Cleveland, Columbus among 11 cities White House privately warns must take “aggressive” action against coronavirus

New red flags about the severity of the coronavirus outbreak come after Trump focused on upsides in televised briefing

 By Liz Essley Whyte, Reporter and Alex Ellerbeck, American University Fellow

 

This article about coronavirus aggressive action was originally published by the Center for Public Integrity, a nonprofit newsroom based in Washington, D.C.

Dr. Deborah Birx, a leader of the White House Coronavirus Task Force, warned state and local leaders in a private phone call Wednesday that 11 major cities are seeing increases in the percentage of tests coming back positive for COVID-19 and should take “aggressive” steps to mitigate their outbreaks. 

The cities she identified were Baltimore, Cleveland, Columbus, Indianapolis, Las Vegas, Miami, Minneapolis, Nashville, New Orleans, Pittsburgh and St. Louis.

The call was yet another private warning about the seriousness of the coronavirus outbreaks given to local officials but not the public at large. It came less than a week after the Center for Public Integrity revealed that the White House compiled a detailed report showing 18 states were in the “red zone” for coronavirus cases but did not release it publicly.

Increasing test positivity — an indicator that a community does not have an outbreak under control — should be expected in areas that reopened and grew more relaxed about social distancing measures, said Harvard epidemiologist Bill Hanage. He said the warnings and data from the White House should be made public. 

“This is a pandemic. You cannot hide it under the carpet,” he said. “The best way to deal with a crisis or a natural disaster is to be straight with people, to earn their trust and to give the information they need to make decisions for themselves and their communities.”

Birx told hundreds of emergency managers and other state and local leaders that they should act quickly to stem the outbreaks. Among her recommendations were to trace the contacts of patients testing positive for COVID-19 in areas where test positivity is going up.

“When you first see that increase in test positivity, that is when to start the mitigation efforts,” she said in a recording obtained by Public Integrity. “I know it may look small and you may say, ‘That only went from 5 to 5-and-a-half [percent], and we’re gonna wait and see what happens.’ If you wait another three or four or even five days, you’ll start to see a dramatic increase in cases.”

Birx said the federal government was seeing encouraging declines in test positivity in places like Phoenix and San Antonio but warned that the outbreak in the Sunbelt was moving north.

“What started out very much as a southern and western epidemic is starting to move up the East Coast into Tennessee, Arkansas, up into Missouri, up across Colorado, and obviously we’re talking about increases now in Baltimore,” she said. “So this is really critical that everybody is following this and making sure they’re being aggressive about mitigation efforts.”

It’s unclear who heard the warnings and was invited to the call, which was hosted by the White House Office of Intergovernmental Affairs and closed to the press. Baltimore and Cleveland were two of the cities Birx warned were facing rising test positivity, but a spokeswoman for the Cleveland mayor’s office, Nancy Kelsey-Carroll, said they did not participate in the call. And Baltimore health department leaders didn’t know about it, agency spokesman Adam Abadir said in an email. That city today announced a mask mandate and new restrictions on indoor dining.

The test positivity rates may not have been news to some elected officials. For example, Pennsylvania already publicly reports that data by county.

Birx’s warning came a day after President Donald Trump resumed his televised coronavirus briefings. The president offered a rosier picture of the pandemic than Birx, focusing on examples of improvements in the fight against the virus, such as better treatment with the drug remdesivir.

Her call also came the same day that Democratic Senate Minority Leader Sen. Chuck Schumer said on the Senate floor that he and House Majority Leader Nancy Pelosi had insisted on greater data transparency in a meeting with White House Chief of Staff Mark Meadows. Schumer said they would push for legislation to “ensure that COVID-19 data is fully transparent and accessible without any interference from the administration.”   

And on Tuesday, former CDC Director Tom Frieden and colleagues released a list of data points they would like states to publish in real-time, standardized, to give officials and residents better information.

“It’s not just people who are holding office who need to make decisions,” said Caitlin Rivers, an epidemiologist at Johns Hopkins University, on a call with reporters. “The more that we can provide information to people to keep themselves and their families safe, the better off we’ll be.”

The White House did not immediately respond to a request for comment on Birx’s warnings, nor did it answer repeated questions over several days from Public Integrity on why it had not made the “red zone” report public. Birx said on the call that the weekly report had been sent to governors for four weeks. One staffer for a governor said his boss received only the section of the report related to his state, not the entire report.

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Racism and Public Health • Converging Viruses Wreak Havoc in Black Communities

David B. Miller

William Hanage

By David B. Miller and William Hanage

Special to The Real Deal

In recent months the world has witnessed the ravages visited upon the United States by two viruses — COVID-19 and racism — that are affecting African Americans in acute and chronic fashion. The acute effects of the COVID-19 pandemic, from higher morbidity and mortality rates from the infection, to skyrocketing unemployment, have so far has been disproportionately borne by minority communities, especially black people.

This is no accident — it is a disaster foretold in the data that show African Americans are more vulnerable to negative health outcomes of all kinds.

COVID-19 has laid bare our society's fault lines, throwing inequalities into stark relief, and few inequalities can match the long unfolding consequences of the founding sin of the United States.

The pandemic has unfolded against a background of chronic legitimized violence, arising from the virus of racism. Four weeks ago the entire world witnessed nearly nine minutes of video depicting state sanctioned lethal police violence against George Floyd. Appallingly, he is only the most recent unarmed black man to have panted the words ‘I can’t breathe’ in his final moments.  Only a few weeks earlier we saw the hunting down and slaughter of another unarmed black man by armed self-appointed representatives of “law enforcement”. These videos portray the deadly manifestations of the virus that is racism. How many similar events have occurred over the years away from the lens of a cellphone camera?

Racism, like the coronavirus, is a transmissible disease.

The convergence of these two viruses is showing more and more Americans the devastating consequences of racism in this country. Like the coronavirus, racism is a transmissible disease; it is passed on through vectors in the media and society, and within families. But unlike COVID-19, the racism virus does not visit its most dreadful effects upon those who are infected with it.

Those infected with racism target others based on the color of their skin — overwhelmingly in the United States those with black skin. The wearers of the skin are marked throughout society in ways too exhausting to list. At worst the result is death to the wearer of the hated, excluded skin.

The men and women who are sworn to protect and serve a community are not immune to racism. The extraordinary power of the racism virus to elicit anxiety and fear too often leads to senseless confrontations that end with black mothers crying and communities marching for justice.

While all known COVID-19 infections descend from a common ancestor a little more than 6 months ago,  the virus of racism is ancient and has evolved and mutated into many different forms. At times, it erupts with fear and lethal rage when those wearing black skin are merely walking home at night with Skittles or playing with a toy gun in a playground.

While we expect the intense global search for a vaccine for COVID-19 will succeed, we can only hope that the reckoning George Floyd’s murder has spurred will be sustained long enough to begin the difficult but necessary conversations and steps needed to eradicate the racism virus.

Since the start of the pandemic we have seen armed mobs protesting shutdowns, shouting (many without masks) at law enforcement officers who exhibited great restraint, lifting nary a finger, baton, or weapon to repel those "protesters". In addition, those “protesters” received support and encouragement from the White House. Yet that same White House directed law enforcement officers to use force against unarmed peaceful citizens exercising their constitutional right to assemble peacefully in a public space. Is it a coincidence that they were protesting against racism?

What's most essential during this pandemic: brunch, blackjack or protest?

As public health professionals we are often asked about the impact of anti-racist protests on the pandemic. The answer is nuanced. Despite the best efforts of organizers to supply masks, hand sanitizer and encourage physical distancing, protests offer opportunities for the virus to transmit that are only enhanced by police actions that limit the ability to maintain distancing. Tear gas, and arrests compound the dangers,  especially because transmission of the virus is associated with poorly ventilated spaces.

As states open up, the opportunities for transmission that arise from the protests will dwindle in comparison to the close encounters that will occur in casinos, tattoo parlors, bars and restaurants. Given there is an historic pandemic going on, what is most essential: brunch, roulette or protesting against racial injustice?

No cure for the virus of racism will be discovered in a laboratory or another “blue ribbon” commission studying police violence. Instead this calls for a reckoning of the hearts and souls of each citizen of this nation. We can no longer close our eyes to how racism continues to place a knee on the collective necks of black Americans. The pandemic offers an opportunity to divide us, which has been avidly taken up by elements of the right-wing broadcast media who focus on maintaining inequality, rather than dismantling it.

Racism is likely to be a problem in the United States after the pandemic is done with us. It has led to untold deaths over the years, including the unequal society that places people of color at risk in the current pandemic. If the protesters now marching against that unequal society can do anything to change that and shift this country to a better place, we will owe them all a debt of gratitude.

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David B. Miller, Ph.D., is Associate Professor of Social Work at the Jack, Joseph, & Morton Mandel School of Applied Social Sciences, Case Western Reserve University.

William “Bill” Hanage, Ph.D., is Associate Professor of Epidemiology at T. H. Chan School of Public Health, Harvard University.