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Posts published in “COVID”

Don’t Blame ‘Racism’ and ‘Inequality’ For Alleged Racial Disparities In the Coronavirus

Does racism and a lack of access to healthcare explain why African Americans are allegedly suffering disproportionately from the coronavirus?

Or instead, do lifestyle choices—including diet, exercise, and obesity—explain this alleged disparity? What about the fact that certain disease (sickle cell anemia, for instance) affect blacks more than whites, and for reasons that have nothing to do with racism?

And does race even matter? Is it a good way or prism through which to understand and address COVID-19?

Sadly, there is no shortage of media reporting, editorializing, and political pontificating purporting to blame “racism” and “inequality” for alleged differences in how the coronavirus is affecting black and white communities.

Political Agendas. So-called progressives and other leftists in the media and Democratic Party are eager to use and exploit whatever crisis they can to advance their left-wing agenda, and this pandemic offers an especially appealing vehicle right now.

“Progressives” and leftists are eager to blame racism for all manner of problems: because then they can use said racism as an excuse or justification to push for racial reparations and government wealth redistribution programs that they claim will benefit African Americans, but which really will give the government more power and control over our lives.

But as Zaid Jilani observes at National Review:

We are still in the early stages of this pandemic, and the research on this topic is as novel as the virus itself. [So] it’s difficult to draw hard conclusions about the causal factors that explain who gets the virus and who succumbs from it.

Exactly. Relatively few Americans, in fact, have even been tested for the coronavirus. The United States has administered fewer coronavirus tests per million people than Germany, Italy, Canada, and South Korea, Vox reports.

Yet, the New York Times published an article Tues., Apr. 7, 2020, arguing that “Black Americans Face Alarming Rates of Coronavirus Infection in Some States.” But as Jilani points out, 

Ironically, on the same day the New York Times published [this] article… New York City revealed age-adjusted numbers showing that Latinos, not African Americans, had the highest age-adjusted coronavirus death rate.

Perhaps this will bring about calls that the Times have should have reframed its article around Latino death rates rather than black ones. Maybe another newspaper op-ed will call the virus a “Latino plague,” at least in New York City.

The city’s data also showed that, despite claims from New York City’s Public Advocate that “New Yorkers of more color” are disproportionately at higher risk, the Asian-American death rate is actually lower than that of whites.

One way to look at this data would be to scramble the racial hierarchy being assembled by liberal activists and the news media—Latinos actually have it “worst,” and Asians, another ethnic minority—have it “best.” But that would simply replace one form of distorted thinking for another.

Moreover, even assuming that racial disparities exist—which, again, is a premature conclusion, given that we don’t yet know enough about the prevalence of the coronavirus nor its effects within different demographic groups—it is far from clear that such disparities are caused by “racism” and “inequality.”

Correlation, after all, is not causation. Consider, for instance, sickle cell anemia. As M. Laurence Noisette, M.D. writes:

Sickle cell disease, an inherited disorder of the red blood cells, is more common in African Americans in the U.S. compared to other ethnicities—occurring in approximately 1 in 365 African Americans… 

“Sickle cell trait,” likewise, “is an inherited blood disorder that affects approximately 8 percent of African-Americans,” notes the American Society of Hematology.

Unlike sickle cell disease, in which patients have two genes that cause the production of abnormal hemoglobin, individuals with sickle cell trait carry only one defective gene and typically live normal lives without health problems related to sickle cell.

Granted, COVID-19 is caused by a respiratory virus, the coronavirus; it is not an inherited blood disorder. So it seems very unlikely that genetic or biological factors would explain any racial disparities in either its incidence or effects.

But the point is that correlation can be explained any number of factors—including but by no means limited to the fact that different diseases sometimes affect various racial and ethnic groups differently.

Thus, seizing upon “racism” and “inequality” as explanations for alleged disparities is bad, sloppy, simplistic, and politicized thinking. And this is especially true when there are other legitimate and plausible explanations.

For example, as we reported here at ResCon1, and as the Washington Examiner’s Tina Lowe observed, “new data seems to indicate that obesity is itself a risk factor” for dying from the coronavirus.

Why does this matter? Because, according to the U.S .Department of Health and Human Services Office of Minority Health:

  • African American women have the highest rates of obesity or being overweight compared to other groups in the United States. About 4 out of 5 African American women are overweight or obese.
  • In 2018, non-Hispanic blacks were 1.3 times more likely to be obese as compared to non-Hispanic whites.
  • In 2018, African American women were 50 percent more likely to be obese than non-Hispanic white women.
  • From 2013-2016, non-Hispanic black females were 2.3 times more likely to be overweight as compared to non-Hispanic white females.
  • People who are overweight are more likely to suffer from high blood pressure, high levels of blood fats, diabetes and LDL cholesterol—all risk factors for heart disease and stroke.
  • In 2018, African Americans were 20 percent less likely to engage in active physical activity as compared to non-Hispanic whites.

Underlying health conditions that make the coronavirus more dangerous and more fatal—hypertension, diabetes, and heart disease, for instance—also are more prevalent within the African American community; and these, too, are caused in large part by obesity.

Does “racism” and “inequality” explain these disparities? I suppose to the racially obsessed, the answer is always yes.

But assuming that this overly simplistic explanation is even partially true, the reality is that, whatever racism exists, all of us—black, white, Hispanic, Asian, Jew, Christian, Muslim, Buddhist, Hindu, et al.—make daily choices in diet and lifestyle that dramatically affect our likelihood of being obese and of contracting high blood pressure, diabetes, and heart disease.

Disempowerment. And that is the biggest problem with obsessing over “racism” and “inequality” as politically convenient excuses for bad health outcomes: Doing so disempowers each of us and denies us agency over our own lives.

The truth is that all of us are in this together. We all face a pandemic that is truly international in scope, and which seriously threatens our very lives and economic well-being.

Dividing us up along racial lines to score cheap and unwarranted political points, while advancing a bad political agenda, is shameful and wrong. And it’s unsupported by the weight of the scientific evidence and data.

The coronavirus doesn’t discriminate; but all of us, certainly, should be more thoughtful and discriminating when it comes to blaming “racism” and “inequality” for the prevalence and effects of COVID-19 within different racial and demographic groups.

Feature photo credit: Data for Chinese COVID-19 deaths as of Feb. 11, 2020, Ruobing Su/Business Insider.

Obesity Explains Why Alarming Numbers of Young Americans Are Dying from the Coronavirus

I wrote a piece March 10 in which I argued that “obesity is a much more dangerous public health problem than the coronavirus.”

Four days later, I apologized for that piece because it wrongly “downplayed the risk of the coronavirus and criticized the resultant ‘public panic (or at least [the] media panic)” over COVID-19. 

”I was not entirely wrong,” I wrote. “For the vast majority of us, obesity is a much more dangerous public health problem than the coronavirus.”

Well, as it turns out, instead of looking at obesity and the coronavirus as two separate and distinct problems or causes of death, we should consider them as complementary partners in crime—as joint and interrelated causes of mortality: because, as the Washington Examiner’s Tina Lowe points out:

“New data seems to indicate that obesity is itself a risk factor” for dying from the coronavirus. “In France,” she notes,

more than 4 in 5 coronavirus patients in intensive care are overweight; and in Shenzhen, China, researchers found that obesity “significantly increases the risk of developing severe pneumonia” for coronavirus patients…

We also know that preexisting conditions—including hypertension, diabetes, and heart disease—contribute. Being overweight or obese are risk factors for all of those conditions…

This helps to explain why, relatively speaking, many more young Americans are dying from the coronavirus than are young people in other countries. As Lowe reports:

Stanford University researchers found that whereas those under 65 comprised 5% to 9% of all coronavirus deaths in eight major European epicenters, those younger than 65 have accounted for a staggering 30% of all coronavirus deaths in major U.S. hotbeds.

For those in New York City, the absolute risk for people under 65 of dying from the coronavirus has been nearly three times greater than those in Italy, seven times greater than those in Belgium, and 46 times greater than those in Germany…

It should come as no surprise, [then], that younger populations in the United States are being hit so hard. More than 1 in 3 Americans is obese compared to roughly 1 in 5 Italians, Belgians, and Germans.

It’s no big mystery. We’re just fat, and right now it’s a big problem.

Indeed, according to the Centers for Disease Control and Prevention (CDC), roughly 2.8 million Americans die annually; and, as Medscape reports:

Overweight and obesity were associated with nearly 1 in 5 deaths (18.2%) among adults in the United States from 1986 through 2006, according to a study published in the American Journal of Public Health. Previous research has likely underestimated obesity’s impact on US mortality.

Mathematically, this means that roughly 500,000 Americans die every year because of obesity (2.8 million x 18 percent = 504,000).

By contrast, the worst projections for the coronavirus initially said it would lead to as many as 200,000 American deaths, or less than half the number of deaths caused by obesity. 

National Public Radio, moreover, reports that, according to Dr. Anthony Fauci, the head of the National Institute of Allergy and Infectious Diseases, “the final toll currently ‘looks more like 60,000 than the 100,000 to 200,000’ that U.S. officials previously estimated.”

But again, my point here is not to minimize the coronavirus, which is far more insidious, sudden, and unpredictable than obesity. Instead, it is to point out that the prevalence of obesity in the United States makes the coronavirus a much more dangerous and potentially fatal problem, especially for young people.

The bottom line: while you’re at home sheltering in place under stay-at-home orders mandated by the government, be sure to limit your trips to the fridge and kitchen pantry, and be sure to get in a good home workout.

That way, if you do contract the coronavirus, you’ll have a much better chance of weathering the storm and coming out alive on the other side.

Feature photo credit: Daily Times.

Tests, Vaccines, and Medical Supplies: America Mobilizes to Combat the Coronavirus

Because the entrepreneurial spirit and rebellion against authority are part and parcel of our national and cultural DNA, you can never say America is down for the count.

Sure, things look bad right now; but it’s always darkest before the dawn. And Americans are not standing idly by and passively accepting their dire fate as predicted by the “experts.” Instead, they’re fighting back, and with notable, if underplayed and unheralded, success.

For example, Abbott Labs announced Friday that it has developed a new, portable test that can determine, within five to 13 minutes, whether someone is infected with the coronavirus.

The company expects to deliver 50,000 tests per day starting next week.

Scott Gottlieb, former head of the Food and Drug Administration (FDA), and a medical doctor who has been at the forefront of assessing the COVID-19 pandemic, calls the new test a “game-changer.” He says it’s very likely that other Point of Care diagnostic tests will soon be coming to market.

Point of Care testing is medical testing that can be done anywhere and not just in a hospital or laboratory setting.

Point of Care testing is critically important because it will facilitate rapid and comprehensive testing, which is integral to mitigation and containment strategies that will break the epidemic spread of the virus and allow Americans to return to work.

“If we know who is infected, who is not, and who has recovered, we could greatly relax social isolation requirements and send both the uninfected and the recovered back to work,” explain researchers Tim Searchinger, Anthony LaMantia, and Gordon Douglas.

Indeed, only “massive testing” of the entire U.S. population will allow us to avert “two disastrous and unsustainable scenarios,” they argue.

The first scenario involves essentially shutting down the U.S. economy for perhaps a year or more until a vaccine is developed.

The second scenario involves shutting down the U.S. economy (or major parts of the U.S. economy) intermittently in response to each new outbreak of the virus.

In either scenario, the result would be a severe recession, if not a great depression. And, “even with intermittent isolation,” write the researchers, hospitals likely “would be overwhelmed and many people would die.”

Thus says Gottlieb: “We need widespread testing to know where and to what extent the virus is spreading.”

Physicians, meanwhile, are making innovative, “off-label” use of hydroxychloroquine (an anti-malarial drug) and azithromycin (an antibiotic) to treat COVID-19 patients, and with promising results.

Medical researchers, likewise, are working round-the-clock to develop a vaccine, as clinical trials are underway and moving apace

“America is home to a vast, dynamic life-science industry,” says Gottlieb. “This is its moment. This is why decades of drug investment and development matter so much.”

The “arsenal of democracy,” moreover, is rapidly retooling to become the healthcare supplier of first resort.

Ventec Life Systems and General Motors, for instance, have teamed up to meet an urgent and unprecedented need for “FDA-cleared Level 1 surgical masks” and “sophisticated, high-quality critical care ventilators.”

“The companies are adding thousands of units of new capacity with a significantly expanded supply chain capable of supporting high volume production. GM is contributing its resources at cost,” the companies announced Friday.

Make no mistake: America was slow to realize the dangers of the coronavirus. We were caught flatfooted and unprepared. We did not realize what was hitting us.

But as Churchill famously said, “You can always count on the Americans to do the right thing—after they’ve tried everything else.”

We may not have tried everything else, but we’re certainly doing the right thing—or at least trying mightily to do the right thing. And that matters. That is why America is not yet done. Not by a long shot.

Feature photo credit: Abbott Labs in Temecula, California via Connect Media.

Trump Is Right About Cuomo’s Failure to Procure Ventilators, and the So-Called Fact Checkers Are Wrong

As we reported here at ResCon1, Tuesday, March 24, New York’s Democratic Governor, Andrew Cuomo, bears significant responsibility for his state’s lack of ventilators.

U.S. intelligence agencies and public health experts, we observed, warned Cuomo and other government officials years ago of likely pandemics that would overburden our hospitals and healthcare system.

A New York state task force, in fact, specifically warned Cuomo of the lack of ventilators during a pandemic. Cuomo, though, opted not to purchase the requisite number of ventilators.

These are all facts, not opinion or conjecture, and this a matter of public record.

What is a a matter of opinion is Cuomo’s assertion that Trump needs to “nationalize” the medical supply chain, because doing so would mean that 30,000 ventilators would suddenly be produced and descend upon New York State hospitals.

Trump, as we reported here at ResCon1, has wisely resisted Cuomo’s call to have the federal government take over the medical supply chain, because doing so would not solve anything.

Instead, nationalization would create more problems because the government is inept at running commercial businesses. That is simply not a public-sector comparative advantage. 

Trump, meanwhile, hit back against Cuomo in a Fox News virtual town hall:

This [article] says that New York Governor Cuomo rejected buying recommended 16,000 ventilators in 2015 for the pandemic—for a pandemic; established death panels and a lotteries instead.

So he had a chance to buy, in 2015, 16,000 ventilators at a very low price and he turned it down.

I’m not blaming him or anything else, but he shouldn’t be talking about us. He’s supposed to be buying his own ventilators. We’re going to help.

But, you know, if you think about—if you think about Governor Cuomo, we’re building him four hospitals. We’re building him four medical centers.

We’re working very, very hard for the people of New York. We’re working along with him, and then I watch him on the show, complaining. And he had 16,000 ventilators that he could have had at a great price and he didn’t buy them.

As a result of these comments, two news organizations, The Dispatch and FactCheck.Org, have published overly long, tendentious, and convoluted criticisms of Trump for allegedly not telling the truth about Cuomo and the ventilators. But their criticisms really miss the mark and are beside the point.

FactCheck.Org flags Trump for charging that, because New York failed to purchase more ventilators years ago, it would be forced to employ a “lottery system” and “death panels” to ration the use of available ventilators. This is “misleading,” they argue.

Moreover, says FactCheck.Org, the New York State task force that looked into the matter in 2015 “did not recommend whether the state should buy more ventilators (and hire the staff necessary to operate them).”

But this is splitting hairs. As Betsy McCaughey explains in the New York Post,

In 2015, that task force came up with rules that will be imposed when ventilators run short.

Patients assigned a red code will have highest access, and other ­patients will be assigned green, yellow or blue (the worst), ­depending on a “triage officer’s” decision.

In truth, a death officer. Let’s not sugar-coat it. It won’t be up to your own doctor.

Exactly. Let’s not sugar-coat it. As for the reference to a “lottery system,” that came from a Feb. 27, 2020, New York Times article:

The task force that issued the report devised a formula, relying partially on medical criteria, to help hospitals decide who would get ventilators and who would not.

It also envisioned a lottery system in some instances. And age could play a role, with children being given preference over adults.

Rationing. But the larger-scale point, which we made here at ResCon1 is this: without more ventilators soon, ventilators will have to be rationed, and that means deciding who will live and who will die.

Call it what you will, that is a problem—a big and serious problem. 

And whether the task force recommended that the state buy more ventilators is immaterial. The reality is that, as Governor of New York State, Cuomo has a responsibility to safeguard the health and safety of his people, the residents of New York. He failed.

He failed by not buying more ventilators—even though he had been warned of this problem, and even though he had been warned about the likelihood of a pandemic that would require many more ventilators. 

Maybe he failed for good reason: because the tradeoffs were too difficult and too stark. Still, he failed. As governor, the buck stops with him.

The Dispatch, meanwhile, complains that “Trump provided no evidence to support his claim that Cuomo could have had the ventilators ‘at a very low price’ in 2015, and that Cuomo ‘turned it down.’”

But cost, too, is really immaterial. When it comes to public health, government has an obligation to spend whatever it takes to protect the health and well-being of their people—us.

That is a fundamental and non-negotiable obligation of the state.If government officials think the cost of public health is too high or prohibitive, then they should say so, clearly and publicly.

That way, we can openly and rationally discuss and debate the tradeoffs involved, our public policy and spending priorities, and what level of risk we, as a society, are willing to assume.

In any case, Trump was echoing what McCaughey argued in her New York Post piece. “In 2015,” she wrote,

the state could have purchased the additional 16,000 needed ventilators for $36,000 a piece, or a total of $576 million. It’s a lot of money, but in hindsight, spending half a percent of the budget to prepare for a pandemic was the right thing to do.

The Dispatch also gets lost in the weeds on the origins of the New York State task force and its precise findings; but this is all background noise and beside the point.

The bottom line is this: Cuomo was warned of a problem and yet, he did not act.

But what’s done is done. What matters now is: where do we go from here? How do we ramp up production and delivery of ventilators to New York and other states that are suffering most from the coronavirus?

The most obvious place to begin is with the Strategic National Stockpile, “the government reserve meant to fortify overwhelmed hospitals in a crisis.” But that stockpile has only 16,600 ventilators, reports the Center for Public Integrity—far fewer than the 64,000 to 742,000 that might be needed.

In truth, only an unleashed and unchained private sector free to innovate can possibly produce the requisite number of ventilators quickly enough to meet the anticipated demand. Fortunately the Trump administration is relaxing the regulatory burden and companies are stepping up to produce.

A company called Prisma Health, for instance, is using 3D printing to manufacture a new ventilator model that can support up to four patients simultaneously.

The company says that it “has received emergency use authorization” from the Food and Drug Administration (FDA) and is working with “COVID-19 [treatment] teams who have no more ventilator capacity, and who can initiate emergency use of the prototype.”

The good news, reports the Wall Street Journal’s William McGurn, “is that players in the private sector… have already been in touch with one another to see how they might team up.”

For example, he writes, before the coronavirus hit, one company’s “peak output was roughly 150 ventilators a month.” However, within the next 90 days, they expect to increase that to 1,000 ventilators a month.

“It won’t be easy [nor will it happen] overnight,” says Chris Kiple, “but it can be done.”

Mr. Kiple is CEO of Seattle-based Ventec Life Systems. He says Ventec is one of about a dozen players in the global market for ventilators, only about half of which are U.S.-based companies.

“Ventec,” McGurn writes, recently

announced it will work in partnership with General Motors. The idea is to combine GM’s experience of mass-production manufacturing with Ventec’s technology.

Mr. Kiple says the partnership will mean getting “more ventilators to more hospitals much faster.” The president tweeted Sunday, [March 22, 2020]: “Go for it auto execs.”

Feature photo credit: NY1

Only the Private Sector Can Deliver the Ventilators NY Gov. Cuomo Says He Needs to Combat the Coronavirus

The severe shortage of ventilators in the United States to cope with the anticipated wave of coronavirus patients who will require them illustrates what government can and cannot do—or at least should and should not do.

The government should plan and prepare for likely or predicted pandemics and other potential mass-scale medical emergencies by ensuring that hospitals and healthcare providers have the necessary supplies and equipment that they need to treat and care for patients.

I say likely or predicted pandemics because we obviously cannot anticipate every possible medical emergency. And it is not practical, feasible, or economical to prepare for everything that might happen, no matter how unlikely or remote.

But the truth is: the coronavirus is a pandemic that we were warned was coming, and which our elected representatives should have anticipated and prepared to combat. As NBC News’ Ken Dilanian reports:

For years, American intelligence agencies have been warning about the increasing risks of a global pandemic that could strain resources and damage the global economy, while observing that the frequency and diversity of global disease outbreaks has been rising.

In a worldwide threats assessment in 2018 and 2017, intelligence analysts even mentioned a close cousin of the current COVID-19 strain of coronavirus by name, saying it had “pandemic potential” if it were “to acquire efficient human-to-human transmissibility.”

For this reason, writes Betsy McCaughey in the New York Post, a New York State task force found, in 2015, that the state had “16,000 fewer ventilators than the 18,000 New Yorkers would need in a severe pandemic.”

Yet, state officials decided not to buy these 16,000 ventilators. The governor of New York at the time: Democrat Andrew Cuomo.

Ventilators. This is the same Andrew Cuomo who has been eloquent about his state’s need for 30,000 ventilators. Otherwise, he warns, hospitals in New York risk being overwhelmed with coronavirus patients.

And, if that happens (as it already has happened in Italy), hospitals and physicians will be forced to make heart-wrenching decisions about who gets a ventilator and who does not—meaning who gets to live and who does not.

Of course, it never should have come to this. State officials like Cuomo should have heeded the warnings of public health experts years ago and prepared for this foreseeable and predicted pandemic.

But we are where we are. What, then, is to be done?

Unfortunately, there are no quick and simple solutions. It takes time and money to manufacture ventilators, and, as Cuomo himself admits:

You can’t find available ventilators no matter how much you’re willing to pay right now, because there is literally a global run on ventilators.

For this reason, Cuomo and his left-wing allies in the media and in Congress want the federal government to provide the ventilators; and they fault Trump for allegedly not using the full powers of the presidency to make it happen.

They specifically fault Trump for supposedly failing to invoke the Defense Production Act to manufacture ventilators.

“I do not understand the reluctance to use the federal Defense Production Act to manufacture ventilators,” Cuomo tweeted. “If not now, when?”

But as the Wall Street Journal points out, Trump already has invoked the 1950 Defense Production Act

that lets a President, during a national emergency, order business to manufacture products for national defense, set wage and price controls, and allocate materials.

On Tuesday the Federal Emergency Management Agency used the Korean War-era law for the first time in this crisis to procure and distribute testing kits and face masks…

[But] businesses know their workforce capacities and supply chains better than the government—and how to retool them to maximize efficiency…

Ford said on Tuesday that it would start assembling plastic face shields and work with 3M and GE to make respirators and ventilators.

General Motors is also exploring how to use its global automotive supply chain to make ventilators.

Ford’s CEO said its ventilators could be available by June, and it isn’t obvious that a government takeover of manufacturing would speed this up,

In short, having the government order or mandate something doesn’t magically make it happen. If that were the case, the Soviet Union would have won the Cold War and we’d all be speaking Russian.

Private-sector companies and manufacturers, moreover, already are stepping up in a big way to provide ventilators, masks, gowns, nose swabs, and other critical health gear and equipment needed to combat the coronavirus. And the Trump administration is watching and prodding them as best it can.

Private Sector. Cuomo says that “only the federal government has the power to deliver” the ventilators. But this is nonsense and shows how little Cuomo knows. In truth, only the private sector has the power to deliver—and it will if the government lets it.

Indeed, contra Cuomo, what is needed is not nationalization of the medical supply chain, but rather deregulation of the medical supply chain. This so that private sector companies are free to innovate and rapidly produce the supplies and equipment that our healthcare professionals need.

And, on that score, there is some good news. Reason magazine’s Scott Shackford reports 

The Food and Drug Administration (FDA) is easing up on some regulations so that ventilators can be manufactured and implemented more quickly to respond to the spread of COVID-19.

In new guidance issued on Monday, the FDA said that it will practice “enforcement discretion” by allowing manufacturers of ventilators to allow for some modifications of hardware, software, and materials.

This allows manufacturers more flexibility in response to supply shortages that could keep them from ramping up production.

The new guidance will also allow for the quicker addition of new production lines and alternative production locations.

[In other words], if other companies that have space to install production lines of their own (GM, for example, has offered unused space in its shuttered plants) those companies are free to do so. 

In short, Cuomo has identified a real problem that he had it in his power to address years ago. However, he lacked the foresight and wisdom to do so. Thus he now urges the federal government to act. But he misdiagnoses the problem, and his recommend cure is no cure at all.

The best thing the government can do is to identify early on big issues and problems that need to be addressed, and then leave the private sector free to experiment and innovate its way toward a solution.

They know, far more than the state bureaucracy, what must be done to get us out of our logjam.

In the meantime, let us hope and pray that the entrepreneurs and the captains of industry can act quickly enough to ensure that, in the weeks and months to come, no American who needs a ventilator is denied a ventilator.

Feature photo credit: Associated Press via Salon.