'Inside G.M.’s Race to Build Ventilators, Before Trump’s Attack' diff viewer (15/16)

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Inside G.M.’s Race to Build Ventilators, Before Trump’s Attack	Inside G.M.’s Race to Build Ventilators, Before Trump’s Attack
2020-06-17 19:50:45 UTC	2020-06-24 15:28:25 UTC (7 days later)
While much of the U.S. economy has ground to a halt because of the coronavirus outbreak, several dozen workers in orange vests and hard hats were hauling heavy equipment on Sunday at a General Motors plant in Kokomo, Ind.	While much of the U.S. economy has ground to a halt because of the coronavirus outbreak, several dozen workers in orange vests and hard hats were hauling heavy equipment on Sunday at a General Motors plant in Kokomo, Ind.
The crew was part of a crash effort to make tens of thousands of ventilators, the lifesaving machines that keep critically ill patients breathing. The machines are in desperate demand as hospitals face the prospect of dire shortages. New York State alone may need 30,000 or more.	The crew was part of a crash effort to make tens of thousands of ventilators, the lifesaving machines that keep critically ill patients breathing. The machines are in desperate demand as hospitals face the prospect of dire shortages. New York State alone may need 30,000 or more.
President Trump on Friday accused G.M. and its chief executive, Mary T. Barra, of dragging their feet on the project and directed his administration to force the company to make ventilators under a 1950s law. But accounts from five people with knowledge of the automaker’s plans depict an attempt by G.M. and its partner, Ventec Life Systems, a small maker of ventilators, to accelerate production of the devices.	President Trump on Friday accused G.M. and its chief executive, Mary T. Barra, of dragging their feet on the project and directed his administration to force the company to make ventilators under a 1950s law. But accounts from five people with knowledge of the automaker’s plans depict an attempt by G.M. and its partner, Ventec Life Systems, a small maker of ventilators, to accelerate production of the devices.
With deaths surging as cases snowball, the two companies have moved urgently to find parts, place orders and deploy workers, the people said. Tasks that normally would take weeks or months have been completed in days. The companies expect production to begin in three weeks and the first ventilators to ship before the end of April.	With deaths surging as cases snowball, the two companies have moved urgently to find parts, place orders and deploy workers, the people said. Tasks that normally would take weeks or months have been completed in days. The companies expect production to begin in three weeks and the first ventilators to ship before the end of April.
On March 19, G.M. began collaborating with Ventec, which normally makes about 200 machines a month, to figure out how to make about 10 times as many in that time. Working through the weekend of March 21 and 22, they hurried to find new suppliers that could provide parts in high volumes, said the five people, who asked not to be named because they fear it would further antagonize Mr. Trump.	On March 19, G.M. began collaborating with Ventec, which normally makes about 200 machines a month, to figure out how to make about 10 times as many in that time. Working through the weekend of March 21 and 22, they hurried to find new suppliers that could provide parts in high volumes, said the five people, who asked not to be named because they fear it would further antagonize Mr. Trump.
Over the weekend, G.M. called in workers to clear out the Kokomo plant, which has been idled because of the outbreak, of machinery previously used to make electrical components for cars. Over the next few days, the automaker and Ventec plan to begin setting up an assembly line. G.M. is already taking applications for the hundreds of jobs.	Over the weekend, G.M. called in workers to clear out the Kokomo plant, which has been idled because of the outbreak, of machinery previously used to make electrical components for cars. Over the next few days, the automaker and Ventec plan to begin setting up an assembly line. G.M. is already taking applications for the hundreds of jobs.
“We continue to work around the clock on our efforts with Ventec,” G.M. said in a statement on Sunday night. “We are working as fast as we can to begin production in Kokomo.”	“We continue to work around the clock on our efforts with Ventec,” G.M. said in a statement on Sunday night. “We are working as fast as we can to begin production in Kokomo.”
“I’m pretty amazed at what they’ve done,” said Kristin Dziczek, vice president for industry and economics at the Center for Automotive Research in Ann Arbor, Mich. “But automotive production involves a massive supply chain, and G.M. has risen to the occasion on other big manufacturing challenges.”	“I’m pretty amazed at what they’ve done,” said Kristin Dziczek, vice president for industry and economics at the Center for Automotive Research in Ann Arbor, Mich. “But automotive production involves a massive supply chain, and G.M. has risen to the occasion on other big manufacturing challenges.”
Mr. Trump does not see it that way. On Friday, he said on Twitter that Ms. Barra and G.M. had promised to provide 40,000 ventilators “very quickly” but were now telling the administration that the company could produce only 6,000 by late April and wanted “top dollar” for the machines. “Always a mess with Mary B,” he said.	Mr. Trump does not see it that way. On Friday, he said on Twitter that Ms. Barra and G.M. had promised to provide 40,000 ventilators “very quickly” but were now telling the administration that the company could produce only 6,000 by late April and wanted “top dollar” for the machines. “Always a mess with Mary B,” he said.
G.M. wasn’t negotiating price and other details with the government. Ventec has led the talks with the Federal Emergency Management Agency and the Department of Health and Human Services about how many ventilators the government would like to buy, and at what price. The automaker has said it will not make a profit on the ventilators it assembles and is seeking only to cover its costs.	G.M. wasn’t negotiating price and other details with the government. Ventec has led the talks with the Federal Emergency Management Agency and the Department of Health and Human Services about how many ventilators the government would like to buy, and at what price. The automaker has said it will not make a profit on the ventilators it assembles and is seeking only to cover its costs.
G.M.’s involvement in ventilators began with a phone call asking for help.	G.M.’s involvement in ventilators began with a phone call asking for help.
This month, Ms. Barra was contacted by a representative of Stop the Spread, a nonprofit campaign started by Rachel Romer Carlson, the chief executive of Guild Education, and Kenneth I. Chenault, the chairman and managing director at the venture capital firm General Catalyst and a former chief executive and chairman of American Express, four people familiar with the discussion said.	This month, Ms. Barra was contacted by a representative of Stop the Spread, a nonprofit campaign started by Rachel Romer Carlson, the chief executive of Guild Education, and Kenneth I. Chenault, the chairman and managing director at the venture capital firm General Catalyst and a former chief executive and chairman of American Express, four people familiar with the discussion said.
The two wrote an opinion essay on March 18 in The New York Times calling on corporate executives to join the fight against the pandemic. Some 1,500 corporate executives have signed a letter pledging to help in response to their plea.	The two wrote an opinion essay on March 18 in The New York Times calling on corporate executives to join the fight against the pandemic. Some 1,500 corporate executives have signed a letter pledging to help in response to their plea.
The four people familiar with the call said that Ms. Barra had offered to help and that the representative from Stop the Spread suggested the company ought to use its manufacturing and purchasing might to help Ventec scale up ventilator production.	The four people familiar with the call said that Ms. Barra had offered to help and that the representative from Stop the Spread suggested the company ought to use its manufacturing and purchasing might to help Ventec scale up ventilator production.
Ventec isn’t a giant in the ventilator industry, but it is known for its VOCSN model, which received approval from the Food and Drug Administration in 2017. The VOCSN, which is the size of a large toaster oven, combines a number of functions that had previously been performed by several machines to pump air into the lungs, suction out secretions and produce oxygen when a central oxygen line is not available. The device is used in critical-care hospital units but also can be used for home care.	Ventec isn’t a giant in the ventilator industry, but it is known for its VOCSN model, which received approval from the Food and Drug Administration in 2017. The VOCSN, which is the size of a large toaster oven, combines a number of functions that had previously been performed by several machines to pump air into the lungs, suction out secretions and produce oxygen when a central oxygen line is not available. The device is used in critical-care hospital units but also can be used for home care.
Around the time of the call, G.M., Ford and Fiat Chrysler were grappling with whether to keep their plants running. The United Automobile Workers union was putting pressure on the companies to do more to protect workers. The day after Ms. Barra spoke to Stop the Spread, G.M. and the other two large U.S. automakers said they would shut down plants until at least March 30.	Around the time of the call, G.M., Ford and Fiat Chrysler were grappling with whether to keep their plants running. The United Automobile Workers union was putting pressure on the companies to do more to protect workers. The day after Ms. Barra spoke to Stop the Spread, G.M. and the other two large U.S. automakers said they would shut down plants until at least March 30.
The next day, Phil Kienle, G.M.’s head of manufacturing for North America, and a few other executives flew to Ventec’s headquarters in Bothell, Wash. Early on Friday, March 20, the G.M. team sat down with Ventec executives to learn how the ventilators are made, and what parts are required. Ventec had already started a push to ramp up production to 1,000 a month. The group concluded that with G.M.’s resources, 20,000 a month would be possible, four people familiar with the talks said.	The next day, Phil Kienle, G.M.’s head of manufacturing for North America, and a few other executives flew to Ventec’s headquarters in Bothell, Wash. Early on Friday, March 20, the G.M. team sat down with Ventec executives to learn how the ventilators are made, and what parts are required. Ventec had already started a push to ramp up production to 1,000 a month. The group concluded that with G.M.’s resources, 20,000 a month would be possible, four people familiar with the talks said.
The next day, G.M. emailed its suppliers specifications of Ventec parts, asking if any could produce them in high volumes. Mr. Kienle’s team quickly zeroed in on Kokomo as a location to assemble the machines, a person familiar with the matter said. The plant, unlike much grittier car assembly factories, has the type of clean room needed for making medical devices.	The next day, G.M. emailed its suppliers specifications of Ventec parts, asking if any could produce them in high volumes. Mr. Kienle’s team quickly zeroed in on Kokomo as a location to assemble the machines, a person familiar with the matter said. The plant, unlike much grittier car assembly factories, has the type of clean room needed for making medical devices.
On the evening of Sunday, March 22, G.M.’s purchasing chief, Shilpan Amin, emailed Ms. Barra and other top executives to let them know that the company and Ventec had secured commitments from suppliers to produce 95 percent of the needed parts, according to three people familiar with the email.	On the evening of Sunday, March 22, G.M.’s purchasing chief, Shilpan Amin, emailed Ms. Barra and other top executives to let them know that the company and Ventec had secured commitments from suppliers to produce 95 percent of the needed parts, according to three people familiar with the email.
By last Tuesday, G.M. and Ventec had the details of their collaboration hammered out, which they discussed publicly early in the week. G.M. would operate as a contract manufacturer for Ventec, which would sell and distribute the machines. Ventec also plans to increase production at its plant in Washington State.	By last Tuesday, G.M. and Ventec had the details of their collaboration hammered out, which they discussed publicly early in the week. G.M. would operate as a contract manufacturer for Ventec, which would sell and distribute the machines. Ventec also plans to increase production at its plant in Washington State.
As talks progressed, coronavirus cases were soaring in New York City, and climbing as well in Boston, Detroit, New Orleans and elsewhere. In a news conference, Gov. Andrew M. Cuomo of New York complained that the federal government had provided only 400 ventilators to the state. “You pick the 26,000 people who are going to die because you only sent 400 ventilators,” Mr. Cuomo said last Tuesday.	As talks progressed, coronavirus cases were soaring in New York City, and climbing as well in Boston, Detroit, New Orleans and elsewhere. In a news conference, Gov. Andrew M. Cuomo of New York complained that the federal government had provided only 400 ventilators to the state. “You pick the 26,000 people who are going to die because you only sent 400 ventilators,” Mr. Cuomo said last Tuesday.
~~Updated June ~~16,~~ 2020~~	Updated June 22, 2020
	A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.	The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.	The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.	So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.	Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.	A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.	The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.	States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.	Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)	If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.	If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.	If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Two days later, Mr. Trump disputed the governor’s numbers while calling in to Sean Hannity’s show on Fox News. “I don’t believe you need 40,000 or 30,000 ventilators,” Mr. Trump said. “You go into major hospitals sometimes, and they’ll have two ventilators.”	Two days later, Mr. Trump disputed the governor’s numbers while calling in to Sean Hannity’s show on Fox News. “I don’t believe you need 40,000 or 30,000 ventilators,” Mr. Trump said. “You go into major hospitals sometimes, and they’ll have two ventilators.”