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| FEMA’s ‘Air Bridge’ to Coronavirus Hot Spots Leaves Other Regions on Their Own | FEMA’s ‘Air Bridge’ to Coronavirus Hot Spots Leaves Other Regions on Their Own |
| (about 13 hours later) | |
| WASHINGTON — The federal government’s program to expedite the shipping of valuable protective equipment to coronavirus hot spots has left hospitals that are out of the spotlight struggling to secure their own protective gear as they watch the outbreak creep closer. | WASHINGTON — The federal government’s program to expedite the shipping of valuable protective equipment to coronavirus hot spots has left hospitals that are out of the spotlight struggling to secure their own protective gear as they watch the outbreak creep closer. |
| The Trump administration has repeatedly endorsed the Federal Emergency Management Agency’s system of flying masks, respirators, gloves, goggles and surgical gowns from overseas suppliers to the United States. The new “air bridge” is rushing supplies to the most hard-hit areas within days instead of weeks. | The Trump administration has repeatedly endorsed the Federal Emergency Management Agency’s system of flying masks, respirators, gloves, goggles and surgical gowns from overseas suppliers to the United States. The new “air bridge” is rushing supplies to the most hard-hit areas within days instead of weeks. |
| But officials who represent areas with fewer serious infections say the system has left them to navigate a mind-boggling private marketplace where state officials and hospital leaders face backlogged orders, last-minute cancellations and rising costs. And the coronavirus can hit fast, like the outbreak that has erupted in South Dakota. | But officials who represent areas with fewer serious infections say the system has left them to navigate a mind-boggling private marketplace where state officials and hospital leaders face backlogged orders, last-minute cancellations and rising costs. And the coronavirus can hit fast, like the outbreak that has erupted in South Dakota. |
| “I don’t take anything away from hot spots,” Gov. Steve Bullock of Montana, a Democrat, said in an interview. “But we don’t want to become one of them.” | “I don’t take anything away from hot spots,” Gov. Steve Bullock of Montana, a Democrat, said in an interview. “But we don’t want to become one of them.” |
| The federal government’s approach has forced local officials to get creative. Some have enlisted 3-D printing. Others have turned to car or painting shops to make medical gear for emergency workers. | The federal government’s approach has forced local officials to get creative. Some have enlisted 3-D printing. Others have turned to car or painting shops to make medical gear for emergency workers. |
| Dr. Thomas Tobin, the chief medical officer at the community hospital in Grand Junction, Colo., is not facing the challenges of an area like New York City. The medical facilities he oversees have 10 patients on ventilators. But with just 30 days’ worth of protective gear for his hospital workers, he said he was desperate for assistance now rather than when infections soar. | Dr. Thomas Tobin, the chief medical officer at the community hospital in Grand Junction, Colo., is not facing the challenges of an area like New York City. The medical facilities he oversees have 10 patients on ventilators. But with just 30 days’ worth of protective gear for his hospital workers, he said he was desperate for assistance now rather than when infections soar. |
| “It’s like not getting a smoke alarm until after the fire’s already in your house,” Dr. Tobin said. “It’s a little late at that point.” | “It’s like not getting a smoke alarm until after the fire’s already in your house,” Dr. Tobin said. “It’s a little late at that point.” |
| The Trump administration’s system of procurement has also prompted criticism from members of Congress and governors who say shipments of previously ordered personal protective equipment, or P.P.E., confirmed for other hospitals are being commandeered and redirected to hot spots around the United States. The leaders of the House Homeland Security and Oversight Committees wrote a letter to Peter T. Gaynor, the FEMA administrator, saying that “the agency’s opaque and evolving processes are clearly not meeting the needs that communities have right now for P.P.E. and medical supplies.” | The Trump administration’s system of procurement has also prompted criticism from members of Congress and governors who say shipments of previously ordered personal protective equipment, or P.P.E., confirmed for other hospitals are being commandeered and redirected to hot spots around the United States. The leaders of the House Homeland Security and Oversight Committees wrote a letter to Peter T. Gaynor, the FEMA administrator, saying that “the agency’s opaque and evolving processes are clearly not meeting the needs that communities have right now for P.P.E. and medical supplies.” |
| Democrats have also criticized the involvement of Jared Kushner, President Trump’s son-in-law, as a back channel for the politically well-connected who make direct contact with Mr. Trump. Mr. Kushner said at a recent White House briefing that he ensured N95 masks were delivered to a New York City public hospital after Mr. Trump told him that “he was hearing from friends of his in New York that the New York public hospital system was running low on critical supply.” | Democrats have also criticized the involvement of Jared Kushner, President Trump’s son-in-law, as a back channel for the politically well-connected who make direct contact with Mr. Trump. Mr. Kushner said at a recent White House briefing that he ensured N95 masks were delivered to a New York City public hospital after Mr. Trump told him that “he was hearing from friends of his in New York that the New York public hospital system was running low on critical supply.” |
| “That’s not how the system should work,” said Juliette N. Kayyem, a former assistant secretary at the Department of Homeland Security. “You want to align supply with need. The random phone call is not necessarily need.” | “That’s not how the system should work,” said Juliette N. Kayyem, a former assistant secretary at the Department of Homeland Security. “You want to align supply with need. The random phone call is not necessarily need.” |
| Administration officials say the more than 40 flights that have delivered protective equipment are just one way to fulfill the needs of localities. In exchange for expediting the shipments of the protective equipment, FEMA requires the distributors to sell about half of the remaining supplies to 100 counties deemed to be struggling the most based on government data on the number of hospitalized patients, number of deaths from the outbreak and available hospital space. | Administration officials say the more than 40 flights that have delivered protective equipment are just one way to fulfill the needs of localities. In exchange for expediting the shipments of the protective equipment, FEMA requires the distributors to sell about half of the remaining supplies to 100 counties deemed to be struggling the most based on government data on the number of hospitalized patients, number of deaths from the outbreak and available hospital space. |
| The rest of the supplies from the flights are sold to distributors’ pre-existing customers, forcing many counties to scramble. | The rest of the supplies from the flights are sold to distributors’ pre-existing customers, forcing many counties to scramble. |
| MaryAnn E. Tierney, one of FEMA’s regional administrators, said she had fielded numerous calls from leaders of counties that were not in the Top 100 list. But Ms. Tierney said in an interview that air bridge flights supplied just a portion of available protective gear. | MaryAnn E. Tierney, one of FEMA’s regional administrators, said she had fielded numerous calls from leaders of counties that were not in the Top 100 list. But Ms. Tierney said in an interview that air bridge flights supplied just a portion of available protective gear. |
| The Defense Department has also distributed 11 million N95 masks, and FEMA is encouraging communities to clean and reuse protective gear. The Department of Health and Human Services has also awarded contracts to five companies to produce 600 million respirator masks over the next 18 months. | The Defense Department has also distributed 11 million N95 masks, and FEMA is encouraging communities to clean and reuse protective gear. The Department of Health and Human Services has also awarded contracts to five companies to produce 600 million respirator masks over the next 18 months. |
| The administration’s Supply Chain Stabilization Task Force is also working to procure additional protective gear from 11 different manufacturers, according to a FEMA spokesman. | The administration’s Supply Chain Stabilization Task Force is also working to procure additional protective gear from 11 different manufacturers, according to a FEMA spokesman. |
| Ms. Tierney said the counties could still turn to private distributors that bring equipment on large cargo ships or from the companies involved in the air bridge program that are free to sell about half of the shipments. | Ms. Tierney said the counties could still turn to private distributors that bring equipment on large cargo ships or from the companies involved in the air bridge program that are free to sell about half of the shipments. |
| “If you’re not in a hot spot, there are still supplies being computed into the system because 50 percent of what lands on one of those planes is going to different locations throughout the country,” she said. | “If you’re not in a hot spot, there are still supplies being computed into the system because 50 percent of what lands on one of those planes is going to different locations throughout the country,” she said. |
| For many communities, that is not nearly enough. | For many communities, that is not nearly enough. |
| The inspector general for the Department of Health and Human Services released a report this month showing widespread shortages of protective gear at hospitals. In Montana, Mr. Bullock said two-thirds of the state’s hospitals reported receiving shipments of supplies that were less than what they had ordered or the shipments were outright canceled. | The inspector general for the Department of Health and Human Services released a report this month showing widespread shortages of protective gear at hospitals. In Montana, Mr. Bullock said two-thirds of the state’s hospitals reported receiving shipments of supplies that were less than what they had ordered or the shipments were outright canceled. |
| Updated June 16, 2020 | |
| 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. | 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. | 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. | 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. |
| The state has received 78,000 N95 masks from the federal government, a sliver of the 550,000 Mr. Bullock said the hospitals needed. Without federal assistance, the state government has been forced to enter a new market and has faced increasing competition from other states and hospitals. Mr. Bullock recently had to ask North Dakota for 50,000 masks. | The state has received 78,000 N95 masks from the federal government, a sliver of the 550,000 Mr. Bullock said the hospitals needed. Without federal assistance, the state government has been forced to enter a new market and has faced increasing competition from other states and hospitals. Mr. Bullock recently had to ask North Dakota for 50,000 masks. |
| “It leaves us at the bottom of the bucket,” Mr. Bullock said of the distribution system. | “It leaves us at the bottom of the bucket,” Mr. Bullock said of the distribution system. |
| Dr. Scott Ellner, the chief executive of Billings Clinic, a health care system in Montana, said the system did receive materials from the federal government, but “that has really slowed to a trickle at this point.” | Dr. Scott Ellner, the chief executive of Billings Clinic, a health care system in Montana, said the system did receive materials from the federal government, but “that has really slowed to a trickle at this point.” |
| “We are aware that equipment is now being diverted to other hot spots,” he said. | “We are aware that equipment is now being diverted to other hot spots,” he said. |
| Dr. Ellner’s staff has been forced to solicit public schools, dentists’ offices and universities for 3-D printers to make additional masks. A ski company produced molds for thousands of masks, and a fishing company made gowns for hospital workers. | Dr. Ellner’s staff has been forced to solicit public schools, dentists’ offices and universities for 3-D printers to make additional masks. A ski company produced molds for thousands of masks, and a fishing company made gowns for hospital workers. |
| “There’s a point where you can only reuse your equipment so much to where it’s not necessarily doing what it’s supposed to be doing,” Dr. Ellner said. “It’s not preventing the spread but creating risk, not just for hospital workers but for transmissions to other patients in the hospital.” | “There’s a point where you can only reuse your equipment so much to where it’s not necessarily doing what it’s supposed to be doing,” Dr. Ellner said. “It’s not preventing the spread but creating risk, not just for hospital workers but for transmissions to other patients in the hospital.” |
| Dr. Lisa Moreno, a professor of emergency medicine at the Louisiana State University Health Sciences Center in New Orleans, said she had gained hope that infection rates in her devastated region had plateaued. But she added that when she was not working in an emergency room, she had faced “astronomical” costs for protective gear in the private market. | Dr. Lisa Moreno, a professor of emergency medicine at the Louisiana State University Health Sciences Center in New Orleans, said she had gained hope that infection rates in her devastated region had plateaued. But she added that when she was not working in an emergency room, she had faced “astronomical” costs for protective gear in the private market. |
| And her physicians did not have the resources to know which vendors were scammers and which companies sold flawed or fraudulent materials, distinctions she said she thought the federal government was better suited to make. | And her physicians did not have the resources to know which vendors were scammers and which companies sold flawed or fraudulent materials, distinctions she said she thought the federal government was better suited to make. |
| Dr. Moreno, the president-elect of the American Academy of Emergency Medicine, said she was also worried for colleagues who could experience new outbreaks in the weeks to come. | Dr. Moreno, the president-elect of the American Academy of Emergency Medicine, said she was also worried for colleagues who could experience new outbreaks in the weeks to come. |
| “I don’t want them to go through what I’ve had to go through, where we are having to wash down our gowns with antiseptic hand wipes and having to wear the same N95 for five shifts,” Dr. Moreno said. “And you have to take it off to take a drink of water, and you don’t know where it put it down because you don’t know what’s contaminated.” | “I don’t want them to go through what I’ve had to go through, where we are having to wash down our gowns with antiseptic hand wipes and having to wear the same N95 for five shifts,” Dr. Moreno said. “And you have to take it off to take a drink of water, and you don’t know where it put it down because you don’t know what’s contaminated.” |