Governors Need Resources and Support, Not Equivocation
A daily Covid-19 update from Andy Slavitt, former head of the Centers for Medicare and Medicaid Services
Pulled from my daily COVID-19 updates on Twitter.
Lots of conversation on the Hill today; called other country’s health leaders to see what was different; heard from many many providers today. And it was a great day under a war time general.
Tomorrow United States of Care is rolling out 5 recommendations to the U.S. Congress with lots of underlying detail on how to respond to the Coronavirus. We reviewed it with Hill staff and experts, and real people. It felt rushed to all of us, but there isn’t much time for perfection.
The priority areas include protecting our health care workforce, protecting vulnerable populations, and rapidly building our health care and public health infrastructure. We will also recommend (obviously given who we are) ways to make sure no one has to worry about paying for care. Tonight a state Health Secretary called and said the largest hospital in the state (a university) runs out of N-95 masks tomorrow. Just in time because they run out of hospital beds next week.
Anyway the status of things in DC is Senate Republicans have sent over a proposal to Democrats in the Senate and over to the House. It’s a $1 trillion package with direct payments and some industry bailouts. Schumer and the Senate are going to review tomorrow and over the weekend. Democrats will likely find this package wholly inadequate. And there will be a negotiation. The United States of Care plan I will post tomorrow is where we believe we need to get.
As I mentioned yesterday, we need $3-4 trillion in my estimation. Trump’s poor planning (I’m tired of offering an apology every time I say that) has really destroyed the support for our front line health care workers. Yesterday Trump said he was activating the ability to take over manufacturing so we could finally build the masks and equipment we need. Then today he backed off. I tried to find out why.
He now calls himself a “war time” president. Trying the moniker on for size. Yet he’s a war time president who can’t read his own maps and doesn’t care if his troops are armed with basic equipment.
War time presidents.
- Eisenhower on Monday: “Germany should not invade France”; Tuesday, “I’m not so sure about that.”
- Churchill: “Let’s let states fend for themselves. I’m not buying ventilators.”
- Lincoln: “We’re a 10. Doing a beautiful job.”
I’m not saying this to bash Trump. That’s an easy game. I’m saying this because I’d love for him to be an actual war time president — decisive, skeptical, uninterested in the PR, trying to minimize casualties. Understanding command and control.
Governors need resources and support, not equivocation. Our troops have no armor. I’m not being partisan. I’m pissed off. He’s wasting days and lives. Because some business owners called and objected (what I heard).
I’m now getting calls from different departments: Heath and Human Services, White House, asking me whose in charge of certain decisions. I say the same thing every time; “if no one knows, then you are. Fucking do something.”
I got a call today about a 40 year old with no risk factors, healthy who is now in critical condition. Another about a doctor in Washington who said they had to keep people over 80 out of the ICU already. I don’t love these calls but I take them. People are anxious. And scared. Just when they thought they knew what to expect the facts seem to change. We don’t understand today what we thought we were understanding yesterday.
A Senator messaged me because he thought his a governor was treating this as a joke. And you know what I think? I think eventually every governor will tell their people to shelter in place for 30 days. And strong leadership in the White House would be coordinating the effort.
I talked to people in Sweden and the UK. The UK tried the opposite approach of most. They tried to expose many people quickly get to herd immunity. It failed. Then Boris Johnson, strategist that he was, turned out last to the party in chasing testing supplies and masks.
The really sad part about having people like Trump or a Johnson as your president/PM is they so badly want to be authoritarians and the one time you actually want them to, they cower in indecision.
We will live for a long time with the fact that Trump dismissed warning signs of a pandemic. Some of our loved ones may not. But we navigate from where we are, not where we wish we were. So: Trump, do it right and we will support it.
