The New York Times - USA (2020-08-07)

A4 FRIDAY, AUGUST 7, 2020

Tracking an Outbreak

N K

The coronavirus pandemic has always been about more than the
pain implied by case counts and death tolls and jobless figures. The
pandemic was also about a global struggle to contain a brand-new
virus that jumped from country to country with malicious speed and
strength. It has now been 199 days since the first case was reported
in the United States, and it is clear that the United States — a nation
that since World War II had been accustomed to leading the way for
the world — stumbled badly. The fragmented, state-by-state re-
sponse made the United States the only affluent nation with a pro-
longed outbreak and fresh hot spots that have driven up case
counts.
In the last month, Florida reported nearly 300,000 cases,
roughly six times the number posted in Spain, which has more than
double the population. On Tuesday and Wednesday, Florida added
more than 10,800 new cases and had 270 deaths. Cases are increas-
ing in 10 states, including five in the Midwest: Illinois, Missouri,
Nebraska, Oklahoma and South Dakota. Puerto Rico and the U.S.
Virgin Islands are also on an upward trajectory. And Illinois re-
ported 1,953 new cases on Thursday, the most since May 24.
But it was other numbers that hung over the stimulus stalemate
on Thursday, including numbers that did not exist yet: the monthly
jobs report, which the Labor Department will issue on Friday.
Thursday’s numbers were once again bleak: While new state jobless
claims declined to the lowest level since March, they still exceeded
one million for the 20th consecutive week. There were jobless de-
clines across nearly all 50 states, even those that have emerged as
the latest hot spots, including California, Florida, Georgia, Louisiana
and Texas. Still, the Labor Department put last week’s total at
nearly 1.2 million. Another 656,000 claims were submitted by
freelancers and part-time workers who are not eligible for conven-
tional state unemployment benefits but are covered by a separate
federal program.
Hiring seems to have picked up — job postings at the online site
ZipRecruiter rose by 7.4 percent in July and have continued to climb
— but the employment index compiled by the Institute for Supply
Management declined last month, suggesting that many companies
have yet to start calling back workers. Some economists speculate
that temporary layoffs are becoming permanent as bosses realize
that a rebound is likely to take longer than they once believed. And
more workers will be idled. Julia Pollak, ZipRecruiter’s labor econo-
mist, who follows plant closings and layoffs that must be disclosed
in advance, said “plenty of layoffs are scheduled for August, Sep-
tember and October.”
In Britain, where 29 percent of the country’s work force has
been furloughed and 2.8 million people have filed unemployment
claims, central bankers had what amounted to some good news and
some bad news. The policymakers at the Bank of England said they
expected the British economy to contract by 9.5 percent this year, a
less severe downturn than they indicated a few months ago. They
also predicted that the unemployment rate would peak at 7.5 per-
cent at the end of the year.
The bank said that data suggested consumer spending was
rising. But the bank’s governor, Andrew Bailey, cautioned that its
projections had an “unusually large downside skew,” meaning that
they covered a wide range of possible negative outcomes.

Ohio Governor Tests Positive, Then Negative

Gov. Mike DeWine of Ohio, a Republican who stood out among
the G.O.P. for warning of the dangers of the coronavirus, became the
second governor known to have been infected with it. Last month
Gov. Kevin Stitt of Oklahoma, also a Republican, tested positive. Mr.
DeWine was to meet President Trump at Burke Lakefront Airport in
Cleveland on Thursday and, following standard protocol for those
allowed near the president, was tested. After a second test later on
Thursday, Mr. DeWine came up negative.
Mr. DeWine, who had not experienced symptoms, left Cleveland
without seeing the president. His office said he would isolate at
home in Cedarville, Ohio, for 14 days. He was the first governor in
thea country to order schools shut down, in March. He also issued
an early stay-at-home order and sharpened his message as cases
rose in Ohio in June and July.
This week he described three clusters of cases in Ohio that
showed how easily the virus can spread among family members,
friends and acquaintances. One cluster began with a 56-year-old
man who attended a church service while he was sick and helped
spread the virus to 91 other people, investigators said.
“It spread like wildfire,” Mr. DeWine wrote on Twitter. At a news
conference, he added: “Just because it’s your family, just because
it’s your friends, they could still be carrying the virus. Choosing to
not gather for parties or barbecues might feel like you’re not being
friendly, but it really is a sign of friendship.”

Face Shield ‘Might Help’

A mask is just a mask. It may not be enough, Dr. Anthony S.
Fauci, the nation’s top infectious disease specialist, said on Thurs-
day. A plastic face shield might also be a good idea. “It certainly
can’t hurt,” Dr. Fauci told a session sponsored by the nonprofit Alli-
ance for Health Policy, “and if you can do it, it might help.”
Dr. Fauci also said that the basic measures he and other health
officials had urged during the pandemic — wearing masks, washing
hands and staying apart — “might really, really blunt the flu season”
in the fall and winter. “Vaccination for flu, public health measures
for flu and Covid would have us be in the situation where both the
flu season is blunted and we have very little Covid,” he said. “That’s
a goal that we should aspire to that I think is possible.”

By JAMES BARRON

Coronavirus Update

Coronavirus Update wraps up the day’s developments with infor-

mation from across the virus report.

10 States Report Growth in Infections

New Jobless Claims Top 1 Million Again

Britain Expects Economy to Shrink 9.5%

New Coronavirus Cases Announced Daily in U.S.

THE NEW YORK TIMES

March 1 August 6
Note: Thursday’s total is incomplete because some states report cases
after press time. Data is as of August 6, 2020, at 5 p.m. Eastern.
Sources: State and local health agencies; hospitals; C.D.C.

As of Thursday evening, more than 4,875,600 people across every
state, plus Washington, D.C., and four U.S. territories, have tested
positive for the virus, according to a New York Times database.

New cases

7-day

average

60,

30,

Average daily cases per 100,000 people

in the past week

16 Few or

no cases

32 48

Hot Spots in the United States

THE NEW YORK TIMES

As of Thursday evening, more than 4 , 8 75, 600 people across every state, plus Washington, D.C., and four U.S. territories, have tested positive for the

coronavirus, according to a New York Times database. More than 159 ,5 00 people with the virus have died in the United States.

Nev.

Ga.

Miss.

Conn.

N.C.

Iowa

N.D.

Kan.

Te x a s

R.I.

Mass.

Ark.

Utah

Mont.

S.C.

Mich.

Calif.

Wis.

N.M.

Ill.

Fla.

Wyo.

N.Y.

Ind.

Minn.

Ore.

Maine

Alaska

Tenn.

Pa.

Md.

Ariz.

Wash.

N.H.

Hawaii

Mo.

Del.

W. Va.

N.J.

Idaho

D.C.

Ohio

Ky.

Okla.

La.

Ala.

Vt.

Neb.

S.D.

Minn.

Colo.

Va.

Puerto Rico

Sources: State and local health agencies. The map shows the share ofpopulation with a new reported case over the last week. Parts of a county with a

population density lower than 10 people per square mile are not shaded. Data for Rhode Island is shown at the state level because county level data is

infrequently reported. Data is as of August 6, 2020, at 5 p.m., Eastern.

WASHINGTON — As Dr. Debo-

rah L. Birx was taking heat from

both President Trump and

Speaker Nancy Pelosi this week,

the Democratic governor of Ken-

tucky spoke up in her defense.

Dr. Birx, the White House coro-

navirus response coordinator, had

visited his state in late July, after

he issued a statewide mask order

and was contemplating even more

aggressive steps, including clos-

ing down bars, Gov. Andy Beshear

recounted on a private conference

call with Vice President Mike

Pence and the rest of the nation’s

governors. It was a difficult move

for a Democrat in a Republican

state, but Dr. Birx provided him

cover.

“She stood in front of our press

and made it very clear that she

and the administration supported

the steps that we were going to

take,” Mr. Beshear said.

It was most likely welcome

praise for the otherwise embat-

tled Dr. Birx, a respected AIDS re-

searcher who took her current

post five months ago and increas-

ingly seems like a woman without

a country.

Old allies and public health ex-

perts have expressed disgust at

her accommodations to Mr.

Trump and, more so, at the per-

formance of the federal response

she is supposed to be leading

against the most devastating pub-

lic health crisis in a century. Ms.

Pelosi said she had lost confidence

in Dr. Birx, while Mr. Trump called

her “pathetic” after she suggested

the obvious: The coronavirus is in

a “new phase” and is spreading

rampantly.

“Her credibility, particularly in

the H.I.V.-AIDS community, has

taken an enormous hit in the last

five months,” said Mitchell War-

ren, the executive director of

AVAC, a global advocacy group

fighting to end H.I.V./AIDS, who

has worked closely with Dr. Birx.

“She is absolutely data driven, so

it is incredibly disappointing to

see her coordinating a national re-

sponse which has not at all been

best in class, but has been a disas-

ter on many levels.”

But beyond the cameras and

outside the Washington media

bubble, governors say she de-

serves praise for persistence and

presence. Gov. Tate Reeves of

Mississippi, a Republican, said

she prodded him for weeks to in-

stitute a statewide mask order;

this week he relented.

Dr. Carlos del Rio, an infectious

disease specialist at Emory Uni-

versity who leads the scientific ad-

visory board for a State Depart-

ment AIDS program run by Dr.

Birx, said, “I know that she told

the vice president, ‘Enough is

enough; you’re putting a mask on

and appearing with a mask,’ ” add-

ing that Mr. Pence followed the or-

der. “It requires a lot of guts to do

that.”

Dr. Birx declined to be inter-

viewed for this article. Her de-

fenders, and even her critics, say

she is in a difficult spot, serving a

mercurial president who has

shown little regard for science.

“Sometimes, looking from the

outside you will say she has been

too cozy to the president in certain

things, but also having talked to

her, she’s pushing,” Dr. del Rio

said.

Within public health circles, de-

bate is raging over how much

blame Dr. Birx bears for the vi-

rus’s spread. Some say Mr. Trump

is responsible, but, they add, the

dangerous misinformation he has

spread has often gone uncorrect-

ed by Dr. Birx.

“Trump is like the reverse Mi-

das,” said Gregg Gonsalves, a

longtime AIDS activist and assist-

ant professor of epidemiology at

the Yale School of Public Health.

“Everybody who is in his orbit, if

they’ve had any integrity, it gets

leeched away from them like some

parasite.”

But some say Dr. Birx is at least

partly responsible for mismanag-

ing the government’s response. A

report issued by the State Depart-

ment’s inspector general in Feb-

ruary relayed criticism of her

AIDS program leadership team,

which was called “dictatorial” and

“autocratic.” She has been critical

of the Centers for Disease Control

and Prevention, and some public

health experts view her as partly

responsible for sidelining the

agency.

From her office in the West

Wing, Dr. Birx serves as a link be-

tween federal agencies — the De-

partments of Defense, Homeland

Security, Health and Human Serv-

ices, and others — engaged in the

response.

She is also the point of contact

for state and local officials, and

oversees the drafting of detailed

reports offering guidance to the

states. She briefs Mr. Pence

weekly and the president at least

once a week, and must contend

with competing forces on the task

force, which includes Dr. Anthony

S. Fauci, the government’s top in-

fectious disease expert, and Dr.

Robert R. Redfield, the C.D.C. di-

rector. She is often the only wom-

an in the room.

In interviews with AIDS activ-

ists and public health experts, Dr.

Birx drew unfavorable compar-

isons with the outspoken Dr.

Fauci, in whose lab she trained.

Mr. Gonsalves, who has long

known both of them, said he wrote

in March to Drs. Birx, Fauci and

Redfield, as well as Adm. Brett P.

Giroir, who oversees coronavirus

testing, complaining that they

were “parroting the president.”

Only Dr. Fauci replied.

“Debbie is now in the position

where she’s saying to the emperor

that those new clothes look fantas-

tic,” Mr. Gonsalves said.

But inside the White House,

aides refer to Dr. Birx as “Dr.

Doom” for her efforts to temper

the president’s positive spin. And

she and Dr. Fauci are not in the

same situation. Dr. Fauci, 79, is

nearing the end of his career and

is a civil servant, which frees him

to speak his mind. Dr. Birx, 64, is a

political appointee who serves at

the pleasure of the president.

“She’s one of the hardest work-

ers, and she’s devoted to trying to

get this pandemic under control,”

Dr. Fauci said in an interview

Tuesday night.

Dr. Birx was right for saying the

pandemic is in a “new phase,” Dr.

Fauci said, even if it meant she

would be “blasted by the presi-

dent.” That phase, “community

spread,” means the virus is racing

through the general population

and is no longer confined to dis-

crete outbreaks in places like

nursing homes, factories and pris-

ons.

In a statement, Alyssa Farah,

the White House director of stra-

tegic communications, said, “Dr.

Birx is an American hero, and the

president has great respect for

her.”

Outside Washington, governors

said they appreciated Dr. Birx’s

forthrightness and her attention

to detail. She has traveled to more

than a dozen states by car to get a

sense of what is happening and is

about to head out on another six-

state swing next week, officials

said.

Gov. John Bel Edwards of Loui-

siana, a Democrat, said Dr. Birx

“knows what’s happening in Loui-

siana in real time in terms of our

tests results, our positivity num-

bers” — down to the parish level.

Mr. Reeves said Dr. Birx had

been unfairly tarred by liberals

who despise the president — the

same people, he said, who “have

said for months that no one should

question the scientists.”

Dr. Birx has drawn criticism for

what she has said — and what she

has not said. She remained virtu-

ally silent while Mr. Trump sug-

gested that exposure to ultravio-

let light or household disinfec-

tants might cure Covid-19. Her

lavish praise for the president on

the Christian Broadcasting Net-

work in March still rankles.

“He’s been so attentive to the

scientific literature and the details

and the data,” she said then.

Dr. Ashish Jha, the director of

the Harvard Global Health Insti-

tute, who has known Dr. Birx for at

least a decade and regards her as

“a genuinely smart and caring

person,” initially gave her the ben-

efit of the doubt on that interview.

“A bunch of people in the public

health world just lost their minds

on that one, but I said, ‘Look, if she

has to praise the president to get

him to do the right thing, I can live

with that,’ ” Dr. Jha said. But now,

he said, “she has to ask herself

whether she’s being effective in

protecting the American people,

and I would argue at this point

that it is not clear that she is.”

Dr. Birx, a colonel in the Army,

began her career in the early

1980s as an immunologist at the

Walter Reed Army Medical Cen-

ter and spent part of her training

as a fellow in Dr. Fauci’s lab.

In 2005, Dr. Birx moved to the

C.D.C., where she remained until

President Barack Obama ap-

pointed her to the State Depart-

ment as his global AIDS ambassa-

dor. When Mr. Trump was elected,

she told friends she wanted to

keep the job; the next day, she

flew to Boston to speak at Har-

vard University’s Institute of Poli-

tics, where she was circumspect

about her future.

“We were all like, ‘Oh my God,

the devil just got elected,’ and she

did not ditto the language,” said

Peter Staley, a longtime AIDS ac-

tivist, who was then on fellowship

at Harvard and hosted that No-

vember 2016 visit. “I could see the

gears in her head moving a million

miles an hour wondering, ‘How

can I survive?’ ”

WHITE HOUSE RESPONSE

Coordinator Becomes a Woman Without a Country

Dr. Deborah Birx’s defenders and critics say she is in a tough spot,

serving a mercurial president who has little regard for science.

DOUG MILLS/THE NEW YORK TIMES

By SHERYL GAY STOLBERG

Allies turned against

her and the president

called her ‘pathetic.’