What is the truth about Trump's travel ban from China?

[Ohioboy]

I heard that it didn't really do much because it allowed anyone coming back to the States in with little testing or screening of any kind. He keeps talking about it as if he did a wonderful thing.

[global1]

1. It Was Too Little Too Late But.....

that is all he did and that's all he has to talk about. That's why he keeps on referring to that to pat himself on the back.

[Ohioboy]

2. Yeah, other than that

he has pretty much dropped the ball, and there are videos of him dropping it.

[pat_k]

3. This may help put it in context: Timeline

The virus was already circulating, undetected, for a minimum of 2 weeks prior to the travel ban on Feb 3. It was undetected because Trump's CDC did not have have any sort of test prior to February 5. To make matters worse, the test they began to distribute 2/5 was flawed, causing further delay in any sort of systematic testing.

There can be no containment without early testing and tracing.

The travel ban was doomed to failure as a means to keep the virus "out" because the virus was already "in."

Furthermore, the rules around screening Americans returning from China after the ban was instituted were very problematic and completely inadequate to protect the public ("screening" didn't involve testing + other problems as described in the timeline).

The administration screwed around for the first 7 most critical weeks.

For the past 3 weeks, states have been moving at lightening speed in an effort to deal with the fallout of the 7 weeks of colossal failures.

Timeline

1/13
Test developed by the department of virology at Berlin’s Charité university hospital with help from experts in Rotterdam, London and Hong Kong available.

CDC inexplicably declines to develop and use this test, opting, instead, to come up with their own.

1/19
Virus is already circulating, undetected, in WA state, and probably elsewhere. (Based on analysis of genetic samples from a 1/20 case and a later case, researchers at Fred Hutchinson Cancer Research Center and the University of Washington found the virus had probably been circulating undetected for at least 6 weeks prior to 3/1 -- finding announced 3/1)

1/31
Azar (DHS) declares public health emergency. Among other things, this triggers FDA emergency use authorization (EUA) power.

Normally, hospitals and labs need FDA permission to use their own laboratory developed tests (LDTs). EUA power allows labs to move forward with test distribution and processing while the FDA reviews information about the test they submitted.

If the FDA had started exercising its EUA power 1/31, as they should have given the fact a public health emergency had been declared, labs at university medical centers, hospitals, private labs, etc., could have moved forward with their own tests or a version of the reliable test that was available on Jan 13. (FDA did not exercise this power until 2/29, as noted later in the timeline.)

2/3
China travel ban
After not testing anybody, and doing no screening on anybody for 3 weeks, DT issues a travel ban on China 2/3. Only returning Americans and foreign nationals with "pre-clearance" are allowed entry.

Selected airports are designated to receive planes and screen passengers as they come in. Anyone who visited China in the past two-weeks is screened. If they have symptoms they are told to go home and quarantine. No testing to determine actual status (because we don't have a test). Everyone else on plane already exposed. (More to it than that -- re-routing to original destination and whatnot.)

2/5
CDC finally begins distributing their "home grown" test.

Shortly after distribution begins, recipients find problems with the test. Apparently it has been distributed without proper quality control checks. Testing by states put on hold. States are directed to send samples to CDC. CDC has very strict criteria for testing to limit number of tests and resultant backlog. The number of people tested is extremely limited.

2/23
First community transfer confirmed in CA. (Virus has therefore been circulating, undetected, there, too.)

2/27
CDC has fixed the test issue. Most states still not getting kits. They continue being directed to send samples to CDC for testing with overly strict criteria. Even with limits and test "rationing" there are backlogs.

2/29
FDA finally begins to use its EUA power to empower labs to distribute/process tests independent of the CDC. A crucial four weeks has been lost.

2/29
DT expands travel ban to include Iran.

2/29
Governor Inslee declares state of emergency in WA (first state)

2/30
Cuomo declares disaster emergency in NY

3/1
With extremely limited testing, 42 cases in the US are confirmed. 2 deaths are attibuted to COVID-19.

People who have symptoms are directed to "self-quarantine."

3/3
Newsom declares state of emergency in CA.

3/8
497 cases have been confirmed. 22 deaths have been attributed to COVID-19. Test capacity continues to be so severely limited we really have no idea how many COVID-19 cases there are. Most states are still being directed to send tests to the CDC for processing. Backlog.

3/15
3,497 cases have been confirmed. 62 deaths attributed to COVID-19. Some states are ramping up testing, but a vast majority continue to face severe sample collection materials shortage and/or extremely limited test processing capacity. The limitations are so severe there is no way to estimate likely incidence per capita in most regions, or to create region-specific data-driven models. In absence of anything else, preparations are necessarily based on worse case scenarios everywhere.

Statewide closure orders begin with Inslee in WA ordering closure of all bars, restaurants, recreational and entertainment facilities. NY follows March 16, and CA follows March 17, with even more restrictive "Shelter in Place" orders. More detailed state-by-state action summary here.

3/22
29,046 cases. 300 deaths attributed to COVID-19.

[Ohioboy]

4. Wow, thank you

I looked around for this type of timeline but couldn't find it. Thank you for posting.

[pat_k]

5. Yes. All the failures were reported, but news cycles tend to...

Last edited Mon Mar 23, 2020, 06:43 PM - Edit history (1)

... focus only on the "latest" news, without context.

These days we only hear vague references to DT admin's slow response. I don't think this serves us. I think we need more widespread reporting of the timeline and details. That way, anyone paying attention would see how screw up upon screw up multiplied.

This wasn't just a "misstep" or two because no system is perfect. It was a disaster at every step.

Just imagine...

-- If the CDC had started sourcing and distributing sample collection materials the week of 1/13, and simultaneously moved to develop and distribute tests and testing supplies to public health entities (there are about 3000 of them) as rapidly as possible.

-- If the public health emergency had been declared 1/13 to empower more rapid preparation and response.

-- If the FDA had used its EUA power as soon as the public health emergency was declared to allow labs across the country to develop, distribute, and process tests.

-- If the public health emergency had conveyed the reality of what we were facing. (i.e., Had conveyed a clear picture of what would come if we failed to act, and act quickly. The grim reality was obvious as soon as it was clear how readily it was transmitted in China and how high the mortality rate was.)

-- If, in response to clear warnings, states and and feds had recognized the need to pass funding bills to get critical testing, tracing, and containment programs off the ground and create specialized task forces to coordinate across states and public health entities (A big job that requires dedicated management and staff -- something we still don't have).

-- If, as soon as testing was available, the power to order tests had been put in the hands of doctors and a public information campaign had been initiated to advise anyone having symptoms, or who suspected exposure, to seek testing.

Even if it took until the beginning of Feb to get "rolling," we would have been mobilized to detect cases that had been contracted in mid-January. With fewer cases to detect, public health entities would have been able to ramp up efforts to trace source and contacts of every case detected (and have time to bring personnel on board to make it possible to trace if/when numbers increased -- funded by those emergency bills).

Perhaps all this is too much to expect of any government, but I don't think so.

The first "sin" was the inability of the DT administration to confront the grim facts about the probable (if not guaranteed) consequences of failing to act early and quickly. In our interconnected world, it was ridiculous to think the crisis in China would somehow, magically, be be limited to China without action on the part of other nations. Effective containment required coordinated mobilization across national borders. Or, failing that, mobilization within our own borders.

Of course, I could be flat wrong and containment efforts would have failed, however early they had been initiated.

We'll never know because our government didn't bother to try.

[mainer]

6. Excellent. Thank you.

You compiled a timeline we need to keep in mind.