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Mixed messages and misinformation aren’t out of the ordinary in the Trump administration. But at a time when the U.S. faces a looming threat from a novel virus, public health experts warn that the administration’s mixed messages aren’t just confusing — they’re dangerous.

On Tuesday, a top official from the Centers for Disease Control and Prevention said the agency expects the virus will begin spreading at a community level in the United States and that disruptions to daily life could be “severe.” But President Trump and members of his administration have also said this week that U.S. containment of the virus is “close to airtight” and that the virus is only as deadly as the seasonal flu. Their statements range from false to unproven, and in some cases, underestimate the challenges that public health officials must contend with in responding to the virus.

“It’s really important for the U.S. government to be speaking with one common voice about these issues right now,” said Tom Inglesby, an infectious diseases physician and director of the Center for Health Security of the Johns Hopkins Bloomberg School of Public Health.

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Without that, experts caution, the public will be left confused about their risks and what they can do to help curb the spread of the virus, such as staying home when sick.

Inglesby noted that health officials are working hard to prepare and plan for the spread of the virus within the U.S. But that work needs to be regularly and clearly communicated to the public — without conflicting statements from other officials.

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“It will erode confidence in the effort if one part of the government says something in the beginning of the day, and another part of the government says something contradictory at the end of the day,” he said.

STAT took a look at what President Trump and other top administration officials have said about the virus — and what’s actually true.

Containment is ‘pretty close to airtight’

— Larry Kudlow, director of the National Economic Council, in an interview with CNBC Tuesday

There have been just 14 cases of the coronavirus diagnosed in the U.S., 12 in people who had recently traveled to China and two in close contacts of those initial cases.

But experts say it’s difficult to know whether that’s actually the case — and warn that it’s possible some cases might be going undetected due to a lack of widespread testing.

As of Feb. 23, the CDC had tested just 479 people, not including those who were evacuated from other countries. Testing kits sent out by the CDC nationwide turned out to be faulty, which means that just 12 labs across the country can currently run tests outside of the CDC.

The CDC is also still only recommending testing for people who have recently traveled to China or been in close contact with someone infected. But as the disease has started to spread in other countries, some public health experts think it’s necessary to broaden the criteria for testing or run the risk of missing other cases.

To Cody Meissner, a Tufts Medical Center pediatrician who specializes in infectious disease, there’s simply not enough information to be certain just how severe the outbreak will turn out to be. The number of infected people could be several-fold higher than current data suggest, he said, but the virus could also prove to be less deadly than officials believe.

“The CDC has taken one position and said we have to get ready for a pandemic,” Meissner said Wednesday at the SVB Leerink health care conference in New York. “The president has said this is going to pass, that it’s not a big deal. And I think it’s somewhere in between.”

The fatality rate is ‘similar to seasonal flu’

—Chad Wolf, acting secretary of the Department of Homeland Security, in testimony before Congress Tuesday

At this point, the novel coronavirus appears to be deadlier than the seasonal flu, though experts caution it’s difficult to pinpoint the case fatality rate at this stage.

The case fatality rate — the percentage of known infected people who die — is between 2% and 4% in Hubei province, where the outbreak began. In other parts of China, the case fatality rate is 0.7%, a World Health Organization expert said Tuesday. The seasonal flu, by comparison, has a case fatality rate of about 0.1%. The flu is estimated to kill between 290,000 and 650,000 worldwide each year.

Ronald Klain, who oversaw the Ebola response under the Obama administration, responded to Wolf’s comments on Twitter, noting the fatality rate isn’t clear at this point.

“The responsible answer is ‘we don’t know yet,'” he said.

‘There’s a big difference between Ebola and coronavirus’

—Trump, in remarks in India Tuesday, when asked about decision to evacuate ill Americans from the Diamond Princess cruise ship, given his past criticism of the evacuation of an American health worker infected with Ebola

This is correct — there are multiple big differences between Ebola and the coronavirus, which Trump called “like day and night.”

It’s true that the case fatality rate for Ebola was substantially higher than the estimated fatality rate of the coronavirus. Many U.S. hospitals are also now better prepared to deal with special pathogens than they were in 2014.

But it’s also true that the coronavirus appears to spread far more easily than Ebola does. To contract Ebola, a person must come into contact with the bodily fluids of an infected person. It can’t be transmitted simply by being in the same area as a person with Ebola. The coronavirus, in contrast, can spread through coughs, sneezes, or close contact with someone infected.

‘We’re very close to a vaccine’

—Trump, also in remarks in India

Trump’s remark about being “very close” to a vaccine, made while discussing the outbreak at a press conference, was initially interpreted as a reference to a coronavirus vaccine. The White House later told reporters the president was referring to an Ebola vaccine being near completion, though the FDA already approved a vaccine to protect against Ebola in December.

There are several groups racing to develop a coronavirus vaccine, but there is still a long road ahead. The CDC has estimated that a vaccine is unlikely to be ready in the next 12 to 18 months.

The National Institutes of Health is working with the biotech company Moderna to develop a vaccine against the virus. In a press conference Tuesday, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said that work is going on schedule.

“A vaccine may not solve the problems of the next couple of months,” he acknowledged.

If the NIH’s vaccine proves effective, it would need to be produced at large scale. No major pharmaceutical company has come forward to say it would manufacture that vaccine.

Johnson & Johnson has also said it’s interested in developing its own vaccine. The company’s vaccine division, Janssen, has said it will partner with Biomedical Advanced Research and Development Authority, an agency of the Department of Health and Human Services, on that work.

New drugs to treat patients infected with the virus are likely to emerge much more quickly than vaccines, a top Food and Drug Administration official told STAT Wednesday.

“The development of a vaccine is not going to prevent a pandemic here,” said Peter Marks, the director of the FDA’s Center for Biologics Evaluation and Research.

The virus might go ‘away in April, with the heat’

—Trump, speaking at a governor’s meeting earlier this month

The arrival of spring — and warmer weather — in the Northern Hemisphere typically means the transmission of cold and flu viruses will dramatically slow down. Though the novel virus isn’t related to flu viruses, it is similar to a new flu virus in some ways. When a new flu virus emerges, it can circulate outside of flu season, simply because so many people are susceptible to the new infection.

It’s not clear whether this is also the case with the new coronavirus. But it’s possible the virus will keep spreading beyond flu season. Most people across the globe are likely vulnerable to infection. There isn’t widespread immunity against the virus. It’s also spreading in Singapore, where the temperatures are equivalent to those seen in summertime in the U.S.

That suggests higher temperatures might slow transmission of the virus, but probably won’t stop it, according to infectious diseases epidemiologist Marc Lipsitch of Harvard. “I think the fact that Singapore is seeing cases transmit is also kind of evidence that it’s not a matter of yes or no,” Lipsitch told STAT earlier this month. “It’s a matter of degree.”

  • Distrust in our governments seems to be the norm and continues to erode at each serious lie occurs. The current admin is probably a good example and noted in the article and in comments.

    The other side of the coin is that government officials also tend to over react and panic just like the rest of the public. They FEAR they will make the wrong decisions in the scarce information available to them early in an outbreak.

    Let me tell you a first hand story. The 2009 H1N1 outbreak. Classified as a pandemic. So is the common cold and influenza each year. “Pandemic” is a clinical term in public health and not Armageddon like in the movies.
    We winter in Mexico and reside in Puerto Vallarta. The first case was identified in La Gloria, Mexico and rapidly spread in Mexico and through the world. Early in the outbreak a reporter, well trained to ask provocative questions, was at a news conference with the head of the WHO speaking. The reporter asked, “Could this virus be as dangerous as the 1918–1920 Spanish flu pandemic?

    Instead of saying ‘we don’t have enough data yet. We don’t know mortality rates, infection rates, vectors etc. to make that kind of determination. We and the media should not speculate on how dangerous this outbreak might be until we have sufficient data. Like I said, that is what she should have said.

    What she did say was simply, “Possibly”

    And the WORLD went crazy A totally inappropriate and dangerous statement by the WHO president. Media coverage, front page, top of the hour news for weeks. Not unlike what we are seeing now. Internet rumors, myths, conspiracies, just like now.

    Tourism dropped to near zero especially to Mexico. We rent our condo part of the winter and travel in Mexico with the rent money. Everybody cancelled until summer. So we just stayed in our condo. And everybody else that planned a trip to Puerto Vallarta also cancelled. Hotel occupancy went from the usual 90% + to 20%.
    The cruise ships cancelled (usually 4-5 /wk in winter) The Canadian airlines stopped flying to Puerto Vallarta and stranded 1600 nationals in town. If they flew elsewhere, the could not travel on to Canada. “Vacations” went over budget staying 4-5 weeks instead of 1. People lost their jobs in Canada. Foot traffic down town in tourist central was like a ghost town. Restaurants dragging you off the street into their establishment offering free drinks, deserts, discounts. We ate cheap and did our share to support their economy. Puerto Vallarta’s economy is tourism. No manufacturing. No shipping port. No interstate access. No trains. No big corporations. Just tourism and related businesses.

    Then the outbreak hit Mexico City. The government closed the schools and universities to help contain the outbreak. In Puerto Vallarta the city officials decided to panic believing all those ‘infected’ college students will come to Puerto Vallarta for an early spring break. In their great wisdom and planning they decreed that every restaurant and bar in town to be closed until further notice. That will keep them away. It lasted about 24 hours when the resorts pointed out to their city officials that their guests paid for all inclusive meals and drinks. They had to eat SOMEWHERE. Likewise the hotels. They don’t have kitchens. They have to eat SOMEWHERE. So they changed to policy. Allowed the resorts and restaurants to open but they could only serve ONE drink per person per meal. (I never heard the one drink reasoning.)

    Well, that is now history. There was NOT ONE confirmed case in Puerto Vallarta. That scare cost that community millions of dollars. Remember, tourism was already in the pits after the 2008 recession. A double whammy.
    It was handled badly from the President of the WHO on down to local officials in Puerto Vallarta.

    The pandemic infected 1 in 5 people in the world. The mortality rate was 0.02%. One fifth of one percent. Just another bug. No Big Deal.

    And similar stories can be told about what is happening now. Time will tell if they hit the nail on the head, over reacted, or under reacted.

  • “Mixed messages and misinformation aren’t out of the ordinary in the Trump administration.”

    This is certainly true, but Trump is certainly not the only administration to engage in misinformation. All government politicians and their bureaucratic leaders engage in misinformation. I would never fully trust anything a government agency or bureacracy says. They’re always trying to make themselves and a situation look better than it may actually be.

  • Where is the fatality percentage for common flu coming from? It indicates common flu infects millions per year but that’s an estimate (Influenza like illness) and not actually confirmed tested cases. Shouldn’t it be more accurate to use hospitalized or confirmed influenza tested cases to associated death to compare COVID-19 fatality rate?

    • Hopefully, this will shed light on your question:

      https://www.cdc.gov/flu/about/burden/2018-2019.html

      First, ‘influenza’ is a mix of several viral strains. The mix changes every year to some degree. They don’t need to routinely “test” for the different strains. The medical management is treating for complications. It is diagnosed by symptom clusters.

      In the document, you will note that the reporting includes those with symptoms reported. Those requiring medical treatment. Those requiring hospitalization, and deaths.

      Of course, there are the cases where cases were not reported. My doctor does not want me to come into the office if I have the flu. There is no treatment for just the flu. She only wants to see me in the office if my temperature gets excessive, I start coughing, Have difficulty breathing. etc. Signs of complications.

      Lastly, there are no deaths caused directly by influenza. It is other infections and illnesses that arise while you are medically vulnerable due to the influenza. For example, Pneumonia is the major cause of death. Those with chronic respiratory impairments are most vulnerable. Persons with diminished immune systems from HIV, Cancer treatment, etc. are vulnerable to normally innocuous bacteria that can lead to sepsis and organ failure.

      Then there is the reporting which can make some of the data a little fuzzy. If the death is reported to be “pneumonia”, it goes in a different category than complications of influenza – pneumonia. Physicians and hospitals are pretty good at reporting according to protocol using the ICD-10 diagnostic manual.

      For the chronovirus, the scenarios are much the same. Some cases are so mild, they do not require medical treatment and are not reported. The testing is not for medical treatment but for assessment of the virus impact on public health. How infectious is it. Infection vectors. (airborne, surface contact, body fluids, etc.) Since symptoms are similar if not identical to influenza, testing helps get more accurate data to manage the outbreak.

      Side note. The news media finally got informed that the masks are ineffective against preventing infection. 1. Viruses are extremely small and can be breathed right though a mask. Mask will only stop particles large enough to carry virus on it. Like spit from someone coughing in your face. 2. Airborne is not the only infection vector for the disease. 3. What they have failed to mention so far is if YOU have symptoms, a mask will reduce your spread of the virus.

      Hope that helps.

  • “By now aren’t you people all aware that the public knows you are always going to blame Trump for everything? The game is up so stop acting like you care about anything other than bashing Trump.”

    EXCUSE ME! I care about American and its people. Democrats, Republicans, Independents and non participates in voting.

    This is NOT about Politics. It is about the safety and healh of Americans.

    However is IS POLITICAL for Donald Trump. The only thing he has to stand on during the election is the economy. He had little to do with how good it is/was. Mostly Fed Policy whom he bashes regularly. The capital gains tax cut helped the economy while raising the deficit because of it. That helped folks with portfolios but not the Average American. But being President he claims the credit.

    So I challenge you to find ONE new conference where he was actually accurate in what he said. Not distorting and cherry picking data. Give me just ONE and the link to the video.

  • I just want the most current unfiltered truth regarding this virus. I don’t trust Trump or his cronies to tell the American people the truth. He put a gag order on the NIH and the CDC.. the information has to be funneled through him first. I want our medical professionals to speak to directly to Americans about the most current events.
    No reason Trump has to approve the information first.

  • By now aren’t you people all aware that the public knows you are always going to blame Trump for everything? The game is up so stop acting like you care about anything other than bashing Trump.

  • The stock market voted on Donald Trump’s credibility for accurate information the day after Donnie’s attempt to smooth the stock market. He scared the hell out of portfolio managers.

    Donnie ignores the information provided by our intelligence services, Federal Reserve,FBI, CNN, BBC and now the CDC.

    But he regularly regurgitates verbiage from the scripted talking heads on Faux News.

    America desperately needs a President that they can believe will be forthright with the American People.

    We can also add Congressmen and women to that list.

  • Must we Inject Politics & denigrate the President at EVERY opportunity? There is much room for “Misinformation” labels in this community. The President is just trying to prevent a panic to give Actual Experts time & resources to stay ahead of this curve. People in Glass Houses…

  • Limited testing, faulty test kits, the WHO retardedly slow, hidden numbers in several foreign countries, Trumps ignoramous stance on the “cAronavirus”, cruiseship incubators, 100,000 Chinese students returning to Australia, no curbs on trade with Africa – the whole approach is a gong-show. This virus has taken the world by surprize and by the nuts. Let’s hope there will be a vaccine soon (more effective than the seasonal flu vaccine with it’s unacceptable 25% meagre effectiveness). Luckily the fatality rate of this Covid-19 appears to be as low as that of the common corona flu viruses. And now we get a real test on VP Mike Pence: how well does he mastermind the US approach while still firmly under the POTUS wing?

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