Tuesday, March 24, 2020

Last Call For Trump Goes Viral, Con't

Trump now says he expects America back to work by Easter weekend as Congress says they are close to a COVID-19 mega-package and the stock markets loved it.

President Trump on Tuesday said he hopes to have the country’s economy back up and running by Easter — Sunday, April 12 — his most concrete goal to date for easing off restrictions meant to curb the spread of the coronavirus.

Trump in a Fox News virtual town hall doubled down on his push to reopen businesses in a matter of weeks in order to reinvigorate the U.S. economy amid the coronavirus outbreak.

“It's not built to shut down. Our people are full of vim and vigor and energy. They don’t want to be locked in a house or an apartment or some space,” Trump said during a Fox News town hall Tuesday afternoon.

“You can destroy a country this way, by closing it down, where it literally goes from being the most prosperous,” Trump said, remarking on the strength of the U.S. economy just three weeks ago before the coronavirus started to have severe impacts in the United States.

"I would love to have the country opened up and just raring to go by Easter,” Trump later added.

The markets jumped up by more than 10%, their best day since 1933.

But here's the reality: Americans aren't going back to work without massive testing.  And increasingly it's looking like massive testing is never coming.

The ability to test at scale appears to have been a crucial—though far from the only—means by which China, South Korea, Singapore, and other countries have been able to control their epidemics. In the U.S., the imposition of lockdowns in Washington, New York, and California have only amplified the demand for a comprehensive testing program that would, ideally, allow for a more targeted strategy of contact tracing, isolation, and quarantine. During an interview on CNN on Monday night, Governor Andrew Cuomo said, “That’s how we’ll restart the economy.” But multiple public-health officials told me that the supply-chain constraints mean that such a program will be, for the near future, impossible to implement. And if there’s anything worse than not having tests for covid-19 broadly available, they say, it’s treating what testing capacity we do have like an unlimited resource.

“Had we had access to high-volume, quality testing prior to there being community transmission,” Rakeman, the director of the New York City lab, told me, “a lot of testing would have been helpful, and maybe would have helped containment.” But, given the prevalence of covid-19 in the city, she said, test results for people who are mildly or moderately ill have little therapeutic or epidemiological value. “When we talk about testing capacity, it sort of gives this tacit message that people should be tested, and feeds into that anxiety: ‘I need to get tested. I need to know my status,’ ” Rakeman said. “You don’t need to know your covid status.” Anyone who suspects they have covid-19 should call a doctor, but in New York, unless you belong to a high-priority category, the recommendation will likely be the same regardless of whether you have the test: stay home for two weeks, or until you’re fever-free for seventy-two hours. In any case, Rakeman said, “If you have a cough and a fever and a sore throat, or any of those, you probably have it.”

A larger problem, Rakeman told me, is that widespread demand for testing is exacerbating the critical shortage of masks and other P.P.E. The supply of available P.P.E. in New York is currently so low that, on Friday, Cuomo put out a public call to manufacturers to address it: “We will pay a premium for these products,” he said. As Rakeman told me, “Hospitals are going to run out of P.P.E. in the next couple of weeks, if not sooner. And any mask that is used now at a doctor’s office or a pop-up tent that’s providing ‘drive-through testing’ is a mask that’s not going to be available for a health-care worker in a couple of weeks.”

Patients seeking testing can also be potent vectors for the disease. “Take a scenario where, say, I have a cough, or a sore throat and a fever, but I’m not sick enough that I need to go to the hospital,” Rakeman said. “If I travel from my home to an urgent-care facility, I’m going to spread the virus to whomever I come into contact with. When I get there, the person who collects my specimen has to wear P.P.E. I’ve also exposed that health-care worker and everybody who works in that office, and all of the other patients, who may not be there for flulike illness.” She added, “By going out and getting a test, you’re potentially killing somebody’s loved one.”

Even outside of New York City, Khani told me, “You have to prioritize who gets tested. We don’t have the testing capacity that we need, and that’s why we want to make sure that those who need testing most have access to testing.” In Missouri, where the odds that someone has covid-19 are still likely lower than they are in other states, Bill Whitmar said that he understands why the first instinct for someone suffering covid-like symptoms would be to seek out confirmation. The tests “give people a feeling that they’re being taken care of. It’s a step that will make you feel a little bit better in this time of unease.” Nevertheless, he said, it was crucial to suppress this urge, at least for the time being. “I understand that the policymakers are trying to help their constituents. However, by doing that, you’re actually reducing the ability for people who really need the test to be able to get the test.”

And yes, as Jon Chait points out, Trump can definitely coerce governors who defy him on an Easter end to closures.

The question, though, is exactly what Trump can do to reopen the country. He can announce a date. But Trump didn’t close anything down to begin with. The closings have been directed by state and local officials. They will retain the legal authority to keep schools, restaurants, and other gathering places shuttered.

Yet his lack of a legal authority doesn’t make Trump helpless. He has several tools he could use if governors and mayors fail to come around to Arthur Laffer’s public-health theories:

1) Refuse to back more federal aid. States are only able to sustain their closures because they have the federal government as a fiscal backstop. States have to balance their budgets, which makes them helpless during a sharp contraction, when tax revenue plummets and social spending needs rise. The federal government, which can borrow, is needed to keep them operational. If Trump withdraws his support for fiscal stimulus to support the states, they will lose their ability to maintain public-health shutdowns.

2) Call on his followers to ignore the bans. Trump can’t open the schools, but he can get his supporters to flout the bans on aggregating in groups. The social distancing requirements depend on voluntary compliance. If Fox News tells its audience to listen to the president rather than their governors, many of them will.

3) Punish the states. Trump has always played favorites between red and blue states, showering those that supported him with attention and cash, and denying aid to blue states that anger him.

Trump has continued to openly state that his level of cooperation depends on governors showering him with praise. “Usually we’ll have 50 governors that will call it the same time,” he said on Fox News today. “I think we are doing very well. But it’s a two-way street. They have to treat us well, also. They can’t say, ‘Oh, gee, we should get this, we should get that.’”

States are dependent on help from FEMA, the military, and other arms of the federal government. New York’s Andrew Cuomo is pleading for Washington to send him ventilators, which he will need within days, or New Yorkers will begin dying for lack of treatment. As the coronavirus spreads, more and more governors will find themselves in this position. Trump has made clear his willingness to use government spending as a political weapon. He could bring recalcitrant governors to heel by withholding aid. What are they gonna do, impeach him?

What, indeed.

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