Rep. Thomas Massie, R-Ky., at the Capitol on Friday, tried to force a recorded vote on the $2 trillion coronavirus relief bill. Massie and other libertarians worry the bill will ruin the United States’ creditworthiness.
Bill Clark/CQ-Roll Call via Getty Images
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Bill Clark/CQ-Roll Call via Getty Images
Rep. Thomas Massie, R-Ky., at the Capitol on Friday, tried to force a recorded vote on the $2 trillion coronavirus relief bill. Massie and other libertarians worry the bill will ruin the United States’ creditworthiness.
Bill Clark/CQ-Roll Call via Getty Images
Let us all have a moment of sympathy – and perhaps even understanding — for Thomas Massie, Republican of Kentucky.
Massie was the guy who caught hell from all sides Friday when he tried to force a roll call vote on the coronavirus relief bill in the House of Representatives. He said he wanted every individual member to record his or her vote on the gargantuan $2 trillion package, which he called the biggest relief bill in the history of mankind.
For Massie and many like him, the bill that aims to forestall economic disaster in the face of a pandemic is, in itself, a fiscal calamity and a radical turn in governing philosophy. Letting this go without a recorded vote was capitulation on a profound scale — a violation of all he held sacred.
“If this bill is so great for America, why not allow a vote on it?” he fumed on Twitter.
Another was that bringing House members back to vote would mean hundreds of people returning to the Capitol, some traveling across the country to be there, risking exposure to the virus or sharing it with others.
Nonetheless, Massie had a point with his cri de coeur for conservatism.
Explicitly, the CARES (Coronavirus Aid, Relief and Economic Security) Act spends money faster than any legislation in history, shoveling it out with an air of near-desperation. That strikes fear in those who routinely regard all government with suspicion and the government in Washington with the most suspicion of all.
Implicitly, the act says that when the chips are down, we as a nation turn to our national parent — the federal government. That has to be anathema to a libertarian such as Massie, who claims that label even as a Republican member of Congress (as does his fellow Kentuckian, Sen. Rand Paul, who didn’t vote on the bill in the Senate because he has tested positive for the coronavirus).
For now, we are in a crisis mode. But in years to come, how do fiscal conservatives who voted for $2 trillion attack the cost of budget items that will now look like rounding error or “decimal dust”?
Speaking about federal outlays decades ago, Republican Senate leader Everett Dirksen once joked: “A billion here, a billion there and pretty soon you’re talking about real money.”
Have we now translated that to the language of trillions?
If one were writing a 30-second TV spot attacking a free-spending Congress in the past, one might have written something like this: “This is an unprecedented gusher of taxpayer money — with no offsetting revenues or spending cuts — that not only balloons the federal budget but triples this year’s anticipated deficit of a trillion dollars (already among the highest in history). With this single vote, Congress has added as much to the national debt as was accumulated in the first 200 years of the Constitution’s existence.”
Some who voted for CARES this week can expect to hear something like that on the airwaves someday, whether it’s a totally fair characterization or not.
Yet the power of this current crisis and the force behind this bill in this hour was such that even the leading fiscal conservatives who would normally be front and center were conspicuous by their absence. President Trump wanted the bill on his desk now. The Senate had voted 96-0. So even members of the hard-line House Freedom Caucus stood back as a big bipartisan majority of the House played the matador and let the bull roar past.
That’s what Massie decided he could not brook without a protest. Was it a grandstand play? Was he being a showboat? Perhaps, and if that is the judgment of his colleagues and constituents, he will pay a price for it. The rest of us will have to judge for ourselves.
Back on Capitol Hill, the floor leaders of both parties scrambled to stymie Massie. Within a few hours, they had established the rule of debate on the bill so that the Senate’s version of CARES could be approved without a roll call vote.
A frustrated Massie had to fulminate on social media while the biggest spending juggernaut of all time rolled down Pennsylvania Avenue for a hasty signing at the White House.
And while his lonely crusade was joined by none of the leaders of his own party, Massie was at least speaking for others across the country who could scarcely believe what they saw unfolding on C-SPAN — and the lack of any meaningful opposition in Washington.
Matt Welch, an editor-at-large for Reason, a libertarian magazine, called the CARES Act “a massive course of experimental economics” and compared the American public to “laboratory rats.” Even the trillion-dollar stimulus package of President Barack Obama, opposed by Republicans in 2009, had not been so robust.
“There is no more politics of fiscal prudence in America,” Welch added, “just a competition to see who can wag the biggest fire hose.”
Indeed, some of the Republican senators who ultimately voted for the bill gave earnest speeches on the floor of the Senate this week bemoaning its necessity. Some invoked the spirit of Ronald Reagan’s presidency or of the America he strove to represent and restore. (His 1980 campaign included the slogan: “Let’s Make America Great Again.”) Indeed, the Reagan era of the 1980s was in many ways a pushback on Franklin D. Roosevelt’s New Deal — albeit a half century late.
“A sharp break with the past did in fact occur in March, 1933,” wrote the historian Arthur M. Schlesinger Jr., referring to FDR’s first inauguration in the The Cycles of American History. “The essence of that break lay precisely in the changes from volunteerism to law as the means for ordering the economy.”
Put another way, the 1933 break was between reliance on the individual and reliance on the collective, between libertarian conservatism and Big Government liberalism. Those competing forces have risen and fallen in relation to each other in our shared national experience ever since.
It would be too much, or at least too soon, to say that what happened in Congress this week was a comparable turning point in that long struggle. But to Thomas Massie and many like him, it must have felt much the same.
Jacob Greenberg, chairman of the Blaine County, Idaho, Commission, is worried that his son, daughter-in-law and grandson might have coronavirus. Colleagues from county committees may have it, too.
Metropolises like New York City and New Orleans have seen a recent explosion of coronavirus cases. But rural counties in Colorado, Utah and Idaho, where hordes of visitors flock each year to ski or hike, are also experiencing some of the highest rates of coronavirus cases per capita in the nation, threatening to overwhelm local hospitals and challenging perceptions of the virus’ reach.
Four counties – Blaine County, Idaho; Summit County, Utah; and Eagle County and Gunnison County, Colorado – lead the nation in per capita rates of confirmed cases, outside New York state and Louisiana, according to a USA TODAY analysis of coronavirus cases across the country.
The rural settings are all affluent, mountain-ringed ski and hiking hamlets with populations under 55,000 that welcome millions of visitors each year. All have been grappling with a sudden surge in coronavirus cases.
“People need to take this seriously. Having people die in your community is really sad,” Greenberg said. “The numbers just grew exponentially. This stuff moves in a hurry.”
USA TODAY has been collecting information on cases in each county as reported by state health departments. To calculate rates, reporters took the confirmed number of cases per 100,000 people according to the most recent census estimates. Coronavirus case numbers were based on tallies as of Thursday.
Outbreak has some rural counties ‘a bit busier than normal’
Blaine County, with a population of 23,021, had 82 cases and two deaths, or 356 cases per 100,000.
The mountainous county in south central Idaho welcomes more than 180,000 visitors a year to its renown Sun Valley ski resorts. Somewhere amid that crush of winter guests is where county officials believe the coronavirus slipped into Blaine County.
The county confirmed its first coronavirus case on March 14. Five days later, on March 19, Gov. Brad Little ordered the county to self-isolate — the first such order in the state. Just a week later, the number had jumped to 82.
Ketchum fire chief Bill McLaughlin said that about 10% of his team of 52 staffers and volunteer firefighters and paramedics have contracted the virus, forcing him to send healthy first-responders home with ambulances to await calls rather than congregate in a station. His station’s call volume has doubled, mostly with coronavirus emergencies.
“We’ve been quite a bit busier than normal,” he said.
As early as February, McLaughlin said he and other officials braced for a surge in Blaine County, given the number of tourists that flock to the region. He stockpiled supplies, such as surgical masks and gowns, and duct-taped plastic in ambulances between drivers and patients, to protect his staff.
The virus spread quickly. Health care workers began getting sick. Two of Idaho’s four coronavirus deaths occurred in Blaine County. One was a hospital volunteer.
On Friday, the commission passed an ordinance further restricting travel in and out of the county and mandating visitors self-quarantine for two weeks, Greenberg said. As more people get tested, he expects the tally to rise.
“We still don’t have all the numbers in,” he said. “I’m sure it’s going to grow huge.”
‘I wouldn’t be surprised if we have 10 times that’
In Summit County, where the population is 42,145, there have been 103 cases and zero deaths, or 244 cases per 100,000.
Home to the Sundance Film Festival and the 2002 Winter Olympics, Summit County has long absorbed thousands of visitors from across Utah and the U.S., and relies on those tourist dollars each year.
The county’s coronavirus spread began in a popular watering hole called the Spur Bar & Grill, on Park City’s lively Main Street, at the height of the city’s busy spring ski season, said Dr. Richard Bullough, Summit County’s health director. An employee there tested positive for the virus, unwittingly exposing dozens of employees and bar patrons and perhaps several hundred others, he said.
Bullough said he expects the county’s cases to soar as testing ramps up.
“Yes, we have 100-something confirmed cases but we have a lot more than that,” he said. “I wouldn’t be surprised if we have 10 times that.”
Even after the ski resorts and business closed in Summit County because of coronavirus concerns, an estimated 10,000 visitors lingered in the area, Sheriff Justin Martinez said. Residents have mostly adhered to the self-isolate orders given by the county. But officials have scrambled to stay ahead of a virus that hit with as much as ferocity as it did in New York and San Francisco.
“This is not just a big city issue,” Martinez said. “It can and is happening everywhere around the world, including in smaller communities like Summit County.”
‘People come from all over the world’
U.S. Rep. Scott Tipton, a Republican from Colorado whose district includes Gunnison County, said he was surprised the largely rural county had such a high rate of cases.
The county, which has a population of 17,462, had 57 cases and one death, or 323 cases per 100,000.
“This shows the uniqueness of this virus that we’re dealing with,’’ Tipton said.
Tipton said attention has been focused on large metropolitan areas like New York, but “on a per capita basis, the impact is just as dramatic in our smaller communities.”
Tipton said he and others have been pushing to make sure state and federal officials help local officials with supplies, including respirators and safety equipment for health workers.
“We are very, very aggressively trying to make sure that our rural communities have what they need,’’ he said.
As of Friday, Colorado had 1,734 cases, including people who were positive and others who had symptoms and were in close contact with a person who was positive.
The number could be much higher since the state has a short supply of tests and is limiting testing, said Jill Hunsaker Ryan, executive director at the Colorado Department of Public Health and Environment.
Gunnison and Eagle counties, home to world-famous ski resorts such as Crested Butte, Beaver Creek and Vail, were among the first in the state to issue public health orders requiring social distancing.
But as cases picked up in other counties, officials took statewide measures to try to stop the spread, including requiring a 14-day stay-at-home order and shutting down ski resorts.
“What that did is it got the tourists out,’’ said Hunsaker Ryan, adding that others were urged to self-isolate and practice social distancing. “Some of the mountain communities just kind of hunkered down and shut down.”
Those communities, she said, were able to then preserve medical resources and supplies for residents. Gov. Jared Polis issued the stay-at-home order Wednesday.
Hunsaker Ryan, who lives in Eagle County, has been working from home. Her husband tested positive last week for the virus and had a mild case.
Hunsaker Ryan attributes the cases in Gunnison and Eagle counties to the high traffic of international travelers to the ski resorts. Some of the tourists had come from Italy and some were Americans who have traveled to parts of Europe, including Italy, she said.
Vail Mayor Dave Chapin said everyone was surprised by the spread of the outbreak. Eagle County, with a population of 55,127, had 147 cases and one death, or 267 cases per 100,000. Chapin, who himself was diagnosed with the coronavirus and is in isolation, has talked publicly about his case, even writing an opinion piece about it in a local newspaper.
“We clearly have people that come from all over the world to come to Vail and that may have had an impact on our town and our county,’’ Chapin said. “As well as many of the people that live here travel to many different places throughout the world so they may have been in contact anywhere.”
Chapin said the outbreak hit the county early in the crisis and the community reacted quickly by shutting down the buses, issuing an emergency declaration and sending notes to residents and employees about best practices. He said the main concern was safety.
“It was a difficult decision, but in hindsight it really wasn’t that hard as the data started coming in quicker and quicker and quicker,’’ he said. “Once it became clear that things were exponentially, rapidly developing, your decisions become a lot easier at that point.”
Colorado Rep. Joe Neguse, a Democrat whose district includes Eagle County, said the county has “experienced the full force of this public health crisis.”
Neguse said the county needs federal support, including funding for rural health centers. He sent a letter to President Donald Trump Thursday calling for him to declare Colorado a disaster area.
‘We don’t know what’s going to happen tomorrow’
Some local officials are also bracing for an economic slowdown because of the outbreak.
Tipton, who voted Friday for an unprecedented $2 trillion emergency aid package later signed by the president, said it’s important to help companies keep jobs and reopen. Most of the employers in his district are small businesses and many have been shut down.
“Your heart is always in the right place,” he said of small business owners. “But your cash flow might not match.’’
Chapin said about 40 percent of revenue for Vail comes from sales tax.
“We don’t know what’s going to happen tomorrow,” he said.
With the spread of the virus, Chapin said he doesn’t think any community, rural or not, should be overlooked.
“There are no boundaries,” he said. “There are no borders.”
Japan is turning to new containment measures after witnessing a surge of new infections. There are now more than 2,000 confirmed cases of the coronavirus, 60 of which were confirmed overnight on Friday. The city is rolling out a stay-at-home order in an effort to limit person-to-person contact. Ramy Incocencio reports from the country’s capital, Tokyo.
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“There’s a fatalism that no matter what he does, he’s going to get blamed by half of the country,” said a former senior administration official with knowledge of Trump’s thinking. “If there is something he has some measure of control over, which is the economy, why not potentially try to take action? Yes, there will be a death toll, and he’ll get blamed one way or another, but in all likelihood, whether he gets reelected or not will depend on where the economy is and where people’s perceptions of the economy are six months from now. That’s where he is primarily focused.”
Illinois Governor J.B. Pritzker said Thursday that people who are ignoring the guidelines for slowing the spread of the novel coronavirus are “spitting in the face” of health care workers.
“For the sake of everyone’s health follow the social distancing guidelines that we talk about here every single day. Stay six feet apart and don’t gather in groups of ten or more,” the governor said during a coronavirus update to the state. “Right now hosting a party, crowding down by the lake, playing a pickup basketball game in a public park – if you’re doing these things you are spitting in the face of the doctors and nurses and first responders who are risking everything so that you can survive.”
Pritzker was referring to those “throwing caution to the wind” when they took the rising temperatures across Illinois as an opportunity to go outside at a time that officials are “quite literally in the middle of a battle to save” their lives. He thanked those who were following social distancing guidelines and begged state residents to remain inside or to go somewhere that is not crowded if they were to go out.
“To be very clear, this virus doesn’t care that you’re bored and that you want to hang out with your friends. It doesn’t care that you don’t believe that it’s dangerous. The virus could care less if you think that I’m overreacting. It has infected infants. It has killed people in their 20s and 30s and 40s. It has forced doctors around the world to make terrible decisions about who will live and who will die,” Pritzker said.
As of this publication, Illinois has 2,538 cases of COVID-19 and 26 deaths, according to the state’s Coronavirus Response website. Pritzker issued a stay at home order and closed all non-essential business on March 20. He said at the press briefing that state officials are currently trying to figure out hospital capacities, the availability of personal protective equipment and ventilators, and increasing the intensive care unit beds in the state for those who will be infected in the future.
Pritzker ended his impassioned plea by appealing to the conscience of his citizens. “Ultimately you’ll be judged by what you do in this moment. And I have one job and one job only: to save as many lives as possible, to keep as many people healthy as possible until we can develop a treatment and a vaccine. Please, please, follow instructions and stay at home.”
Awarding a medal to Mr. Nicklaus, Mr. Massie argued, “is not a good use of our resources,” adding that the golfer “didn’t die on the golf course.”
His unwillingness to bend on even the smallest issue has charmed a slew of powerful conservative groups, including the Club for Growth and FreedomWorks. His closest friends on Capitol Hill are Representative Justin Amash, the Republican turned independent from Michigan who is also a frequent invoker of constitutional principle, and Senator Rand Paul, Republican of Kentucky.
Mr. Paul provoked the ire of his colleagues this week for continuing to work in the Capitol while awaiting coronavirus test results that came back as positive. (Mr. Massie, in a nod to his friendship with Mr. Paul, for years sported a “Stand With Rand” decal on his Tesla.)
But that approach found few admirers on Friday. His primary race challenger, Todd McMurtry, who has accused Mr. Massie of being insufficiently supportive of Mr. Trump, eagerly seized on the president’s comments, saying he agreed with Mr. Trump’s assessment that Mr. Massie was “a disaster for America.”
Nor were Mr. Massie’s colleagues — a majority of them older or with a pre-existing health condition — amused. Many were privately terrified of the health risks of traveling. Shingles and lice, one senior Democratic aide said, were more popular than Mr. Massie.
The normally affable Representative Dean Phillips, Democrat of Minnesota, used Twitter to confront him, tagging Mr. Massie in his broadside.
“If you intend to delay passage of the #coronavirus relief bill tomorrow morning, please advise your 428 colleagues RIGHT NOW,” Mr. Phillips wrote, “so we can book flights and expend ~$200,000 in taxpayer money to counter your principled but terribly misguided stunt.”
“Rationing” — a form of decision-making to allocate scarce resources — is something health care providers hope they never have to do.
But already the Covid-19 pandemichas forced doctors and nurses around the world — in Italy, the UK, and South Korea — to ration lifesaving equipment and interventions: who gets a ventilator when there aren’t enough for every patient who needs one, for instance. And now, reports from overwhelmed and under-resourced hospitals across New York City’s five boroughs indicate that doctors and nurses there expect to begin rationing soon — if they haven’t already.
“These decisions run counter to everything that we stand for and are incredibly painful,” wrote Meredith Case, an internal medicine resident at Columbia/New York-Presbyterian Hospital, in a March 25 Twitter thread. “Our ICU is completely full with intubated Covid patients. … We are rapidly moving to expand capacity. We are nearly out of PPE. I anticipate we will begin rationing today.”
A worst-case scenario that epidemiologists have warned of — patients dying because the system is too overwhelmed to care for all of them — looms for New York City as a growing number of patients with severe cases of Covid-19 seek emergency medical care, and hospitals run low on ventilators. Hospitals are also running low on beds, intensive care units, personal protective equipment (PPE) to protect their frontline staff, and staff themselves. And after being ordered by the state to increase capacity by a minimum of 50 percent, hospitals are working rapidly to prepare for an even greater influx of patients in the coming weeks.
Because as bad as things are right now, they’re predicted to get worse. In a March 27 announcement, New York Gov. Andrew Cuomo said that the peak in the city’s epidemic curve — when the number of Covid-19 cases top out before declining — could be as many as 21 days away. It’s based on the fact that people infected with Covid-19 can go for days before they show any symptoms and weeks before the most severe cases require hospitalization.
There’s still uncertainty in how the outbreak will play out in New York, since it is impossible to know the number of residents who have already contracted the virus. Though the testing rate here is the highest in the country, the city still doesn’t have the capacity to test everyone with and without symptoms. But officials and medical professionals agree the official counts — as of March 27, there were more than 25,000 reported cases and more than 350 reported deaths in New York City — don’t reflect the true extent of the outbreak.
“The number of patients with severe enough illness to need hospitalization and ICU-level care is expected to rise faster than our ability to fully meet the demand,” wrote Vicki LoPachin, the chief medical officer at Mount Sinai Health System, in a letter to the hospital staff on March 25. “This is the humanitarian mission of our lifetimes. And we won’t win every battle.”
Hospitals are reaching capacity and workers on the frontlines are falling ill
With more than 4,700 Covid-19 related hospitalizations as of March 26 in New York City, about 850 of which have been intensive care unit hospitalizations, hospitals are in crisis mode. Many of them have been for days.
“Even for my senior attendings, it is the worst they have ever seen,” wrote Fred Milgram, an emergency medicine resident physician, in the Atlantic. “Here, the curve is not flat. We are overwhelmed.”
Nurses and doctors have been reusing masks and other personal protective equipment, or PPE meant for single-use since last week, and some health providers are continuing to care for patients even while they experience symptoms of their own. “I am ending my night by delivering acetaminophen to a co-resident who spiked her first fever today,” Case wrote in another tweet. “She is one of many in recent days.”
While New York City officials have not provided an official tally of how many health care providers have tested positive for Covid-19, data from other countries hit hardest by the pandemic, including Italy, reveal that providers are at a high risk of contracting the virus — especially in the absence of adequate PPE.
“As I’ve sat in a room full of coughing patients for 60 hours a week, I have worried about my own safety,” wrote Rachel Sobolev, another of NYC’s emergency resident physicians, in a letter to President Trump published on HuffPost.
On March 24, Kious Kelly, an assistant nurse manager at Mount Sinai West hospital died of Covid-19. According to social media posts from his family members and colleagues, the 48-year-old Kelly was otherwise healthy, but he had not had adequate PPE while caring for his Covid-19 patients.
Gov. Cuomo said in a press conference March 26 that there was “no question” that New York at large would exceed its hospital bed capacity. According to data from the Harvard Global Health Institute, the city has roughly 1,400 ICU beds total. For several hospitals in NYC, including Elmhurst Hospital in Queens, where 13 patients died of Covid-19 in 24 hours, this has already happened.
“I don’t think it’s a question of ‘when’ hospitals are out of space anymore,” says Ani Bilazarian, an ER nurse at one of New York City’s major trauma centers. “It’s happening now.”
The measures that NYC hospitals have taken to extend capacity and care for critically ill Covid-19 patients are extreme and unprecedented. Hospitals have begun to convert pediatric units into adult ICU rooms, transferring the children who previously occupied those rooms to other hospitals. Operation rooms previously reserved for surgery – left vacant in the wake of cancelled elective procedures – have also been converted to ICU rooms at many hospitals.
The equipment shortage is “becoming dire”
In addition to dwindling physical space and hospital beds, NYC’s hospitals are running dangerously low on critical equipment. “The shortages of resources is becoming dire even outside of the news reporting of ventilators,” says Bilazarian. “We are on critical shortages of multiple medications, protective equipment, cleaning products, and space.”
To intubate patients, hospitals need ventilators, the crucial machines that pump air into the lungs of patients unable to breathe properly on their own. In the face of a virus that attacks the respiratory system, these machines can be lifesaving. And yet, as of March 26, Cuomo said that New York had only about 12,000 ventilators total, just over a third of the projected 40,000 ventilators required to accommodate the inevitable increase of patients.
A shortage of ventilators would be a dire situation in the face of any respiratory pandemic, but the drawn-out nature of Covid-19 illness exacerbates the problem.
“Non-Covid patients are on ventilators two, three, or four days,” Cuomo said in his March 27 press briefing. “Covid patients are on ventilators from 11-21 days.”
Bilazarian adds: “The challenge with ventilator resources is not just the high numbers of patients we are intubating but the length of time they are required to remain on a ventilator. We have been keeping patients on ventilators for about 14 days before we decrease ventilator support in a process called ‘weaning’.”
In other words, patients with Covid-19 are staying hooked up to these scarce ventilators for long and indefinite periods. Accordingly, the equipment cannot be recirculated fast enough for use in newly-admitted patients.
Beds are set up on March 27 at the Jacob K. Javits Convention Center in New York City, which is being turned into a hospital for Covid-19 patients.Eduardo Munoz Alvarez/Getty Images
Solutions are arising – but hospitals need more help now
New York City’s hospitals aren’t fighting Covid-19 alone; they are working alongside the state and local health departments and the private sector to address the shortage of space and resources. The Jacob J. Javits Center, a convention space on Manhattan’s west side, is being converted into a 1,000-bed temporary hospital. A 1,000-bed hospital ship, the USNS Comfort, is expected to begin admitting NYC patients in mid-April. Nationally, several manufacturers in the auto industry have converted to making ventilators, but the progress has not been adequate.
In a tweet on March 27, President Trump said that General Motors, the automotive company that had previously promised to manufacture 40,000 ventilators “very fast,” has since backtracked, promising 6,000 ventilators by late April.
As usual with “this” General Motors, things just never seem to work out. They said they were going to give us 40,000 much needed Ventilators, “very quickly”. Now they are saying it will only be 6000, in late April, and they want top dollar. Always a mess with Mary B. Invoke “P”.
New York City’s hospital systems need resources immediately and cannot wait for these national solutions; accordingly, several are taking matters into their own hands.
Northwell Health, for example, the New York health care system with 23 hospitals, has begun 3D printing equipment to use machines that they already have in their own facilities as opposed to waiting on companies. Northwell Health has partnered with the 3D printer company Formlabs to expedite production of nasal swabs required for Covid-19 testing kits as well as 3D-printed nozzle-like devices that allow ventilator machines meant for single patients to be split between two patients.
The 3D printed nasal swabs for the Covid-19 testing kits, which are modeled after swabs that already existed, have gotten the green light for production and are currently being dispersed throughout Northwell’s hospitals and testing centers.
But 3D printing ventilator splitters — which are essentially T- or Y-shaped nozzles that hook onto a single ventilator tube and redirect the oxygen flow from the ventilator into two tubes as opposed to one — is not quite so straightforward, because these designs are unchartered territory and need to be tested for safety and efficacy.
“Splitting ventilators is really a last-ditch effort,” says Todd Goldstein, Northwell Health’s director of 3D design and innovation. “The ventilators are made for one individual patient, and even though it’s been done before, it’s complicated to split them. There are a lot of factors you have to control, and there are a lot of issues that can arise.”
Several other hospitals have already begun splitting ventilators between multiple patients.
“We are also trying to be more flexible in how we support patients … to try and prevent patients from needing vents at all,” Bilazarian said of her hospital. In other words, hospitals are trying to use less invasive electronic breathing devices first (such as the mask-like BIPAP machines, which are sometimes used for people with sleep apnea) to stave off the need for full intubation.
Expanding the frontlines
Nowhere does the wartime rhetoric of the Covid-19 pandemic seem starkest than in the draft-like call-to-action for volunteer health providers in New York. The state’s department of health has added a form on its website for any qualified health providers to join a volunteer reserve workforce. “We are looking for qualified health, mental health, and related professionals who are interested in supporting the state’s response,” the site reads.
On March 24, New York University announced that it would allow fourth-year medical students to graduate early so as to join the frontlines of the Covid-19 response in New York City as soon as April. By March 25, nearly 70 medical students had decided to graduate early; they made the choice to enlist in the frontlines in spite of the risks.
If nothing else, New York’s health workers’ dedication to the work they’re doing — saving as many lives as they physically can — is clear in their remarkable reports from the front lines.
“We feel honored to continue serving our patients to the best of our abilities,” says Bilazarian. “This pandemic will require citizens to make real sacrifices. We need you to stay at home. But as our ER says, ‘we never close, we are always open, we are here for you.’”
During his 20 seasons playing in New England, former Patriots quarterback Tom Brady tried to downplay his personal relationship with Donald Trump, both before and after he was elected President.
According to WCVB in Boston, it began on a private phone call with governors from across the country.
Washington Gov. Jay Inslee, a Democrat, urged Trump to use his full authority to ramp up production of necessary medical equipment, according to an audio recording of the call obtained by AP. But Trump said the federal government is merely the “backup.”
“I don’t want you to be the backup quarterback, we need you to be Tom Brady here,” Inslee replied, invoking the football star and Trump friend.
So clearly, what Inslee suggested was for Trump to take the lead in the nation’s fight against COVID-19, to call the plays, rally everyone and lead us to victory.
However later in the day, while meeting with the White House media for a coronavirus briefing, it became apparent that Trump didn’t understand what Inslee meant. Per WEEI:
“Somebody in the fake news said, uh, one of the governors said, ‘Oh we need Tom Brady. I said, ‘Yeah.’ He meant that in a positive way. We need Tom Brady. And we’re gonna, uh, do great, and he meant it very positively but they took it differently. They think Tom Brady should be leading the effort. That’s only fake news and I like Tom Brady. Spoke to him the other day. He’s a great guy. But, uh, I wish, uh, that the news could be real. I wish it could be honest. I wish it weren’t corrupt. But so much of it is. It’s so sad to see.”
Of course Trump called it fake news and of course he called Brady a great guy. Those are No. 1 and No. 2 in his playbook. Trump’s misunderstanding came on the same day the U.S. passed China to become the country with the most cases of the coronavirus, with almost 86,000 in America, including close to 7,000 in New Jersey.
Lieutenant General Todd Semonite, commanding general of the U.S. Army Corps of Engineers, speaks out from NYC’s Javits Center on efforts to transfer non-COVID-19 patients from hospitals to makeshift facilities.
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Appearing on “Fox & Friends” with host Brian Kilmeade, Semonite said that the idea came a little more than a week ago after New YorkGov. Andrew Cuomo said there would be a massive shortage of capability in the Empire State.
“We knew we had a significant deficit of hospital beds,” he explained. “So, we said there is no way we can build hospitals in three weeks. We said we have got to take an existing facility with a standard design, let the HHS guys, let the FEMA guys, let all the docs take a look at it and once we have that, we are going to make four different options of how to apply that standard design either into a hotel or a dormitory or into a stadium or like a field house.”
Semonite said that because hotels are empty all over the United States right now, there are a lot of places to potentially put COVID-19 patients.
However, the U.S. Army Corps of Engineers would need help from hotel chains and other vendors to access these facilities.
“We would go into the hotel and lease a hotel for three months. The state would do it,” he continued. “We would make those modifications and just think of all those rooms that would be relieved.”
Another plan is to utilize stadiums and convention centers. The U.S. Army Corps of Engineers is already in the process of converting New York City’s Javits Center into a hospital with 2,900 rooms for patients.
“You take an existing hospital like a FEMA hospital, you bring it into one of these existing structures, and, Brian, here is the power of the idea is that you have already got everything to code. You have got electricity, you have got fire, you have got water, you have got parking lots, [and] you have got the entire [surrounding area],” Semonite remarked. “And, we can do this in a convention center and any type of a big open facility.”
Semonite told Kilmeade the best way for people to assist in their efforts is by getting on the phone and making “something happen.”
“Call up your mayor. Call up your FEMA director. Say you have an available facility,” he advised. “Whether it’s the Corps of Engineers — whatever we can do to be able to help out, we can work that.”
“And, the last thing is we can’t go for the perfect solution,” Semonite concluded. “We have got about two to three weeks to really turn the corner. We need a good enough solution done now and executed ruthlessly.”
For the millions of Americans who found themselves without a job in recent weeks, the sharp and painful change brought a profound sense of disorientation. They were going about their lives, bartending, cleaning, managing events, waiting tables, loading luggage and teaching yoga. And then suddenly they were in free fall, grabbing at any financial help they could find, which in many states this week remained locked away behind crashing websites and overloaded phone lines.
In 17 interviews with people in eight states, Americans who lost their jobs said they were in shock and struggling to grasp the magnitude of the economy’s shutdown, an attempt to slow the spread of the virus. Unlike the last economic earthquake, the financial crisis of 2008, this time there was no getting back out there to look for work, not when people were being told to stay inside. What is more, the layoffs affected not just them, but their spouses, their parents, their siblings and their roommates — even their bosses.
“I don’t think anyone expected it to be like this,” said Mark Kasanic, 48, a server at a brasserie in Cleveland who was one of roughly 300 workers that a locally owned restaurant company laid off last week. Now he is home-schooling his children, ages 5 and 7, one with special needs.
Congress has agreed to a $2 trillion stimulus relief package, which is expected to be signed by … [+] President Trump. Here’s everything consumers need to know in the bill. (Photo by Alex Edelman / AFP) (Photo by ALEX EDELMAN/AFP via Getty Images)
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COVID-19 continues to wreak havoc on the world’s peoples and economies. In the United States, as businesses shut down or pare back, millions of workers have already been laid off, leaving many to wonder how they’ll pay their bills.
The package grants households relief in the form of stimulus checks sent directly to most Americans, expanded unemployment benefits, paid sick leave, temporary student debt relief and more.
Here’s what consumers need to know about the stimulus package. For more coverage of COVID-19 and how it affects your financial health, click here.
Stimulus Checks
One much anticipated provision of the final stimulus bill is the checks that will be sent to most Americans. These one-time payments will be sent to eligible individuals, which means anyone who is a legal resident, is not claimed (or eligible to be claimed) as a dependent on someone else’s tax return and doesn’t earn too much.
American adults will be granted the following one-time payments:
Upper income folks aren’t eligible for the checks; the payments start to phase out for single filers with adjusted gross income above $75,000; married couples filing jointly with AGI above $150,000; and heads of household (that’s a single person with dependents), with AGI above $112,500. Stimulus amounts will be paid out based on 2019 income (or 2018, if an individual hasn’t yet filed their 2019 tax return).
Those who receive Social Security retirement or disability benefits but earn too little to have to file returns, will also receive stimulus checks, based on the information sent to the IRS on 2019 forms SSA-1099 and RRB-1099 . (College students and older teens who are dependent on their parents for more than half their support aren’t eligible for the checks, even if they earn a little money on the side.) Use this calculator to get an idea of how much stimulus money you’ll need.
Technically, the checks are a 2020 tax credit. So what if your year-to-year income changes? Suppose you earned too much in 2018 and 2019 to be eligible, but your income dropped with the economy in 2020? In that case, when you file your 2020 taxes in 2021, you’ll be eligible for the payments. It appears that individuals who qualify for the stimulus based on their 2019 returns (or their 2018 returns, if they haven’t yet filed for 2019), yet would not qualify based on their 2020 income, do not need to pay any of the stimulus amount back.
So when will your stimulus money come? If you’ve used a bank account for direct payments to or refunds from the IRS, your money will be direct-deposited. On Thursday, Treasury Secretary Steven Mnuchin said on CNBC that direct deposits could go out within three weeks. Individuals who don’t have a bank account on file with the IRS will be sent checks in the mail, according to their most recent address on file. That’s likely to take longer.
In addition to normal state benefits, an additional $600 per week will be paid to individuals for up to four months. This boost will help individuals earn around the median weekly wage; Senate Minority Leader Chuck Schumer, D-NY, recently said on CNN it will help most individuals get their full salary, or “very very close to it.”
Benefits will last longer too. Regular state unemployment eligibility of 26 weeks has been expanded by an additional 13 weeks, for a total of 39 weeks.
The package expands unemployment insurance to those who don’t typically qualify: Gig economy workers who are classified as independent contractors and self-employed individuals.
Individuals who haven’t been laid off, but can’t work due to a variety of reasons related to COVID-19, would also be eligible for unemployment checks. These reasons would include a case where they were diagnosed with COVID-19, were awaiting a diagnosis, or had a family member diagnosed with the disease; Individuals who were scheduled to start a job and could not because their future workplaces had been shut down due to the COVID-19 pandemic, would also be eligible. Additionally, individuals whose head of household died directly due to COVID-19 will be eligible.
Workers who are furloughed, but haven’t been fully laid off, are eligible.
The 7-day waiting period before an unemployed worker can get benefits, which is a standard feature of most states’ unemployment systems, is being waived to help individuals receive cash as quickly as possible.
If you’re considering filing for unemployment, there are other provisions experts recommend considering first, like exhausting paid sick leave (which could end up paying you more than unemployment insurance). Keep in mind there are already reports of unemployment offices experiencing an overwhelming number of calls, which might stall the process of enrolling and receiving payments.
Paid Family Leave
The new law expands the family leave provided in the Families First Coronavirus Response Act that President Trump signed into law on March 18. That bill covers workers in businesses with fewer than 500 employees. Those covered by the act can get up to 12 weeks of family leave (with the first two weeks unpaid) if they must stay home with children whose schools and day care centers have closed because of the pandemic.
The expansion allows individuals who were laid off on or after March 1, but then rehired before the end of 2020, access to this family leave. (To be eligible for this leave, they need to have worked in that job 30-60 days before the initial layoff).
The benefit paid to individuals eligible for this family leave is two-thirds of pay, with a maximum of $200 per day, or an aggregate $10,000 per worker. In other words, it can be a maximum of $1,000 per week. (Employers cut the family leave checks and then get reimbursed by the federal government through the IRS.)
Paid Sick Leave
Employees (both part-time and full time) will get 80 hours of paid sick leave at full pay, capped at $511 per day, or an aggregate $5,110 per worker, with part-timers receiving a proportionate number of hours. Individuals who are unable to work or telework because they are under medical quarantine or treatment for COVID-19, suspect they have the illness or are ordered to quarantine at home are eligible for the pay.
Additionally, individuals who are staying home to care for someone else who has COVID-19 or is suspected of having it, or who have a child whose school or day care is closed because of coronavirus, are eligible for two-thirds of pay capped at $200 per day, or an aggregate $2,000 per worker.
Mortgage and Renter Relief
Borrowers with federally backed mortgage loans—loans under Fannie Mae and Freddie Mac—who are experiencing financial hardship due to COVID-19 can request forbearance on their payments for up to six months. Borrowers must submit a request to their servicer and affirm that they’re experiencing a financial hardship during the crisis. Additionally, no foreclosures or evictions from properties with federally backed mortgages can occur during this period.
During the mortgage forbearance period, interest will still accrue. However, additional fees, penalties or extra interest cannot be added to mortgages.
Renters have some eviction protection, but only if they live in a multifamily building or single family home that has a federally backed mortgage. Landlords cannot evict tenants of these buildings or charge any late fees, penalties or other charges for late rent payments.
Interest will not accrue on federal student loans from April through September 30 and no payments must be made.
Even though payments are suspended during this time period, the Department of Education will treat it as if the borrower made a payment toward public service loan forgiveness or other forgiveness programs.
Borrowers who are in loan rehabilitation programs will also have the suspension period count toward rehabilitation. These programs are for borrowers working to pull their loans out of default.
Credit reports and scores will not be impacted during the suspension of payments period.
Wage garnishment and tax refund seizures will be halted during the forbearance period.
Additionally, the Department of Education announced on Wednesday it will be refunding approximately $1.8 billion in offsets to more than 830,000 borrowers. The announcement also requires private collections agencies to stop pursuing defaulted borrowers through such methods as phone calls, collection letters and billing statements.
Normally, individuals who withdraw funds early from retirement accounts early (typically before age 59 1/2) must pay a 10% penalty as well as ordinary income taxes. The stimulus relief package, however, provides that “coronavirus-related” distributions of up to $100,000 will be allowed, without the early withdrawal penalty being applied. The sum withdrawn may be re-contributed to a retirement account within three years, without being subject to the usual annual contribution caps. If it’s not repaid, the withdrawal will be taxed at ordinary income tax rates over a three-year period.
In addition, the limit for retirement plan loans has been temporarily raised from the normal $50,000 to $100,000, while the current rule that loans may not exceed half of a 401(k) participant’s vested account balance has been waived.
Meanwhile, required minimum distributions (RMDs)—which those over 72 must take from traditional IRAs, SEPs and 401(k) accounts (but not from Roth accounts)— have been waived for 2020.
The House passed a massive rescue package for the American economy amid the coronavirus pandemic on Friday—shooting down a high-profile effort by a Republican representative to block it.
The effort by Rep. Thomas Massie of Kentucky to force a recorded vote rather than a voice vote on a $2 trillion economic stimulus was shot down with bipartisan support, an extraordinary phenomenon for a chamber so consistently split by bitter partisan politics.
“I came here to make sure our republic doesn’t die by unanimous consent in an empty chamber,” Massie said, triggering groans from Democrats who said to “look around” at the filled room. He accused lawmakers of trying to subvert accountability and later told reporters “there’s a big cover-up in there.”
“They’re trying to protect the members who are there from political ramifications,” Massie continued. “If they’re telling people to drive a truck, bag groceries and grow food, by golly, they could be in there and they can vote.”
The legislation was eventually passed by voice vote, which was approved by the Senate Wednesday with unanimous support and was swiftly signed by the president. That means checks to Americans, expanded unemployment benefits and relief for businesses could be coming in a matter of weeks.
Massie’s concerns stemmed from what the $2 trillion stimulus would mean for the national debt and how American taxpayers in the future would be forced to foot the bill.
The ability to thwart Massie’s effort was the culmination of hundreds of members of Congress who spread themselves out between the floor seats and those above in the public gallery in order to muster a majority while practicing social distancing. Attempts by House Speaker Nancy Pelosi (D-Calif.) and Minority Leader Kevin McCarthy (R-Calif.) to persuade him not to call for a recorded vote just minutes before fell on deaf ears.
Despite the brief opposition, the bill had overwhelming bipartisan support. The legislation will provide many Americans with $1,200 checks, expands unemployment insurance, bails out large corporations, gives funding to small businesses teetering on the edge of existence and boosts relief for state and local governments.
“Let us again return to the words of his holiness, Pope Francis,” Pelosi said. “May we enlighten those responsible for the common good so that they may know now to care for those entrusted to their responsibility.”
“The virus is here. We did not invite it. We did not ask for it. We did not choose it,” said McCarthy. “But we will fight it together until we win together.”
The intention all along was for the legislation to be passed by voice vote with only a skeleton crew of members needed. But lawmakers were forced to scramble back to Washington, D.C., after it became clear Thursday evening that Massie would block such a procedure and request a roll call vote, forcing hundreds of members to return and ensure there was a majority present to get the bill across the finish line.
Massie’s decision infuriated his colleagues on both sides of the aisle, who accused the Kentucky Republican of putting people’s health and safety at risk. And the frustration was not exclusive to those in Congress. President Donald Trump even weighed in, lambasting Massie as a “third rate Grandstander” and a “do nothing Kentucky politician” who was only seeking “publicity” and should be booted from the Republican Party.
“I’m at least second-rate,” Massie quipped to reporters.
Congress will now depart from Washington until after Easter as the country continues to hunker down and await the pandemic to subside. But lawmakers have their sets set on yet another stimulus package that’s been dubbed Phase 4, which will begin to take more concrete form in the coming weeks and months.
That legislation could touch on a wide variety of topics, including pensions, student debt, medical funding and the economy.
The number of deaths in New York state related to the coronavirus pandemic has topped 500, Gov. Andrew Cuomo said Friday.
Cuomo revealed that the number of COVID-19-linked fatalities jumped dramatically overnight by 134, bringing the current death toll statewide to 519.
COVID-19 cases are “still doubling, and that’s still bad news,” he said in New York City at the Jacob K. Javits Convention Center, where the U.S. Army Corps of Engineers is setting up temporary a hospital.
“The rate of increase is slowing. But the number of cases are still going up.”
New York state, which is the epicenter of the pandemic in the United States, confirmed 7,377 new cases overnight, bringing the total in the state to 44,635.
More than half of those cases, 25,300, are in New York City.
Cuomo also Friday extended school closures across the state by two weeks to April 15 as the number of coronavirus cases continues to rise.
“When you look at the number of cases that’s still increasing, it only makes sense to keep the schools closed,” he said.
“We want to see the rate slowing and then we want to see the number of cases going down or flattening,” he said.
The governor, referring to medical workers, said, “This is a rescue mission that you’re on.”
“In 10 years from now, you’ll be talking about today with your children or your grandchildren and you will shed a tear because you will remember the lives lost and you’ll remember their faces, you’ll remember their names,” Cuomo said.
He called on hospitals across the state to double their capacity to deal with the virus outbreak.
The state currently has 53,000 hospital beds, but will need 140,000 of them for coronavirus patients over the next three weeks when the outbreak is expected to peak in New York, he said.
“We’re asking hospitals to try to increase capacity 100% … We’re looking at converting dorms. We’re looking at converting hotels,” he said.
Part of both Pelosi’s and McCarthy’s stances is member management. For Pelosi, she wants to assure her caucus that there will be more chances to include Democratic priorities that didn’t make it into the first three bills. And for McCarthy, he needs to calm jittery conservative hard-liners who are wary of big government spending and might have objections to allowing the Senate package to pass by voice vote.
McConnell, meanwhile, has been noncommittal about their next legislative steps, instead focusing his energy on getting the $2 trillion economic rescue package over the finish line first.
“The real problem here is it’s on the health side and we’re all hoping that we’re going to begin to bend the curve here in the next few weeks. So I don’t have an announcement to make about the future yet,” McConnell said in an interview with POLITICO on Wednesday. “We’re hoping and praying that we’re going to begin to get a handle on this pandemic.”
The massive relief package expected to clear the House Friday is the third in a wave of bills Congress has quickly mobilized to pass as the coronavirus spreads across the U.S., infecting thousands and shutting down massive sectors of the economy.
Congress passed a bill with $8.3 billion in emergency funding in early March and the Senate followed that by clearing the House’s “Phase 2” bill last week, which greatly expanded federal safety programs to address the virus.
Democrats and some Republicans have said a fourth piece of legislation — and maybe more — is needed to ensure the U.S. doesn’t enter into a full-blown depression. Just on Thursday, unemployment claims reached a record high, skyrocketing to 3.3 million according to the Labor Department.
“In this case, it’s about public sentiment. People say, ‘Oh, why do we need another bill?’” Pelosi said. “These are needs that people have. … this is all about the coronavirus. It’s not about anything else.”
Since he was traveling by gigantic boat and not by car, he’d been en route since Monday.
“I’m sitting in my cabin right now,” he said.
Captain Rotruck is the commanding officer of the Mercy, the 1,000-bed U.S. Navy hospital ship heading to the Port of L.A. to alleviate pressure on the region’s health care systems caused by an anticipated surge in coronavirus patients.
Officials have said the medical staff aboard the ship will treat Angelenos with conditions not related to Covid-19, like heart attacks, or who have been in car crashes.
Though the task may sound grim, for many of the roughly 1,000 sailors aboard, including a full-time crew of 61 who maintain the vessel, it’s a new kind of mission, Captain Rotruck said.
“I see a tremendous amount of enthusiasm,” he said. “It’s very unusual for us to be able to do something this directly for the American people.”
Typically, he said, the ship goes out every couple years to provide care or to help build medical capacity in other countries, like the Philippines, Indonesia and Malaysia.
This time, the mission is hitting much closer to home, not just because it’s on American soil, but because many of the crew are based in San Diego.
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