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Chomsky: COVID-19 Has Exposed the US Under Trump as a “Failed State”
The label “failed state” has started to fit the U.S. like a glove as the COVID-19 national health crisis continues to reveal the structural flaws and weaknesses of the United States, argues world–renowned public intellectual Noam Chomsky in this exclusive interview for Truthout. Meanwhile, the Trump administration continues to exact a high price in human lives due to its caricaturish but highly dangerous response to the crisis. In the interview that follows, Chomsky also analyzes what’s behind Trump’s encouragement of the “anti-lockdown” protests, discusses the right-wing determination to destroy the U.S. Postal Service, and lays out his views on the electoral “lesser of two evils” principle.
C.J. Polychroniou: Noam, it is widely accepted by now that the U.S. coronavirus response not only was delayed, but remains mired in contradictions as Trump battles with scientists over policy. Moreover, the country as a whole was shown to be completely unprepared for a major health crisis. Are we talking here not simply of an incompetent administration but also of a failed state?
Noam Chomsky: Fifteen years ago, I wrote a book called Failed States, a common locution in the day, referring to states that are incapable of meeting the needs of citizens, in the most important case because of deep policy choices, and are a danger not only to their own citizens but the world. The prime example was the United States. Extensive evidence was reviewed. That’s not of course the intended use of the phrase in the doctrinal system, just as “rogue state” means some enemy, not ourselves, the prime example.
I still stand by that judgment, which was not mine alone. A few years later, a Gallup/WIN international poll found that the U.S. is regarded as the greatest threat to world peace, no one else even close. And the severe threats of government policy to the domestic population, already quite apparent when the book appeared, became much clearer a year later when the housing bubble burst and the financial crisis ensued — along with Obama’s response: bail out the perpetrators, who became richer and more powerful than before, and forget about the congressional legislation that called for some help to the many who had lost their homes in corporate scams facilitated by the Clinton-Rubin-Summers deregulation extravaganza, extending the neoliberal assault on the population that took off under Reagan.
That’s a large part of the background for what finally brought us the Trump malignancy — which may, quite literally, doom human society on Earth. We’ve discussed elsewhere why this is no exaggeration. I hope that the basic facts and their dread import are well understood, and won’t review them here.
Trump has indeed hit America with a hammer blow — and much of the world as well, a matter we should not overlook. Just keeping to the current COVID-19 crisis, it is remarkable to see how little attention has been given to his sadistic assault against poor and suffering people around the world in pursuit of his goal of enhancing his electoral prospects.
There has been some attention to his extending his vicious attacks against refugees fleeing from misery and oppression, appealing to a deluded voter base that has been led to believe that refugees are the source of their suffering under the programs to which Trump is passionately committed.
“Incompetent” is not the right word for Trump’s malevolence, which turned serious problems in the U.S. into a devastating crisis.
But there is hardly a word about his attack against poor people in Africa, where unknown numbers will die thanks to his defunding of the World Health Organization (WHO), which has been protecting them from a wide range of diseases, now this new plague. Or about Palestinians in the occupied territories, victims of Israel’s racist contempt for their health and other basic needs, amplified by Trump’s defunding of their meager health, educational and support systems generally because — as he explained — they weren’t treating him with enough respect while he’s smashing them in the face.Trump’s withholding funds from the WHO was just the first step in his campaign to destroy the organization. The campaign provides real insight into the deeply rooted malevolence not only of Trump but of the gang he has collected around him, most of whom cower in silence (though some speak out), sometimes even outdoing the boss. Secretary of State Mike Pompeo has been in the forefront of demonizing the WHO in support of Trump’s increasingly desperate efforts to find a scapegoat for his terrible crimes against Americans. It doesn’t matter how many miserable people are slaughtered in Africa and elsewhere in the Global South as crucial WHO services are undermined. Just “shithole countries” anyway, as the Dear Leader has explained.
It is by now common understanding that the U.S. under Trump is a failed state that is a serious danger to the world. Diplomats speak in muted tones, not wanting to offend the raging beast in Washington who has unlimited power to destroy. But the meaning is clear when a “senior European official” says that “The U.S. administration is very fixated on the reelection campaign and on who can get blamed for this catastrophic covid-19 situation in the U.S. They are blaming WHO and China for it. Therefore it is very difficult to agree on a common language about the WHO.”
The “common language” in question has to do with a UN Security Council resolution that the Trump administration is blocking. The resolution calls for “a global ceasefire pertaining to armed conflict in response to the pandemic [and urges] member states to ‘share timely and transparent information regarding the outbreak of COVID-19.’” But the resolution is unacceptable to the White House, because it calls on countries to “support the full implementation of the WHO International Health Regulations.” As the senior European official said, asking countries to implement procedures to contain the crisis is harmful to Trump’s reelection campaign.
In brief, the dedication to slaughter poor and suffering people in pursuit of personal gain is so profound that even reference to WHO health regulations cannot be mentioned. The WHO is reaching the status of climate change, a phrase that has to be excised from official documents dealing with the environment. Across the board, Trump and his acolytes are echoing the words of Francisco Franco’s fascist Gen. Millán Astray: “Down with intelligence! Long live death!”
Turning directly to your question, I think “incompetent” is not the right word for Trump’s malevolence, which turned serious problems in the U.S. into a devastating crisis. But we should not overlook the serious problems inherited by the cruel gang in today’s White House. It’s crucial to understand the background for the crisis if we hope to contain the next pandemic, likely to be worse than this one because of the impact of the global warming that is a far more severe threat.
At the root, there are three factors: general capitalist logic, the more brutal neoliberal variant, and reactions by individual governments.
In 2003, after the SARS epidemic, scientists were well aware that a pandemic is likely, probably a related coronavirus. They also understood how to prepare for it — just as scientists today have a good idea as to how to prepare for the coming one.
But it’s not enough to know. Someone has to pick up the ball and run with it. The obvious candidate is Big Pharma, with huge resources, bloated with profits thanks to the exorbitant patent rights granted them under the highly protectionist “free trade” agreements. They’re ruled out, however, by normal capitalist logic. There’s no profit in preparing for a catastrophe down the road. And in fact it can be in their interest to impede a constructive response.
Next, the government could step in, but that’s blocked by the neoliberal intensification of capitalism’s inherent inhumanity. As Reagan declaimed in his inauguration speech, government is the problem, not the solution. Translation: Take decision-making away from government, which is at least partially responsive to public influence, and hand it over to private tyrannies that are unaccountable to the public. An essential component of neoliberalism, overt since its origins in interwar Vienna, is that democracy is a threat that must be contained, even destroyed by state violence if necessary, principles advocated in word and action by the gurus of the movement: Ludwig von Mises, Friedrich Hayek and others. Furthermore, as Milton Friedman counselled in the Reagan years, the unaccountable tyrannies who control decision-making must be guided by sheer greed. Any concern for others would shake the foundations of civilization.
The creed was not strictly observed. Obama tried to evade it slightly, but the efforts were quickly smashed by capitalist logic (the ventilator-Covidien affair that we’ve discussed elsewhere is an example). But government intervention was largely blocked.
The third factor is the reactions of individual governments. They varied. China very quickly provided the WHO and the world with all relevant information. By early January, Chinese scientists had identified the virus and sequenced the genome. Some countries at once reacted: Taiwan, South Korea, Singapore, New Zealand, a few others, which now seem to have the crisis largely under control. Europe dithered but finally acted, with varying degrees of success.
An essential component of neoliberalism is that democracy is a threat that must be contained, even destroyed by state violence if necessary.
At the bottom of the barrel is Trump, reflecting his dedication to his primary constituency, private wealth and corporate power, lightly hidden under a farcical display of “populism.” Throughout his term in office, Trump has systematically pursued policies that enrich his primary constituency while harming others, including his adoring crowds. One part of this program was steadily defunding the Centers for Disease Control and Prevention (CDC) and dismantling programs that could have provided advance warning of what was likely to happen. As a result, the U.S. was singularly unprepared.Though the U.S. and a few other failed states had all the information that led functioning societies to react appropriately, of course not all was entirely clear. That could hardly have been possible in such tumultuous circumstances. Like others, high U.S. health officials had some uncertainty about what exactly was happening and how best to handle it. Nevertheless, it was possible to take effective action, as shown by the record of governments that have some concern for their citizens. U.S. intelligence and health officials understood more than enough. Through January and February, they were trying to get through to the White House, but Trump was too busy watching his TV ratings. In the style of petty dictators, he has surrounded himself with sycophants or comical figures. So, nothing from them. Or from the Republican Party, now trembling in fear of the crowds that can be mobilized by Trump and his corporate sponsors.
When some dare to inject a little rationality into administration discussions, they quickly learn their lessons, like the physician in charge of developing vaccines who was dismissed in April for warning against one of the quack medicines that Trump was advertising.
“Down with intelligence! Long live death!”
Trump should be given credit for his considerable achievements. It’s not easy to get away with holding up a banner with one hand saying “I love you, I’m our savior, I’m chosen by heaven to protect you,” while the other hand is stabbing you in the back. But Trump is doing it, brilliantly. He’s the supreme con man, who makes P.T. Barnum look like an amateur. He’s in a long tradition, back to trading tales for fun in the old West, to the self-declared King of France in Huckleberry Finn, to the guy who’ll sell you the Brooklyn Bridge. Moving to a different sphere, we might also include the president who won the “marketer of the year” award from the Association of National Advertisers for his political campaign, easily defeating Apple and other amateurs, and went on to win a Nobel Peace Prize for some pleasant rhetoric.
But Trump is in a class by himself. Not just as a con man, but much more significantly as a dedicated enemy of the human race. That much is demonstrated by his policies on accelerating environmental catastrophe and dismantling the arms control regime that has provided some protection from terminal nuclear war, quite aside from a stream of peccadilloes of the kind already mentioned.
While praising Trump for his considerable achievements, we must also bear in mind that the health system that he has been wrecking was already in terrible shape. The privatized profit-driven health system in the U.S. was an international scandal long before Trump, with costs about twice as high as comparable countries and some of the worst outcomes. On the eve of the pandemic, the costs of this dysfunctional system were estimated at $450 billion in wasted expense and 68,000 deaths annually by The Lancet, one of the world’s leading medical journals.
Beyond that, the neoliberal business model dictates that hospital care must be “efficient”: the minimum number of nurses and hospital beds to just get by in normal times — not much fun for patients even in normal times even at the world’s best hospitals, as many can attest (myself included). And if anything goes wrong, tough luck.
It should be added that contrary to common belief, the U.S. does have universal health care. It’s called “emergency rooms.” If you can drag yourself to one, they’ll take care of you, often with superb care — and often a hefty bill. It’s the most cruel and expensive form of universal care known, but at least it’s there.
Bad as the situation was that Trump inherited, he has been committed to making it worse. One illustration of the commitments (and moral level) of the White House is the budget it submitted for the coming year on February 10, while the pandemic was raging. It called for still further cuts for the CDC along with increased subsidies to the fossil fuel industries that are driving us to final catastrophe. And, of course, more funding for the bloated military and for the famous wall that will protect us from the rapists and murderers surging across the border.
That barely skims the surface. Failed state? Four more years?
Are the anti-lockdown protests, which Trump is openly encouraging, merely about the shutting down of the economy and quarantines?
We have enough experience to see that virtually everything Trump does is about himself — the country and the world be damned. In this case, one can detect a strategy behind the ongoing circus. Trump has been casting about to find someone to blame for his crimes. After evoking the Yellow Peril and laboring to destroy the WHO, with grim effects, he’s pretty much run out of targets. A rational next step is to tell governors that it’s your business: the federal government, which has all the resources, can’t do anything for you. If anything goes wrong, it’s your fault, not mine. And if something happens to go right somewhere, it demonstrates what a stable genius I am, and will be trumpeted by Sean Hannity as the most brilliant decision in human history.
Trump is in a class by himself. Not just as a con man, but much more significantly as a dedicated enemy of the human race.
This is similar to the strategy of saying one thing today and the opposite tomorrow, each echoed rapturously by Fox News while the liberal press dutifully tots up the lies (20,000?). If you shoot arrows at random, some may hit the target. And if one does? I’m vindicated and the scam goes on. You can’t lose.The governors’ ploy is about the same: enforce lockdown, open up the economy (and protect our “Second Amendment rights,” which has nothing to do with anything but pushes the right buttons). If it makes life harder for the governors and leads to many deaths, that’s OK too. It’s all the fault of the urban centers where diseases and other maladies fester among those who are poisoning our lily–white society.
Malevolent, but not stupid.
It’s tempting to add the injunction to the states by Mitch McConnell, the real evil genius of the Republican organization. Go bankrupt. The Republican Senate is not going to compensate you for your foolish decision to give pensions to firefighters, teachers, policemen and other undeserving takers. We have to save the money for the makers, like the airline industries that need $50 billion because in the glory days of high profits, instead of improving services and building the enterprises, they spent close to $50 billion in buybacks to inflate stock prices and compensation for management. After all, first things first. There’s no need to elaborate. His vileness has been so egregious that there’s been plenty of commentary in the mainstream press.
In defense of Trump, McConnell and rest of the merry gang, they are carrying to an extreme the only way of dealing with the dilemma that the Republicans have faced since they turned to pure service to the business world. It’s hard to go to voters and say, “Look, we’re the more extreme of the two business parties. We’re designing policies to benefit our primary constituency of great wealth and corporate power, and to throw you into the waste bin. So vote for us.”
Somehow, that doesn’t work well. So it’s important to divert attention to “cultural issues,” to pretend to be adamantly opposed to abortion rights and love assault rifles, to be terrified of them, to dismiss global warming as a Commie plot, and all the rest. The word “pretend” is quite appropriate, but I won’t go into that here.
The Democratic establishment has its own sins to answer for, but it is nothing like this; more like the moderate Republicans of the days before the Gingrich-Hastert-McConnell era. And it is subject to popular pressures, which have moved the party considerably to the left in recent years. That’s not insignificant.
World leaders’ approval rating has soared as a result of their handling of the coronavirus crisis, with the exception of Donald Trump. Could coronavirus be the determinant element that will put an end to four years of a nightmarish scenario written, directed, produced and carried out by the most dangerous buffoon this country has had for president? Trump’s Waterloo, so to speak?
Trump benefited from the usual leadership bump when he finally acknowledged that the crisis was real, two months late, and assumed the proper presidential pose. His approval ratings have since receded to the norm from the beginning of his presidency. That’s a pretty impressive performance considering what he’s done to the country. I can’t guess where it will go from here. It’s really hard to say. He’s damned resilient, and his voting base and media echo chamber stay loyal. Current statistics show that he seems to be back to his norm of approval, which hasn’t varied a great deal through his term. And if it looks bad, they might pull something before November. Like concocting an incident and bombing Iran.
Why is Trump bent on destroying the U.S. Postal Service (USPS)?
What does the postal service contribute to private wealth and corporate power (Trump’s primary constituency)? Essentially nothing. Just means that they have to pay taxes for rural mail service and other services for ordinary people — insofar as they pay taxes, another interesting topic that I’ll put aside. If the USPS is privatized, it can contribute to private wealth and corporate power, and they can run it “efficiently,” like the health care system.
A good deal more is involved. It’s important to them to drive out of people’s heads the idea that democracy might work, that a public system can serve the needs of the general public. In much of the country, the local post office not only serves people’s needs efficiently but is even a place where you can stop by and chat with a human being and meet your friends.
And — horror of horrors — activists might be able to help people realize why the postal service was set up by the founders. Its prime function in early years was to deliver journals and magazines cheaply, a subsidy to an independent press, what the founders seem to have had in mind in framing the First Amendment. These matters are explored in depth in scholarly work by Robert McChesney and Victor Pickard, who carry the discussion right to the 20th century struggles to join the world in having vibrant public media, a critical matter for media activists today.
That’s dangerous turf. Better to destroy the virus of democracy before it infects too many people.
Joe Biden expressed the fear last week that Trump might attempt to delay the November 2020 election. Is this a likely scenario? Does the sitting president have the authority to do so on account of a national crisis?
No constitutional authority, but Trump is quite capable of imitating his ludicrous friend Jair Bolsonaro and declaring “I am the Constitution.” Unlike the Brazilian judiciary, the Roberts Supreme Court might back such a statement up. And if granted another four years of court-packing up and down the line with young ultra-right figures, virtually anything will be possible. Anything, that is, but mildly progressive measures. Their fate will be dim for a generation or more.
It’s also not beyond imagination that if Trump loses the electoral college (not just the popular vote), he’ll declare the election illegitimate, claiming that the Democrats brought in undocumented immigrants, and insist on staying in office, surrounded by armed militias.
I can’t verify it, but it’s been credibly reported that if he has to leave the White House, Trump may be facing serious charges brought by states’ attorneys. That aside, given his mental state, Trump might not be able to handle defeat and walk away like a normal human being.
Many on the left feel, naturally, and with much justification, extremely uncomfortable about Joe Biden. In fact, we hear now from some quarters the same arguments we heard in 2016 about Hillary Clinton, which is to say that it would be unconscionable for progressives to accept the “lesser of two evils” principle. How can we understand the political and conceptual context of electoral choices made by progressives and the left in November 2020?
These questions are plainly important. They are a matter of intense discussion and often impassioned debate on the left, and plenty of invective. That makes them worth discussing. To be quite frank, I don’t see much other reason for discussing them. I’ve tried to explain in recent interviews, and judging by the reactions, have failed. So, I will repeat in more detail.
I’ve been around for a long time and can’t think of a candidate about whom I was not “extremely uncomfortable,” at least since FDR (and I was too young to have considered opinions then).
In Biden’s case it’s easy to think of reasons to be extremely uncomfortable. We can begin with his participation in the destruction of Libya and Honduras, in Obama’s global assassination campaign, in breaking all records in deportation — and on from there. But while continuing with constant efforts to change that world, we have to take off a few minutes to each make our own choices on election day.
In the moral domain, what matters is the predictable consequences of your actions, those you are well aware of but choose to ignore. No one cares if you feel your conscience is clear.
Let’s think through the two concepts that lie behind the question: “unconscionable” and “lesser of two evils principle.”Let’s start with “unconscionable.” There are those — including close personal friends and long-time activists whom I greatly respect — who take the position that some actions are simply “unconscionable,” whatever the consequences. I will ignore this position. To me, frankly, it seems not worth discussing. In the moral domain, what matters is the predictable consequences of your actions, those you are well aware of but choose to ignore. No one cares if you feel your conscience is clear.
Let’s turn to the lesser of two evils principle.
Throughout my lifetime of activism (almost 80 years), I’ve been familiar with two doctrines about voting. One is the official doctrine.
Official doctrine holds that politics consists of showing up every few years, pushing a lever, then going back to one’s private pursuits. Citizens are “spectators,” not “participants in action,” according to official doctrine. They can choose one or another member of the leadership class (“the responsible men”) but that’s the limit of popular participation. I happen to be quoting Walter Lippmann, a respected public intellectual of the 20th century (a Wilson-FDR-JFK liberal), in his “progressive essays in democracy,” but the ideas are representative of prevailing liberal opinion. They trace back to the framers of the Constitution. That’s why the “gold standard” in constitutional scholarship, a fine and illuminating study by Michael Klarman, is called “The Framers’ Coup” — a coup against the popular demand for democracy.
On the right, views are much harsher.
A second doctrine is the one that has always prevailed on the left, call it “left doctrine.” Politics consists in constant direct popular engagement in public affairs, including a wide variety of activism on many fronts. Occasionally an event comes up in the formal political arena called an “election.” For left activists, that requires spending a brief period assessing the options (a very brief period for legitimate activists, who’ve been following everything relevant closely). Then comes a decision as to whether it’s worthwhile to take a few minutes away from ongoing political work to push a lever in the quadrennial extravaganza. It’s at most a brief departure from political engagement.
That’s the doctrine that I’ve followed all my life, sometimes abstaining because the show didn’t seem to matter and there’s no point legitimizing the charade by participating, sometimes voting for a third party, sometimes voting for Jones if it’s important to block Smith. I’ve sometimes voted for a Republican, in years when the Republicans were still a bone fide political party and had a better candidate.
There are, of course, myriad other cases, but the general point of left doctrine seems clear.
In recent years, a third doctrine has made an appearance and is now consuming much debate on the left: the lesser of two evils principle. I’d never heard of it before, in a lifetime of intensive political engagement (in the left doctrine sense). And it seems quite strange to me. It obviously is quite different from left doctrine, the prevailing doctrine on the left. The intensive debate about it falls within official doctrine, with its laser-like focus on the elections.
My own feeling about the lesser of two evils principle, of course, is that we should reject it in favor of left doctrine. It has no merits that I can see, so I think we can put it aside, along with the often–fevered debate about it.
Let’s now consider the immediate case in hand. If the traditional left doctrine were applied to the current situation, it would require comparing Trump and his entourage with Biden and his, and asking whether there is a difference between them.
I personally think the difference is colossal. First and decisive, another four years of Trump and we’ll have approached or possibly passed tipping points on the path toward environmental catastrophe toward which Trump is racing, his “party” in tow, virtually isolated in the world, certainly in the political system here. Just as important, the arms control regime will be dismantled, sharply increasing the threat of terminal war. The severe threats that Trump has incited in the Middle East will have increased, if not exploded. The Doomsday Clock, already reduced to seconds under Trump, will probably be close to abandoned. The reactionary international led by the White House that Trump is establishing will be well solidified. At home, the judiciary will be so packed by ultra-right young judges that no progressive initiatives will be able to be implemented for a generation. By the wayside we’ll be observing other horrors, like children sent to concentration camps on the border, Black people murdered on a whim, etc.
An advocate of left doctrine will spend a few minutes reviewing the familiar facts, then take off another few minutes to push a lever, then go back to work.
I know of only one proposed counterargument. We have to put pressure on the Democratic establishment. To begin with, it’s not a counterargument. It simply reiterates the main thesis of left doctrine: constant pressure. The only remaining question is how to impose pressure. There are, basically, two proposals on the table. The first is left doctrine. The second is refusing to vote for Biden.
Let’s take a look at these.
Left doctrine efforts can work, as they often have before. We all know that that has been the main source of progress over the years.
First, left doctrine. We continue with what has been done, and has been very effective. One illustration is the Sanders campaign, which has been a remarkable success in shifting debate and policy choices to the left. The activism of the Sunrise Movement — aided by young congresswomen brought to office in the Sanders wave, notably Alexandria Ocasio-Cortez — has brought to the legislative agenda a Green New Deal, with the cooperation of liberal Democrat Ed Markey, senator from Massachusetts. Some version of a Green New Deal is essential for survival. There have also been significant shifts in other areas (health care, minimum wage, harsh repression in vulnerable communities, women’s rights, on and on). We can, in fact, see this in Biden’s program, which is well to the left of previous Democratic front-runners. That’s why Biden is supported against Trump by Sanders (who had a large role in bringing the shift about) and also by longtime labor activists like Lawrence Mishel and Jared Bernstein. It’s not my program, or yours, but we can hardly doubt that it is an improvement over what preceded.Left doctrine efforts can work, as they often have before. We all know that that has been the main source of progress over the years, particularly when there were administrations susceptible to activist pressure.
It could be argued that political programs are just words. True, but irrelevant. Left doctrine efforts can keep Biden’s feet to the fire, as has often happened in the past. And there will be opportunities to go far beyond, an urgent necessity.
In contrast, we can be sure that a Trump administration will be rock solid in opposition.
The second approach is to refuse to vote for Biden in the hope that withholding the vote will convince the Democratic establishment to take us seriously down the road. I can’t honestly construct a plausible version of this view, and it would be unfair to try.
Turning finally to your question, “How can we understand the political and conceptual context of electoral choices made by progressives and the left in November 2020?”
To me the answer seems clear. We should assess whether there is meaningful difference between the candidates, and also recognize that, for most of us, voting takes a few minutes. Then we go back to our real activist work.
LA Rams 2019 mid-season additions act like 2020 NFL Draft picks
LA Rams 2019 mid-season additions act like 2020 NFL Draft picks
by Bret Stuter 1 day ago Follow @milroyigglesfanThe LA Rams added 3 players in the midst of the 2019 NFL season. Here’s why they should be considered to be 2020 NFL Draft picks
The LA Rams ended the 2019 NFL season with just five draft picks. The team faced multiple scenarios through the course of the year which required roster adjustments, whether to shed players, add players, or exchange players. In the end, each transaction affected the roster at a point midway through the year.
Unlike player injuries or coming back from injury, or even being called up or demoted to the practice squad, these three circumstances placed a jersey on football players who had no foreknowledge of the LA Rams’ playbook, coaching staff, players, or even community. And one of the greatest assets for the LA Rams is offensive line coach Aaron Kromer. Two offensive linemen, one of whom a starter at multiple positions in 2019, never had the chance to benefit from his training camp.
Rams building that OL is probably the most underrated part of what they've done. Not many guys that were considered big deals when they were acquired, outside of Whit
— Jon Ledyard (@LedyardNFLDraft) September 28, 2018
The shortage of 2020 NFL Draft picks stems from the Rams desperate attempt to go all-in on the chance to make the 2019 NFL Playoffs. While that effort fell short, the team finished at a very respectable 9-7 record. That is despite all the horror stories of multiple injuries that haunted the offensive line all season, a defensive backfield which was blown up and restocked in mid-season, and three of the most highly paid players on offense all having sub-standard seasons.
Addition 3: Center
The LA Rams added center Coleman Shelton by signing him from the Arizona Cardinals practice squad. At the time, the team had lost rookie center Brian Allen for the season and had lost veteran interior offensive lineman Austin Blythe for several games due to injury. To compensate, the LA Rams had to trade for an interior offensive lineman in midseason and then needed a center to be the team’s backup.
Fortunately for the LA Rams, they chose very wisely.
Coleman Shelton has not had the benefit of LA Rams offensive line coach Aaron Kromer, and as a result, has waited patiently for his opportunity to take offensive snaps on the starting line for several years. At 6-foot-5 and 285 pounds, he is a huge center who becomes the offense’s own worst enemy to shorter quarterbacks trying to peer over him to find receivers downfield. Thankfully, LA Rams quarterback Jared Goff stands in a 6-foot-4, giving him plenty of height see over Shelton and find his targets in their downfield routes.
Shelton is extremely athletic, a muscular center whose role on an offensive line requires plenty of snaps to understand his own assignment, and that of other players at the line of scrimmage. While he has yet to play significant snaps for any NFL team, he has yet to benefit from an offseason training program under Coach Kromer. At worst, he is the equivalent of a seventh-round pick. But compared to the talent level of the 2020 NFL Draft, Shelton is more like the equivalent of a fourth-round pick.
Addition 2: Interior offensive lineman
After a series of injuries exhausted the LA Rams reserve offensive lineman, general manager Les Snead acted quickly by trading the team’s 2020 fifth-round draft pick to the Cleveland Browns for their reserve interior offensive lineman Austin Corbett. Originally drafted by the Browns in the second round of the 2018 NFL Draft, Corbett soon found himself buried on the depth chart. That is where he was when the LA Rams traded a 2020 NFL Draft fifth-round pick for him.
From the moment he arrived at the Rams, he was placed into service. First at the center, then at the left guard, he was the Rams version of duct tape. Despite the hurried manner of onboarding, he was a solid player and he held his own on the team’s badly besieged offensive line.
#LARams Austin Corbett and David Edwards were able to provide some impressive production in 2019 during a period of OL uncertainty
Among all Guards (min 500 snaps):
– Corbett allowed 11 pressures (4th) and 1 sack (T-7th)
– Edwards allowed 14 pressures (T-6th) and 1 sack (T-7th) pic.twitter.com/TzRsAHbG6Y— PFF LA Rams (@PFF_Rams) January 30, 2020
After a better than expected debut in 2019, Corbett now has the opportunity to train, practice, be coached, and earn his 2020 starting role once more. Not only should he be able to do so, but he should be able to perform as one of the better NFL offensive linemen this season. His original draft spot of pick 33 is the equivalent 2020 NFL Draft pick value he has for the Rams this season.
Addition 1: Cornerback
When the LA Rams decided to trade for cornerback Jalen Ramsey, the team had to overcome a number of hurdles in order to do so. The team had to clear a roster spot. In addition, the team had to clear sufficient salary cap space to do so. And then ultimately, the LA Rams needed to exchange sufficient assets to make the trade complete.
Despite the lack of a first-round pick in the 2020 NFL Draft, the LA Rams can equate that value in obtaining one of the best cornerbacks in the NFL today, Jalen Ramsey. The Rams traded their 2020 first-round pick plus their 2021 first and fourth-round picks to the Jacksonville Jaguars for cornerback Ramsey, whose contract expires in 2020.
The ultimate cost to the Rams for Ramsey is more than the picks required to pry him from the Jacksonville Jaguars. He also cost the Rams the play of both Aquib Talib, Marcus Peters, and a fifth-round pick. Ultimately, was he worth it? Yes.
In the 2020 NFL Draft, the Jacksonville Jaguars selected edge rusher, K’Lavon Chaisson with the 20th pick. Four cornerbacks had already been selected off the board and the players remaining on the board did not have the same value as that of Rams CB Ramsey. In essence, Ramsey is the equivalent of the Rams 2020 first-round draft pick.
While the LA Rams added nine rookie players in the 2020 NFL Draft, the Rams have the equivalent of a fourth-round pick for Coleman Shelton, a second-round pick for Austin Corbett, and a first-round pick for Jalen Ramsey. That translates into 12 pick-equivalents from the 2020 NFL Draft and includes two interior offensive linemen who will be capable of starting in 2020, plus an elite cornerback. In the end, the LA Rams 2020 NFL Draft was fairly comprehensive after all.
Rams General Manager Les Snead & Head Coach Sean McVay – – April 21, 2020
(On what he learned this Spring during the evaluation process that might change or impact how he approaches the draft this year)
MCVAY “I think what’s been really good is the dialogue, especially between (Rams General Manager) Les (Snead) and myself and really our groups as far as looking back on the three years of experience that we’ve had. The good things, maybe some things that we would say, maybe we would handle differently and that’s what it’s always about is self-evaluating, being able to learn from our mistakes, continue to try to replicate some of the things that have enabled us to have a certain level of success. I think it’s about recommitting every single year to evaluating your own roster, what are some of the needs? What do we feel like based on the flow of the league and trying to be competitive within your own division, the types of players that we want to onboard and the types of people that we want in our building? We’re hopeful that our people and our way of doing things will create our edge. We’re excited about attacking this draft process and fulfilling some of those needs to try to complete our roster to be a competitive group in 2020 in a very tough division.”(On if any players other than OL Brian Allen or anyone in the organization has tested positive for COVID-19)
MCVAY “No, not that I know of. When we spoke last time, out of respect for the privacy of (OL) Brian (Allen) and where that was at, at that time and that’s why I didn’t want to reveal any specific names. When he had decided to speak about it openly, then you at least felt comfortable to acknowledge who it was. I was really pleased and proud of the way that Brian communicated immediately. I think (Senior Director of Sports Medicine and Performance) Reggie Scott’s guidance and leadership through that process, as you’re trying to navigate through it and handle it in all the right ways, was instrumental in us taking those steps with some urgency and now our facilities are opened back up. There hasn’t been anybody else that’s been exposed to that, to my knowledge.”(On what went into the decision to trade WR Brandin Cooks)
SNEAD: “Many variables go into any time you trade someone, but probably to keep it simple is – a lot of teams did contact us about (WR) Brandin (Cooks) throughout this, I guess you’d call, offseason, whenever the new league year started, even before a little bit. We were committed to keeping Brandin because of what he did for our offense. I think in that time where we, I’d call it, naturally played hard to get because we weren’t actively trying to move him. When a few teams did come with a chance to get a second-round pick, that’s probably when we sat down and (Rams Head Coach) Sean (McVay) and I discussed, ‘Hey, what could be best moving forward?’ That pick being very valuable. Us with the emergence of (WR) Josh Reynolds and (WR) Robert Woods and (WR) Cooper Kupp, especially Josh Reynolds coming. We’ve got a deep receiver room, I think that helped and then getting another pick in the top 60, very valuable. I think those two variables – getting a second-round pick, having Josh Reynolds to go with two other very accomplished players allowed us to do that.”(On how he sees WR Josh Reynolds fitting in and if it will be Cooks’ role or seeing interchangeable parts with his three starting receivers)
MCVAY “In a lot of ways, it’s a big vote of confidence to what we feel like Josh is capable of, of continuing to ascend to. He’s stepped in and been a starter and he’s got the ability to play really our X or Z, he can play in the slot. I think, really, we just feel like he’s a capable starting receiver if you’re getting into some of those three receiver sets. I think it’s also a reflection of the confidence that we have, really in our skill group as a whole. You can activate five different skilled players at any time, it doesn’t necessarily always have to be three receivers. You look at the emergence of (TE) Tyler Higbee, we’ve talked a lot about the confidence that we have in (TE) Gerald Everett, we’ve got to get (RB) Darrell Henderson going. We’ve got some skilled players that we’re excited about doing a better job of developing and seeing these guys have success. When you take a look at that unit as a whole and the entirety of what they represent, those are where you feel comfortable to make those decisions and there are some capable guys that we might be able to add in there in the next couple of days.”(On how they see the possibilities for drafting a wide receiver given how many there are in this draft)
SNEAD: “Again, it’s obviously been well stated, this is a very deep receiver draft. With that being said, usually when a draft is considered deep in a position, it’s probably a lot of those players are gone in the first 32 (picks). That’s usually what deep means, right? There’s a lot of quality players. The one thing about the wide receiver position in college football, there’s a lot of teams throwing the football, there’s a lot of wide receivers on the field, so it’s imperative for us, our scouting staff working with our coaching staff to maybe get beyond some of the household names that make this draft deep ,that are probably going to go in the top-32 and find some of those players that have a skill set that can fit in to Sean’s offense and help us continue gaining yards, getting first-downs and scoring touchdowns.”
MCVAY “I think a lot of the same. Really, for us, I think our coaching staff, Les and his group have done a great job collaborating to find players that we see value in. It doesn’t exclusively have to be that receiver position. It’s players that have an opportunity to make plays when the ball is in their hands and ultimately, it’s about scoring points. There’s a lot of different playmakers that come from different position groups in this draft and that’s something that we’ll see how things play themselves out. We’ve got a nice opportunity to be patient on Thursday and then Friday will be an exciting chance for us to get four picks off the board, but you guys know Les Snead. He’s a wheeler and dealer, you never know.”(On how the logistics are looking and if everything has gone smoothly on his end and if he has any concerns about the communication for this weekend)
SNEAD: “It’s been very smooth. I think the experts we have helping us or assisting us get through this on our IT team, our video team, I give that group all the credit. Sean’s probably a little more adapt at some of this than I am, but I do know this have relied on some smart people and have not had a glitch at all and definitely am not anticipating any glitches. I do know this, if like anything, you have a phone, so if the screens go out or as (Senior Director of Communications) Artis (Twyman) just did with myself, I don’t know if you all knew this, but I was struggling to get into this Zoom conference, so guess what Artis did? He gave me a call on the old cell phone and it all worked out.”(On what the NFL draft setup will be like at their homes)
MCVAY “This is the command center, that you can see here. It looks like I can set off a spaceship at this thing. Les and I have the same setup. They even got a camera in my office that they’ll film during the draft to make sure that Les and I aren’t at the same location. This is something that’s going to be different for sure.”(On what has been the biggest challenge has been having to go virtual since the NFL Combine and not being able to bring players to the facility)
MCVAY “That’s really been the biggest challenge. I think in a lot of ways, the best part about this is, we’ve probably been more efficient, more detailed, just being able to operate on a cleaner schedule because it does take out – when you’re only just remotely working – you don’t have some of the other distractions that do inevitably come up. So, certainly not minimizing all the stuff that’s going on way bigger than football, but it has probably been the smoothest process. Les and I were able to talk this morning. We’ve been able to connect with the personnel and coaching staff and really have some clarity that you probably haven’t had in previous years because of the limited distractions that you have outside of ‘Hey, let’s focus on getting ready for this draft,’ and then our virtual offseason program with the players will start next Monday (April 27, 2020). So, that’s where there’s been positives. The negatives are where you don’t have that interpersonal interaction, that when you can bring the Top 30’s in. One of the things that I thought was instrumental in our first year that Les has done in previous years, we went around and actually got a chance to workout some guys. We worked out (WR) Cooper Kupp, we worked out (TE) Gerald Everett, some other guys that we were considering. Those are really beneficial things to get that up close and feel, most importantly for the human being, but then also some of the physical things that you’re looking for. That’s where you get a little bit minimized, but it’s sometimes does create clarity because we’re asking them to play football. The Zoom meetings or the FaceTimes have enabled you to have some interaction with the players, where you can still get a feel for their personality and how they’re wired.”(On if the Rams are in the market for a backup quarterback through the draft that the team can develop or if they are satisfied with QB John Wolford in that role)
MCVAY “Yeah, I think, you’re always looking to upgrade that position, but John Wolford is a guy that we’re very excited about. We feel like he is more than capable of continuing to ascend and develop. I think his skill set and just the way that he’s wired above the neck are great traits and things that we look for from that quarterback position. I think what’s just as important is the rapport that he has with (QB) Jared (Goff) because it starts with Jared and then making sure that there’s a good comfortable relationship with whoever that person is as the backup. You never know exactly how this thing sorts itself out, but if you said, ‘We’re going into a season and John Wolford is your backup, and God forbid something happen to Jared, do you think he can come in operate and have you function as an offense?’ The answer is absolutely.”(On if McVay can give a visual tour to media on the call of his at-home command center)
MCVAY “I can give you a quick view as long as it’s got the screensaver that doesn’t have our board. So really, that’s where our boards will be on those monitors – offensive board, defensive board and then the draft tracker, and the other one. That’s really what that entails, so it’s as close to a simulation as what we would have if we were sitting in our draft room at the office. I can’t say enough about (Rams Manager, Information Technology) Jeff Graves and Dan Dmytrisin (Director, Video) on what a job they’ve done of making this as smooth as a process with IT and the video.”(On if the draft board is behind the screensavers of McVay’s command center monitors)
MCVAY “Don’t ask me to show that, now we’re getting carried away (laughs).”(On concern of hackers during the 2020 NFL Draft)
MCVAY “I’m not too worried about that. If they’re worried about hacking us, these things never go exactly according to plan. So, the board is a demonstration of where we have it, but it doesn’t always work out that way, which is why the planning and contingency planning is vital.”
SNEAD: “…You see, I’ve got this little thin notebook.”
Media Member: “It’s the little red book?”
MCVAY “His (Les Snead) penmanship is pretty impressive, too. He’s sent some notes. It’s impressive.”
SNEAD: “Yeah, I think it says ‘2019 Draft area scout draft meeting, coaches meetings.’”
MCVAY “You see the problem is, Les doesn’t know what year it is, but other than that we’re in good shape (laughs).”(On Snead’s quarantine beard)
SNEAD: “I don’t know if this is a beard, this is just probably laziness of not shaving. Then when I got the text from (Rams Senior Director, Communications) Artis (Twyman) this morning, I was slightly embarrassed that I was coming back on a Zoom call, with kind of my fisherman look. I do plan to clean up before the draft. The dress code is the pros of this quarantine.”
MCVAY “Like a true PR director too, look at Artis (Twyman). He looks like he is getting ready to film a shot on Good Morning America or something. He’s got the office setup. I just got my mom’s blinds as an interior designer (laughs).”(On if there’s any concern regarding computer glitches while selecting draft picks)
MCVAY “I think there’s enough time in between picks. The NFL has done a great job of communicating and understanding and some flexibility if some of those things do arise. If you were telling me we’re operating on a real play clock, like 40 seconds or 25 in a really game, I’d say maybe I’d feel a little bit differently, but we have a little bit more time in between those selections and I think the NFL has done a nice job of kind of getting ahead of some of those things that could come up.”(On how the League’s practice draft went and if doing that affected the way they’ll approach the draft)
SNEAD: “I think it went well. I think it served what a – if you want to call it a practice session is for. To get everyone on the same page, to get used to how it was going to play out, especially from a technical standpoint. I don’t think it will change a lot of how you’re going to strategize in the draft. I think if we do make a trade, as Sean mentioned earlier, that’s definitely a possibility. I do think at that point, it’ll probably be a little different than just on the phone, just walking through it. Maybe we’ll be a little more careful to make sure all parties are onboard and in the know, so we can execute a trade without a glitch. I do think like Sean said, I do think the league will be well aware if two teams are trying to make a trade. I do think Jeff Graves showed me, I think there’s an emergency line that you can eventually call in and go, ‘Mayday, mayday. We’re trying to make a trade but technology is down.’ Don’t quote me on that, but I do believe that is the case. I did tell Jeff, that I’m glad Jeff is going to be here. An IT person can be in your home, so that will be a great sidekick.”(On why there’s been a delay in Leonard Floyd being introduced and how important it is to find a potential successor for LT Andrew Whitworth in the 2020 NFL Draft)
SNEAD: “We’ve agreed to terms with (OLB) Leonard (Floyd) and (DL) A’Shawn (Robinson) based on language in your contract on when the players can get physicals and things like that is really the nuances of why you can’t officially announce. That is, again, a little bit of the adversity during these quarantined-times with the physicals. On the OL, I think we have been trying to strategically attack the offensive line position over the last few years and with one main goal to accomplish, is get as many young players that can grow together as possible. When you step into a draft, and say, ‘you have to find your next left tackle.’ It doesn’t matter where you’re picking, that may be hard to do. I think just like in drafts past, if there’s a potential player that can maybe have a shot to replace ‘Big Whit’ (T Andrew Whitworth) in time – now as Sean may say, ‘I don’t know if Whit’s ever going to retire.’ He may be 50 and we’re still talking about replacing ‘Big Whit.’ We’ve done it with (OL) Joe Noteboom, we’ve drafted (OL) Bobby Evans, we can do it again this year. Goal would be, draft someone who can be versatile, not only a left tackle, but as many players that can play left tackle as possible is always good.”(On what would have to happen for the Rams to trade into the first round)
SNEAD: “I think simply put, there’s a football player where we really like the human being and we really like the skillset and we think that player and person can be a benefit, can help us continue contending, continue our winning ways that we’ve established over the past few years.”(On if trading up to the first round is a possibility)
SNEAD: “There’s definitely been, since we’ve been here, we’ve proven that we’ll go get a player and we’ll also move back to acquire, let’s call it, more picks in the draft, which ultimately means more players. So that’s the benefit, you either give up a player on the back end to go get one, or maybe you gain one or two more that you weren’t expecting if you trade back. We’ll try to navigate that as the draft comes to us, because when you’re picking 52 (overall), 57 (overall), there is an element that you have to allow the draft to come to you a little bit.”(On if they expect this year’s draft to be more unpredictable in terms of where players are taken)
SNEAD: “No, I think all drafts are unpredictable. I think the way, let’s call it your profession (media), covers the draft – we all could name maybe the 15-20 (or so) players that we feel like might be first rounders, I don’t know if we could get the order right, so that’s even unpredictable in itself. Except, maybe you can get the names right. I do think once you get late 20s, into the second, third round, you can study a lot of mocks and those players go anywhere from second to fifth (round). The draft’s always unpredictable in that nature. What I like to say is, ‘Everything up to this point is speculation. But no one has seen each 32 team’s draft boards and what they feel and who they feel can help them.’ Then when that team decides to take a player that becomes his IPO, his initial public offering, everything else is speculation up until that point.”(On if Snead tends to get more calls when the Rams do not have a first round pick to move into the round or does he tend to make more of the calls to see what’s out there)
SNEAD: “I think you try to make calls to get a feel for who may be willing to move. In all honesty, when you’re at 52 (overall), I bet teams that are trying to move out of late first would rather not come back that far, and usually the ammo it takes to move up, could be a little unrealistic or maybe less rational unless you’re just wanting to come away with one player.https://www.latimes.com/politics/story/2020-04-07/hospitals-washington-seize-coronavirus-supplies
Hospitals say feds are seizing masks and other coronavirus supplies without a word
By Noam N. Levey Staff Writer
April 7, 2020
2:07 PMWASHINGTON — Although President Trump has directed states and hospitals to secure what supplies they can, the federal government is quietly seizing orders, leaving medical providers across the country in the dark about where the material is going and how they can get what they need to deal with the coronavirus pandemic.
Hospital and clinic officials in seven states described the seizures in interviews over the past week. The Federal Emergency Management Agency is not publicly reporting the acquisitions, despite the outlay of millions of dollars of taxpayer money, nor has the administration detailed how it decides which supplies to seize and where to reroute them.
Officials who’ve had materials seized also say they’ve received no guidance from the government about how or if they will get access to the supplies they ordered. That has stoked concerns about how public funds are being spent and whether the Trump administration is fairly distributing scarce medical supplies.
“In order to have confidence in the distribution system, to know that it is being done in an equitable manner, you have to have transparency,” said Dr. John Hick, an emergency physician at Hennepin Healthcare in Minnesota who has helped develop national emergency preparedness standards through the National Academies of Sciences, Engineering and Medicine.
The medical leaders on the front lines of the fight to control the coronavirus and keep patients alive say they are grasping for explanations. “We can’t get any answers,” said a California hospital official who asked not to be identified for fear of retaliation from the White House.
In Florida, a large medical system saw an order for thermometers taken away. And officials at a system in Massachusetts were unable to determine where its order of masks went.
“Are they stockpiling this stuff? Are they distributing it? We don’t know,” one official said. “And are we going to ever get any of it back if we need supplies? It would be nice to know these things.”
PeaceHealth, a 10-hospital system in Washington, Oregon and Alaska, had a shipment of testing supplies seized recently. “It’s incredibly frustrating,” said Richard DeCarlo, the system’s chief operating officer.
“We had put wheels in motion with testing and protective equipment to allow us to secure and protect our staff and our patients,” he said. “When testing went off the table, we had to come up with a whole new plan.”
Although PeaceHealth doesn’t have hospitals in the Seattle area, where the first domestic coronavirus outbreak occurred, the system has had a steady stream of potentially infected patients who require testing and care by doctors and nurse in full protective equipment.
Trump and other White House officials, including his close advisor and son-in-law Jared Kushner, have insisted that the federal government is using a data-driven approach to procure supplies and direct them where they are most needed.
In response to questions from The Times, a FEMA representative said the agency, working with the Department of Health and Human Services and the Department of Defense, has developed a system for identifying needed supplies from vendors and distributing them equitably.
The representative said the agency factors in the populations of states and major metropolitan areas and the severity of the coronavirus outbreak in various locales. “High-transmission areas were prioritized, and allocations were based on population, not on quantities requested,” the representative said.
But the agency has refused to provide any details about how these determinations are made or why it is choosing to seize some supply orders and not others. Administration officials also will not say what supplies are going to what states.
Using the Defense Production Act, a Korean War-era law that allows the president to compel the production of vital equipment in a national emergency, Trump last month ordered General Motors to produce ventilators to address shortfalls at hospitals.
The law also empowers federal agencies to place orders for critical materials and to see that those get priority over orders from private companies or state and local governments.
Experts say judicious use of this authority could help bring order to the medical supply market by routing critical material — ventilators, masks and other protective gear — from suppliers to the federal government and then to areas of greatest need, such as New York.
Yet there is little indication that federal officials are controlling the market, as hospitals, doctors and others report paying exorbitant prices or resorting to unorthodox maneuvers to get what they need.
Hospital and health officials describe an opaque process in which federal officials sweep in without warning to expropriate supplies.
Jose Camacho, who heads the Texas Assn. of Community Health Centers, said his group was trying to purchase a small order of just 20,000 masks when his supplier reported that the order had been taken.
Camacho was flabbergasted. Several of his member clinics — which as primary care centers are supposed to alleviate pressure on overburdened hospitals — are struggling to stay open amid woeful shortages of protective equipment.
“Everyone says you are supposed to be on your own,” Camacho said, noting Trump’s repeated admonition that states and local health systems cannot rely on Washington for supplies. “Then to have this happen, you just sit there wondering what else you can do. You can’t fight the federal government.”
Mitra Khazain on Facebook
Amish Shah is an emergency room doctor and an Arizona State Representative. Here is his view from the frontlines of #COVID19. It’s worth your time to read.Amish Shah
Friends,
Two weeks have passed since my last post. We are now squarely in the throes of this crisis, and the situation has changed for the worse as we all expected. COVID19 continues its devastating march across the world, but one country has been hit especially hard – The United States. America now has the most confirmed cases at 311,000. We now stand at 8,400 deaths and rising fast. For comparison, we had 25,000 cases and under one thousand deaths just two weeks ago. Yesterday we recorded over 34,000 cases and 1,300 deaths in 24 hours – again, the most recorded in the world. Since our testing is uneven and haphazard, there are likely many more cases in the community that are unrecorded. Unfortunately, our situation will still get worse before it gets better.
The New York City metro area is hardest hit, and conditions at many of their hospitals are dire. I trained at Lincoln Hospital in the Bronx and worked as a faculty member at Mount Sinai in Manhattan and Elmhurst Hospital in Queens, so I feel for the health care workers at those locations in particular. (See for example: https://www.nytimes.com/…/ny…/nyc-coronavirus-hospitals.html)
I have spoken with some of my colleagues at the New York hospitals and have read their accounts. They describe a heartbreaking scene:
– Huge lines of very sick patients waiting to be seen, all coughing and febrile
– A painful and miserable course for patients lasting weeks, including persistent shortness of breath and severe weakness
– Multiple “Code Blue” (cardiac arrest) announcements throughout the day
– Emotionally and physically exhausted staff who are afraid for their lives but continue to persevere
– Several doctors and nurses who have fallen sick and a few who have lost their lives
– Lack of PPE (personal protective equipment) and supplies such as masks, drugs, and ventilators
– Dead bodies being loaded into refrigerated trucks because there is no space in the morgueThe Governor of New York and their Mayor continue to plead for help, and the help they are receiving does not seem to be enough to meet demand, possibly because other hot spots have emerged across the country, such as Detroit and New Orleans.
We must use all available means to prevent this from happening in Arizona. Currently, we continue to see large increases in cases here. Today, April 5, we have 2,269 cases and 64 deaths – compared to the 100 cases and one death that I mentioned in my last post. Unfortunately, these numbers will continue to rise. Compared to New York, our growth rate is lower, with cases doubling about every five days instead of every three.
Despite the increase in cases, the good news is that the *growth rate* is actually slowing across America – meaning that even if we are on the upslope, the curve is starting to flatten. We believe that this is a result of our ever-stricter social distancing. Let’s keep it up. This is crucial for the sake of our individual safety and for those on the front lines. From all of us health care workers out there, we really appreciate how the vast majority of the public has acted with great responsibility and sacrifice, as well as offers of help.
Meanwhile, I have reached out to many of my physician colleagues to understand how our health system is coping. So far, our Arizona hospitals are not yet saturated with cases. Emergency departments are seeing fewer patients overall. Patients that do present are more often truly ill or injured. We are freeing up resources appropriately, and I’m grateful that the public is responding to our messages to come to the hospital only when appropriate. With regard to sicker patients, several Arizona hospitals have ICUs that are partially full with COVID19 patients, and one (in Flagstaff) is reported to have a full ICU. But most hospitals still have capacity, and the Governor’s order to increase beds in every hospital by 50% will certainly help.
Meanwhile, our hospitals continue to see an increased demand for PPE and are keeping up at this point, even as the situation is tenuous. I have been personally working to connect our hospitals and the Arizona Department of Health Services (ADHS) with suppliers. While manufacturing has ramped up and more supplies are available for sale, we have also received reports of a chaotic and difficult marketplace. Hospitals, state governments, the Federal government (by way of FEMA) and foreign countries are vying for the same precious resources. Just today, however, we received welcome news that Honeywell will manufacture millions of masks here in Arizona for our use.
Testing continues to expand. The US has tested over 1.7 million people. This number continues to increase rapidly with more tests entering the market due to expedited FDA approval. Yet Arizona is still behind. We have run over 27,000 tests, but there are concerning bottlenecks, including availability of swabs and testing reagents. Currently, we can only test those who are ill or with whom we have higher suspicion of contagion. With increased availability, we hope to broaden testing criteria. (I discussed the individual and public health benefits of testing in my prior posts.) Also, researchers in Colorado have developed an antibody test to determine who has already recovered from the virus. This will take months to formulate, but if successful may help many people return to normal life.
Throughout these two weeks, our Governor has taken more steps to maintain social distancing. We’ve pared down the list of essential businesses, allowed for emergency refills of chronic medications, and allowed the use of telemedicine for a number of occupations including physical therapists and veterinarians. Schools are closed for the rest of the year. This will continue to reduce human interactions and therefore viral spread. The CDC has not yet issued a national recommendation that everyone wear a mask in public, but I believe it would be helpful.
Meanwhile, the economy continues to be in free fall, and the pain is real. This week, Arizona saw 88,000 unemployment claims, compared to the few thousand we usually see. The US had over 6.5 million, compared to the usual few hundred thousand. These figures are unprecedented since the Great Depression of the 1930s. Importantly, the supply of food, financial services, and other necessities remains very stable. We are continuing to provide for the basic needs of our people.
These past two weeks, I have heard from so many tenants who have had difficulty with rent, small business owners who are afraid that they will have to permanently shut down, and unemployed people facing uncertainty. We are working to connect every constituent to resources to help them through this difficult time. To highlight, we have increased unemployment benefits, made Small Business Loans much more accessible, and placed a temporary halt on evictions, among other initiatives. Please visit my website at http://www.AmishForArizona.com/Covid for a complete list.
Finally, I want to address a few questions that I have been asked frequently in recent days.
How are we doing? Is our public response adequate? Since the beginning of this crisis, I have continued to support all of our elected officials who continue to act in good faith to serve the American people. This is not a time for politics and backbiting, but rather a time of national unity and good governance. We are certain to learn some important lessons, and once this is over, I hope that we will never forget nor let this happen again. Our human toll and the economic hardship cannot be in vain.
In the longer term, we will have to take specific actions to protect humankind. The origin of the current virus appears to be a food market in China with wild animals and unsanitary conditions, and the international community will have to insist that these types of markets be closed or heavily regulated to stop the emergence of such diseases. We will have to spend more money on research into the development of vaccines for known, predictable threats. Most importantly, we will have to ensure that the national preparedness plan is not just a dusty document on a shelf but a reminder of a real danger to our existence.
Have any drugs been proven effective in treating COVID-19? As for medications, we have had mixed news. Chloroquine has been touted as a promising drug, and one small controlled trial demonstrated some efficacy, but another showed no effect. Larger studies are still ongoing. Another drug, Kaletra, was not found to be useful in one trial. But researchers continue to investigate dozens of other drugs that either block viral entry into our cells or stop its replication. Vaccine development is also promising as more than one research lab has identified a real candidate, but these will take several months of development before we can demonstrate true efficacy and safety in humans.
When will this end, and how can we end it? The timing is very difficult to predict, but it will take at least several weeks before cases start to decline. Once we are certain that the decline is stable, we will want to end the crisis by progressively clearing areas and declaring them virus-free and safe for resumption of normal life.
But to get there, we will need a systemic public health effort to track and trace the virus. This piece of the puzzle has been glaringly absent so far. Such an effort would begin with rigorous quarantine of all positive cases. Then, we would find all of their recent contacts and test/isolate them if positive. We would rinse and repeat until very few positives occur. Several Asian countries enacted such a strategy, and it is akin to using a fine scalpel to cut out the disease from society. It would be a win-win scenario, because once we have only a few positives, whole communities that are free of disease can re-open and restart the economy.
Unfortunately, we do not have a “scalpel” available to us yet. That takes preparation and effort. All we have instead is the “hammer,” meaning massive lockdowns that disrupt much of society. The hammer is blunt and causes collateral damage. My hope is that our hammer buys us enough time to develop a scalpel soon. (For more, see: https://medium.com/…/coronavirus-the-hammer-and-the-dance-b…)
I know that the days ahead are dark, especially the next few weeks. I wish I had better and more uplifting news for you, but my intent here is to give you a real look at what our people are now facing. If this is not affecting your immediate circle, it likely will soon, and I want you to be safe and prepared. I feel the melancholy of our national mood, but find real strength in the knowledge that all of you are striving to make your contribution to our great country every day. For some of you, this means providing essential services like staffing grocery stores and maintaining the food supply despite personal risk. Others are navigating the stress of family obligations while working at home. Some of you are just isolating and making TikTok dance-challenge videos. While social distancing may not feel always like contributing, it’s the most patriotic and community-minded action we can take.
I promise that one day this will end. We have seen other countries get past their terrible peaks and we will, too. Until then, let’s continue to give it our best fight every day, like so many proud generations of Americans have before us during the most difficult of times.
Thank you, and please continue to reach out.
Chloroquine inhibits the virus in test-tubes, is used with Lupus patients as an anti-inflamatory. Might prove effective, might not.
This scientist has some thots on other approaches.
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