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25 April 2020

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Terence Gore

Sorry to read your post and hope everyone fares well. Many nursing homes may be in the same situation.

https://www.uchicagomedicine.org/forefront/coronavirus-disease-covid-19/uchicago-medicine-doctors-see-truly-remarkable-success-using-ventilator-alternatives-to-treat-covid19

“The proning and the high-flow nasal cannulas combined have brought patient oxygen levels from around 40% to 80% and 90%, so it’s been fascinating and wonderful to see,” Spiegel said."


Possibly positive news.

Laura Wilson

Thank you, our veterans and American residents ALL deserve a better response. This in formation is horrifying because the federal government has ALL the responsibility for veterans care...no pushing it off on governors or private companies.

Pj20

It isn’t just the VA, hospitals all over the country are short of PPE. And that is one of the problems with opening up the country too soon. Unprotected staff in suddenly flooded hospitals become ill themselves risking the viability of local health systems.

turcopolier

All

https://en.wikipedia.org/wiki/Hunter_McGuire He amputated Stonewall Jackson's arm on the battlefield at Chancellorsville.

turcopolier

All

Everyone who wants to blame Trump for the shortage of PPE ought to sober up long enough to think about how vast the Executive Branch of the federal government is and how many improvements Trump has made in the system of VA medical care. Do the people who have run VA medical not responsible for what they did not stockpile and what about the Chinese who ran around the world buying up PPE AFTER they knew the virus had escaped?

Fred

"The federal government dropped the ball… for several administrations."

Pray tell how that is now Trump's fault? What were the experts of the federal government doing since January of 2016 when he was inaugurated. Were Sally Yates, James Comey, LTC Vindman, "The super secret only Schiff knows his name whistleblower" et. al. just anomalies and all the other federal employees on the ball; except for the ones who dropped the ball - like NOT ordering PPE or NOT budgeting for PPE "for several administrations."?

"Trump should have invoked and used the Defense Production Act robustly in January ..."
Based on what, the impeachment hearing, the Speaker of the House showing great courtesy and concern by ripping up the SOTU speech transcript or just Fauci, who said just what? Oh, no need for a travel ban and his counterparts were saying - in that very timeframe - there was nothing to worry about.

"Every household could have been sent a dozen disposable masks with a note from President Trump ..."
Well that would have induced either some fatal cases of laughter or a panic, but by all means tell us just how you would have managed all this without the information that is avialable on April 24th but with only the infromation available in January, when it would have been politically impossible to do what you propose.

JoeC100

TTG -

I read a while back that the key supply chain issue with N-95 masks is that their essential core material is a synthetic spun fiber that we are completely reliant on China for sourcing. In addition. the machines that make this fiber are complex, quite expensive and there is no capability to quickly and significantly ramp up their production. Further they are challenging to set up and operate.

And for perspective, of the 200 million masks China currently makes a day, only 600,000 are N95 standard masks, used by medical personnel,

So yet another "essential supply chain" item for a critical health system need that simply can't be ramped up out of this air.

Hopefully some one in the Federal system is looking for all similar needs and working on a plan to facilitate onshore manufacturing.

Full (scary/sobering) details are at: https://www.npr.org/sections/goatsandsoda/2020/03/16/814929294/covid-19-has-caused-a-shortage-of-face-masks-but-theyre-surprisingly-hard-to-mak

I see this as a long term "lack of US preparedness" problem vs. something that could have been easily addressed if the administration had moved a couple on months earlier..

JohninMK

We have the same problems here in the UK. With people, mainly it seems like in the MSM, blaming the Government's leadership for the supply issues.

Ignoring totally the management of our respective national health organizations who knew, at the latest in mid January, that there was probably a nasty contagious problem coming down the tracks, that would, based on already clear Chinese actions, need more PPE than was on their shelves.

Bear in mind that, in the UK at least, hundreds of these NHS bureaucrats earn twice what a Government minister earns and a few twice the PM's salary. In both nations they have failed their people dismally, seemingly like rabbits trapped in the headlights. None will be punished of course for failure, they are just pleased that the Government steps up and takes the blame.

Then we have the academics and think tank personnel. All accepted as impartial and offering honest opinions based on state of the art models. Again the Governments take what they are offered as gospel and acts on it. Only to discover that the models are more of the garbage in garbage out variety, not fit for purpose. Then we find how much funding the impartial academics are receiving from potentially very interested parties, as there are $Bs at stake. In the UK there was a Pandemic 2016 exercise to check things out. Result everything in NHS under control. In the real world under four years later, a shambles. Did you have a similar last autumn?

The real heroes and heroines in this saga are the doctors, nurses and their support and ancillary staff who are actually at the sharp end. Many working in appallingly unsafe conditions. Hats off to them.

turcopolier

JoeC100

The Administration? What about the giant highly complex federal bureaucracy? Do you really think you can effectively administer that from the WH? Have you ever worked for the US federal government at the executive level??

JoeC100

Col Lang -

I was just responding to what I took as TTG's suggestion/implication that if Trump had acted earlier he could have alleviated this shortage (at least to some extent). And I have seen enough public bureaucracy to understand it would be impossible to effectively administer much of anything from the WH.


turcopolier

joeC100

I took that as a political ad from TTG. He has a right to political opinions that I do not share. From my experience it is very difficult to get the government to; change directions, shut down the economy, confine people in virtual house arrest, seize control of industry under the DPA for something less than an announcement from God that you had better do it.

turcopolier

All

BTW, I am entitled to and registered for VA medical care and have never used it. SWMBO and I are well taken care of without depriving needier people of available VA resources.

mcohen

Direct action attack on world supply chain would naturally start in China.The domino effect is now quite evident.Expect the next outbreak in China early June.covid 20 will flatten the bump.

Bobo

For 200 plus years our hospitals utilized laundries to cleanse their medical protection gear (PPE) until the advent of synthetic PPE. The present generation is taught to utilize the N95 mask and other gear once and then trash it. This was derived as a manner in reducing Sepsis and MRSA in hospitals and an effective one though those diseases are still present.
Our hearts went out to these young medical personnel without the plastic masks and gear as they were working outside of what they were taught and they were much more susceptible to the Covid-19.
Now we all saw every Chinaman walking around Wuhan with a N-95 mask in January and unfortunately those were our masks that were re-routed to the Chinese people. Hopefully we have now learned a very hard lesson that Just in Time Inventory does not work for medical diseases or viruses and that the USA needs to manufacture all PPE and medicine in the USA amongst other things.
Regarding the political implications I can only say that the guy in the hot seat made things happen when the chips were down something his predecessors nor his competitor had/have the ability to do in a timely manner. Coercion worked.

The Twisted Genius

Fred,

"The federal government dropped the ball… for several administrations."
"Pray tell how that is now Trump's fault?"

That's easy. Who led the last two administrations? Obama and Trump. Given the 2009-2010 H1N1 pandemic, Obama should have definitely improved our readiness in remaining six years in office. Trump had three years to fix what I'm sure he would view as one of Obama's failures. He didn't. Hence, they both dropped the ball.

Terence Gore

“Maybe there is a beast… maybe it's only us.” “Ralph wept for the end of innocence, the darkness of man's heart, and the fall through the air of the true, wise friend called Piggy.”

steve

Obama did have longer to refill the stockpile, but the economy was much, much worse under Obama. Trump has lead us to the best economic performance in US history so we should have been able to afford to refill the stockpile during the last 3 years.

We decided early that there wasn't going to be much access to extra PPE for quite a while. The US can tramp us production very much. No company is going to open up a new factory to make PPE for just year or two. Foreign countries will want to keep the PPE they can make, at least for a while. So we invented our own mask sterilizer. We are sterilizing our masks plus those of the local nursing homes and some of our local first responders.

Steve

Fred

TTG,

What is "The Resistance" and how did that affect Obama's terms in office and how is it effecting Trump's?

The Twisted Genius

Fred,

The resistance? You mean the Republican movement to ensure that Obama failed in everything he did announced by Limbaugh at the 2009 CPAC and implemented by McConnell in his fervent desire to deny Obama a second term? That did set a precedent that haunted the Republicans for the last three years.

BillWade

TTG and JoeC100, Just wondering, what was more egregious:

President Trump comes into office and does not know of an inventory deficiency of N95 masks and similar.

President Bush comes into office and does not know of a planned attack on the United States of America.

optimax

Much of the federal stockpile of PPE sent to the states had passed their expire dates, 2010 for some, and was either useless or had to be repaired. I blame the failure on the person, or persons, charged with monitoring the wharehoused stockpiles. The president only knows what he's told. He can't micromanage the nation. He needs Jack Webb directing him to stick with the facts.

We have two groups of psychopaths vying for political power.

https://time.com/5815652/national-stockpile-medical-supplies-unusable/

elaine

I read somewhere the V.A. ordered the masks but F.E.M.A expropriated
them on the directions of Jared Kushner, who will later decide who
receives the masks...something about the National Emergency Stockpile...what a mess.

Jose

Trump should have invoked and used the Defense Production Act robustly in January rather than waiting until March and April to weakly wield that executive authority. TTG

And if Obamacare did not impose a medical device tax maybe all these things would still be made in America.

Also, why did Obama-Biden-Fauci send $3.7 million to Wuhan to study Corona viruses, Fort Detrick, John Hopkins, Harvard-MIT, Satnford-UCSG-Berkely were to busy or not good enough?

Philip Warren

The Chinese Communist Party in January bought up all the PPE they could find in the US, Europe and Australia. My friend’s wife is a manager at the Home Depot in the Bronx and she she witnessed this first hand. The PPE was manufactured in the PRC, and they knew exactly where it was going abroad. They took this action not only for their own needs, but also to make it harder for the West to protect its medical community. The goal of this is to try they get their economy open while the rest of the world is locked down. Many people may not be interested in Chinese communists, but they are interested in you and your N95 masks.

https://nationalfile.com/video-chinese-woman-brags-about-buying-truckloads-of-facemasks-from-us-supermarkets/

https://en.wikipedia.org/wiki/Unrestricted_Warfare

JohninMK

Optimax, very valid points but the only reason I can see why a polypropylene or similar mask, probably in sealed packets, bulk packed in cartons, has an expiry date at all is to enable the manufacturer to sell more. In an emergency why dump them when there is little of no inbound replacement stock.

This is the wrong mindset at work.

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