe impacts. The White House daily COVID-19 briefings, which through late April had regularly featured President Trump misrepresenting the state of the US response, resumed in late June with Vice President Pence downplaying the severity of the recent increase in cases. The administration could likely strengthen public trust by allowing scientists to communicate honestly with the public—including reporting bad news and uncertainty—but several CDC scientists recently told CNN reporters they feel they’ve been muzzled. The White House also barred Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, from testifying at a House of Representatives appropriations committee hearing, while allowing him to testify before a Republican-led Senate committee hearing.

Without strong federal leadership, the payoff from our shared sacrifice was merely a pause in the COVID crisis, not control over it. The actions elected officials take in the next several weeks will determine how much more suffering we will endure.

Looking ahead: Publicly available data sources like COVID Exit Strategy and the COVID Racial Data Tracker are helping advocates hold their elected leaders accountable. By exposing data manipulation in states, journalists and advocates are helping to exercise the oversight the federal government has failed to provide.

Using data to advance equity

Decades of policies and practices that discriminate against Black, Latinx, and other historically marginalized groups have resulted in conditions that put these communities at greater risk of both catching and dying from COVID-19. Early in the pandemic, many states did not report the racial or ethnic breakdown of people who tested positive for or died from the disease; now, with more data by race available, we see that Black people are dying of COVID-19 at nearly twice the rate we would expect based on their share of the population. As protests across the country highlight both police violence against Black people and broader structural inequities, calls to address centuries of injustice are growing stronger. Collecting and acting on data are key components of fighting COVID-19, racism, and police violence. The Justice in Policing Act of 2020 would create a National Police Misconduct Registry that would make it harder for offending officers to switch jurisdictions and avoid accountability, and better data and research funding can allow researchers to paint a clearer picture of the health impacts of police brutality. The COVID-19 Racial and Ethnic Disparities Task Force Act introduced by Senator Kamala Harris (D-California) and Representative Robin Kelly (D-Illinois) would require a task force to make data-driven recommendations about directing resources such as testing supplies and protective equipment to communities with disproportionately high levels of COVID-19 infections, hospitalizations, and deaths.

Looking ahead: The Data for Black Lives Movement has released a roadmap, stating: “We demand the use of COVID-19 data for the abolition of the structures, systems, policies and narratives that have made Black people indefensible and vulnerable to COVID-19. We reject any current use of COVID-19 data to police, surveil, control and target Black communities, and any use of COVID-19 data to reinforce the narratives about Black people that have made race a risk factor, while blatantly ignoring the central role of racism.”

Trump fires or sidelines five inspectors general

President Trump has dismissed two confirmed inspectors general (IGs) in recent months: Michael Atkinson of the intelligence community, who believes he was removed for having properly handled the whistleblower complaint involved in President Trump’s impeachment, and Steve Linick of the State Department, who had reportedly opened an investigation into Secretary of State Mike Pompeo for potential misuse of a political appointee. He also replaced three acting inspectors general: Glenn Fine of the Department of Defense, who was slated to lead the Pandemic Response Accountability Committee; Christi Grimm of HHS, who had published a report warning of inadequate protective equipment and COVID-19 testing capacity at many US hospitals; and Mitch Behm of the Department of Transportation, who was reportedly examining whether Secretary of Transportation Elaine Chao was giving preferential treatment to projects in her home state of Kentucky. The goal of these actions appears to be not only to halt investigations whose findings might be politically damaging to Trump administration officials, but to create a chilling effect on all who are tasked with providing essential oversight of the executive branch.

Looking ahead: Congressional committees have opened investigations, but could do more. Advocates for strong oversight urge Senators to reject nominations of IG replacement candidates who appear unqualified and Congress to enact reforms to ensure current and future IGs are “independent, qualified, and expeditiously appointed.” Senator Chuck Grassley (R-Iowa) has introduced a bill that would require administrations to provide advance notice and a reason for firing an inspector general.

Requiring better approaches to evidence

When the House of Representatives passed the HEROES Act, the latest COVID-19 relief bill, it included the bipartisan Scientific Integrity Act—a victory for ensuring evidence guides science-related activities in the executive branch. Passage of the Scientific Integrity Act by one chamber brings the US closer to a future in which federal agencies must adhere to Congressional requirements for shielding government scientists and their work from political influence. In another win for the role of evidence, recent court decisions have also rebuked the Trump administration for failing to provide adequate explanations of their actions. The Supreme Court ruled that the Trump administration failed to provide sufficient justification for rescinding Deferred Action for Childhood Arrivals protections of immigrants brought to the US as children. “Much of [the Trump] administration’s approach to governance rests on attempting executive actions that lack any meaningful justification rooted in expertise, or even rational thought,” write legal experts Neal K. Katyal and Joshua A. Geltzer. This approach has resulted in an unusual pattern of court defeats. Relatedly, EPA abandoned a policy that barred many top scientists from serving on the agency’s science advisory committees after being challenged by three separate lawsuits led by Earthjustice, NRDC, and the Union of Concerned Scientists.

Looking ahead: Several Senators have urged Senate Majority Leader Mitch McConnell (R-Kentucky) to bring the HEROES Act to the floor for a vote.


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