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25 April 2020

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JJackson

In 2005 the reality that influenza's came in many different levels of severity and that the 1918 pandemic was far from a worst case scenario was forced on consciousness of policy makers by H5N1. Everyone busily developed pandemic plans and with typical human short term-ism within a few years let them lapse and the progress made evaporate. The WHO got an influx of funds to create a rapid response team but by the time it was need for Ebola in West Africa those funds had dried up and the teams and equipment disbanded. This is the reality of emergency healthcare funding. Now we will have money for all kinds of research which will produce vaccines and therapeutics for this outbreak but few, if any, will be available for this epidemic. The funds for all the buoys deployed for Tsunami detection have dried up and they are not being repaired and replaced. We seem to have the attention span of a gadfly.
Tsunami's have not gone away, Avian influenzas are doing very nicely, SARS-3 will be along shortly as will other zoonotic disease. The only thing more certain than these is that we will not be ready for them when they do. Pick a gear and stay in it.

Fred

TTG,

The ever accurate wiki doesn't seem able to come up with that equality between political oppositions, sir. Why there is zero mention of an inaguration day protest by millions or an ongoing investigation by the FBI into collusioin by the Obama campaign with foreign governments. I wonder why that didn't get into the public eye by leak after leak. Even the protests in public don't apprear to be the same.

https://en.wikipedia.org/wiki/Protests_against_Barack_Obama#2009
2009[edit]
April 15 – Tea Party protests against high taxes and big government in Lafayette Park.
May 17 – the University of Notre Dame's selection of President Barack Obama as its commencement speaker led to a gatherin the day before of around 100 anti-abortion rights activist to protest against his invitation.[2] The ceremony itself took place peacefully with the few hecklers shouted down and Obama receiving several standing ovations.[3]
July 4 – About 2,000 small-government advocates gathered for Tea Party Day to protest the economic stimulus plan and health care initiative of the Obama administration and Congress.[4][5]

Oooh, 2,000 people! That seems to rather timid compared to the :
January 21, Women's Marches – A series of political rallies known as Women's Marches took place in locations around the world.[291][292] Estimates suggest between 3.3 and 4.6 million people took part, making it the largest protest in United States history.[293]

https://en.wikipedia.org/wiki/Timeline_of_protests_against_Donald_Trump#Protests_during_Trump's_campaign.

Fred

JJackson,

"Pick a gear and stay in it." The healthier a person appears to be, the more dangerous they are, better obey the government. Meanwhile survival stats from the health experts commenting in public, or commenting here, appear to be zero. The only settled science is climate change; and the political science observation by jledell's comment about the Kavanaugh hearings - 'it's just politics'.

optimax

johnmk

The article said some suffered dry rot. I don't know why. the rotted elastic bands are replaceable but I don't know why ventilators would deteriorate over time, but maybe they were defective to begin with or have rubber washers. Whatever a country, company or individual stockpiles should be checked every once in a while. It's common sense. Why wait until an emergency?

confusedponderer

TTG,
may the PPE supply be fixed soon. COVID-19 is a bad thing and it will be some times with us, until we get a not national exclusive vaccine or, in the bad case, that herd immunity is achieved in two or so years after many many more deaths. So, good luck and respect for the hospital staff.

That written, it may have been worse if Trump's choice Ronny Jackson (the candy man) was now head of the VA - even though then the hospital likely would not be short of chloroquin, bleach, viagra, ketamin, prozac, morphine, aspirin, paracetamol, speed or valium and other essential medicine, which IMO is not a comfort.

But then, according to Trump it was totally Jackson’s decision to withdraw from the job application. Naturally. Just like injecting or drinking antiseptic medicine or bleach is a 'very interesting idea' not in my mind. I propose self experiment here to get the surely very interesting, perhaps final, experience.

optimax

johninmk

From the California Department of Public Health:

Q: What is the shelf life of an N95 respirator?

A: The standard shelf life of N95 respirators is a maximum of five years from production date and if it has been stored in the original packaging. Storage conditions can also affect shelf life.

https://www.cdph.ca.gov/Programs/EPO/Pages/Wildfire%20Pages/N95-Respirators-FAQs.aspx

harry

Good piece, and i totally agree.

JohninMK

Thanks Optimax.

steve

JohninMK-

No, they actually do dry rot. An entire order we received from FEMA was no good due to that.

Steve

Terence Gore

What the President actually said

http://adam.curry.com/enc/1587931121.382_trumpandwilliambryanhssecretaryonuvlightandbleachmachinefeed.mp3

What was said just previous by Homeland security secratary

http://adam.curry.com/enc/1587931121.382_trumpandwilliambryanhssecretaryonuvlightandbleachmachinefeed.mp3

JamesT

A lot of governments dropped the ball on this. Thirteen years ago the province of Ontario stockpiled 55 million n95 masks in the aftermath of the SARS outbreak to protect healthcare workers during a future pandemic (we did not handle SARS well and studied what went wrong).

But n95 masks expire, they expired years ago, and they were not replaced. Did we jump on acquiring such masks early on in this pandemic - nope.

mcohen

Developed in n.k released in wuhan,k-pop sure is popular around the world.

Fred

Optimax,

You make to much sense and provide too much clarity on what supply chain person in the hospital field would be doing. An individual at a hospital would be tasked with cycling the inventory in a FIFO manner, just like they would do with N2 or O2 cylinders.

The Twisted Genius

Fred, Optimax, et al.,

Your comments about managing supply chains and rotating stockpiles hit on the reason this situation irked me so. My last active duty position was as the mobilization planner for Fort Jackson. In conjunction with the South Carolina STARC mobilization planning office, I wrote and managed the writing of Fort Jackson's mobilization and contingency plans. I oversaw the management of various stockpiles to support these plans. The maintenance and rotation of those stocks was important enough to be briefed to the installation commander and staff as well as SC state and National Guard leadership on a regular basis. We conducted various exercises throughout the year to ensure the plans and stockpiles would be ready. I know the importance of these efforts and the degree of attention higher levels of military and civilian leadership should pay to those efforts.

Recent events indicate proper attention to detail was/is lacking in our national emergency response plans and preparations. Even though the Obama administration upgraded plans and organization for pandemic contingencies since the last major pandemic to hit us in 2009-2010, it is clear the national stockpiles were not properly replenished or managed. The Trump administration did not remedy these shortfalls. The planning and organization for such contingencies appear to have also deteriorated in the last three years. I don't expect the president to personally inventory, maintain and rotate stocks in the national stockpiles, but I do expect him to ensure that it is done.

elaine

Philip Warren, I first noticed this buying in bulk of masks, etc
@ a Home Depot & the clerk even admitted the buyer, a foreign national, bragged they were sending them out of the country. I
alerted a higher up in state gov to no avail. Makes you wonder...

The video you posted is not the only one circulated, that woman
was only 1 of many. This was well organized & I doubt anything will
be done about it either. This behavior was documented as early as
the beginning of February.

A.I.S.

Concerning Surgical masks:

They actually do something. Generally speaking, a considerable proportion of viral material will not be just a small virus that easily gets through a surgical masks on account of being small, but will be bound to droplets of other stuff. Said droplets can well be large enough to be blocked by surgical masks. You typically dont get infected by a "single virus", essentially, how many initial viruses you get considerably impacts the probpability of actually getting infected. You could kind of equate this in military terms to the probability of the viral troops succesfully establishing a beachhead or not, which is considerably defined by the number of viral tropps who initially get in.

Still, not having realy protective masks is a disgrace, although the US is hardly alone in this. Germany fucked up too.

turcopolier

TTG

I seem to remember that Obama was in office until 2017.

Fred

TTG,

Yes, the President is not directly responsible for the conduct of lawyers at the DOJ, but is indirectly responsible. BTW did you hear about the DOJ lawyer who fabricated evidence in FISA warrents? Some obscure congressional committee had hearings about that and it was written about in some obscure blog you might have perused. Remember who was president when that criminal conduct occurred? Yeah, we can't criticize that guy and those are completely different circumstances than some WG-7 in a warehouse not doing their job, why that's impeachable not supervising that person - indirectly - in all the links in the chain that gets you to the President; unless it is a third party warehouse, then it's contracting fraud. Yep, better get on the phone to Adam Schiff.

JP Billen

4-ply microfiber cleaning cloth is the best material for homemade masks per an Army Times article.

https://www.armytimes.com/news/your-army/2020/04/24/army-researchers-say-this-is-the-best-material-for-a-homemade-face-mask-theyve-found-so-far/

They are available as cleaning cloths in autoparts stores & most hardware outlets. I'm not talented enough to make my own mask, so I just wear a surgical mask over one to hold it in place.

ked

New Rule: The Buck Always Stops Somewhere Else.

optimax

Fred. TTG,

After the 2009-2010 pandemic, The Feds replenished their supply of N95 masks and then forgot about them, and this was done with only a one time money procurement from congress. No thought of possible future pandemics or the expiration dates of PPE.

After replenishing the N95 supply, they could cycle out FIFO, as Fred suggested, and instead of throwing them out, sell them at cost to hospitals, and give them to VA and rural/inner city clinics for nothing. The masks would still be one to three years from expire date, and the cost to the Feds would be minimal. The funds to do so would have to be renewed every couple years.

Also, the states need to prepare better for pandemics by having at least six month to a year supply of PPE and depend on the fed as a last resort. But it is easier to blame someone else for not not being prepared. Both the feds and states lack foresight.

The Twisted Genius

Fred,

It is not some WG-7 who is responsible for maintaining the Strategic National Stockpile (SNS). The Assistant Secretary for Preparedness and Response (ASPR) under HHS is currently responsible for maintaining and replenishing the Strategic National Stockpile (SNS). The ASPR reports periodically to President’s NSA on status of the SNS. Of course we’re all aware of the turmoil at that level of White House management over the last several years. I doubt Bonkers Bolton ever gave a rat’s ass about the SNS and Robert O’Brien was only in the NSA position a few short months before the virus hit the US.

The possibility of a major pandemic hitting the US was not totally ignored by the Trump administration. In July 2019, a blue ribbon committee including the ASPR proposed a “Manhattan Project for Biodefense.” Also in 2019, Senator Burr re-introduced the All-Hazards Preparedness and Advancing Innovation Act. A similar bill failed to get through Congress the previous year. The 2019 bill was passed and sent to Trump for his signature on 13 June 2019. In September 2019, Trump issued an executive order requiring the government to modernize influenza vaccines and technologies.

But the readiness of the SNS suffered for years under both Obama and Trump. Olga Khazan addressed this subject in a recent “The Atlantic” article. It's a pretty good article in my opinion. “Officials bought millions of N95 masks and other flu-type preparations with supplemental congressional funding that trickled in from 2005 to 2007, says Greg Burel, who was the director of the stockpile from 2007 until January 2020. But then that supplemental money dried up.”

“Since then, other changes to the stockpile might have made it less capable to handle crises like the one we’re living through. In 2018, the stockpile was moved out of the jurisdiction of the CDC and into a different domain of the Health and Human Services Department—the [ASPR]. While some of the experts I spoke with saw this as a harmless change, most worried that institutional memory was lost in the process. The CDC, they say, was better at doing operational things like mobilizing a stockpile. Having it at the CDC “puts everybody who’s working on different aspects of being prepared and able to respond together,” Levy said.” Levy oversaw the SNS as acting Division Director for the CDC in 2013 and 2014.

https://www.theatlantic.com/health/archive/2020/04/why-were-running-out-of-masks-in-the-coronavirus-crisis/609757/

Fred, I don’t understand why you insist that Trump was no more than an innocent and impotent bystander for the last three years. He even controlled both houses of Congress for two of those years. Yet the best he can do is whine “No, I don’t take responsibility at all.” I will say that even if the SNS was fully stocked with brand new gear, we’d still face a crisis. Even the “god-emperor” Trump couldn’t wave his tiny hands and keep the virus away from our shores, nor did he bring it to our shores. But he could have done better and he should do better from this point on.

I await your response, if you desire to write one. After that I’ll close comments. I’m reminded of Jerry Clower’s story of the coon hunt. “Just shoot in amongst us! One of has got to get some relief!”

The Twisted Genius

Optimax,

Yes, that's exactly how it should work.

Fred

TTG,

So "managing supply chains and rotating stockpiles " is the responsibility of the The Assistant Secretary for Preparedness and Response. How many WG 7's report to the GS whatever supervisor that reports to that SES employee.

"Fred, I don’t understand why you insist that Trump was no more than an innocent and impotent bystander for the last three years."

I fully agree with "not soon enough". I look forward to the House "Not soon enough" impeachment. I also look forward to the house funding for all that gear for the next thing the WHO tells us not to worry about.

"He even controlled both houses of Congress for two of those years."
Oh, he was a dictator and Paul Ryan took his orders, during the Russia Investation by Mueller? That doesn't seem to be what happened. Please feel free to point out the Senator Warner and Kaine sponsored legislation to do what you wish had been done and maybe point to the congressman in your district as well.

"even if the SNS was fully stocked with brand new gear, we’d still face a crisis."
Thanks to Communist China and a corrupt WHO with a giant assist from incompetent or corrupt civil servents. Jerry Pournelle's Iron Law of Bureaucracy seems to be in play.

A.I.S.

I think you are massively overstating how much influence someone like Trump, or for that manner Obama, actually has.

General speaking, if you are in a position of authority, you can pretty strongly influence 1 layer below you, and effectively influence 2 layers below you. Anything more, well, basically forgetaboutit.

People whose main portfolio is how much masks there are are not, to my knowledge, within 2 levels of hierarchy from the president of the united states.

What could have been done is to build up mask supplies, and draft plans for mask supply (as well as ventilation apparate supply, as well as making an inventory of ventilator trained nurses who are currently not nurses and who could be rehired as nurses with a risk bonus).
These type of planning is staff work and fairly cheap because you only invest man hours of quite probably federally employed planners. Add figuring out how to rapidly create spare hospital or quarantine station capacity. This is also a plannable thing.
It is also waht the US did in the runup to WW2. The amazing logistical feats achieved by the US (including highly important lend lease) where based on solid staff work which started prior to the outbreak of hostilities.

Someone dropped the ball on not having such staff work prepared and ready.
In Germany, the health ministry epically derped essentially (appropriate planners came up with a proposal to increase the mask supply in january, basically a German mask producing firm was explicitly asking the Health ministry if it shouldnt rather sell 1 million masks to it instead of the Chinese, and was explicitly told that Germany does not need masks), which essentially resulted in the more common sensical and more hard assed interioer ministry taking over.

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