COVID-19 pandemic in the United States

"Tonight, @FLOTUS and I tested positive for COVID-19. We will begin our quarantine and recovery process immediately. We will get through this TOGETHER!"

"If you look at the therapeutics, which I’m taking right now, some of them, and others are coming out soon that are looking like, frankly, they’re miracles, if you want to know the truth, they’re miracles. People criticize me when I say that, but we have things happening that look like they’re miracles, coming down from God."

"Am I going out like Stan Chera?"

"I learned a lot about COVID. I learned it by really going to school. This is the real school, this isn’t the let’s-read-a-book school. And I get it and I understand it and it’s a very interesting thing and I’m gonna be letting you know about it."

"Flu season is coming up! Many people every year, sometimes over 100,000, and despite the Vaccine, die from the Flu. Are we going to close down our Country? No, we have learned to live with it, just like we are learning to live with Covid, in most populations far less lethal!!!"

"I will be leaving the great Walter Reed Medical Center today at 6:30 P.M. Feeling really good! Don’t be afraid of Covid. Don’t let it dominate your life. We have developed, under the Trump Administration, some really great drugs & knowledge. I feel better than I did 20 years ago!"

"REPEAL SECTION 230!!!"

"We know that we could have done better. China, faced with the first outbreak, chose strict quarantine and isolation after an initial delay. These measures were severe but effective, essentially eliminating transmission at the point where the outbreak began and reducing the death rate to a reported 3 per million, as compared with more than 500 per million in the United States. Countries that had far more exchange with China, such as Singapore and South Korea, began intensive testing early, along with aggressive contact tracing and appropriate isolation, and have had relatively small outbreaks. And New Zealand has used these same measures, together with its geographic advantages, to come close to eliminating the disease, something that has allowed that country to limit the time of closure and to largely reopen society to a prepandemic level. In general, not only have many democracies done better than the United States, but they have also outperformed us by orders of magnitude."

"Bob Woodward’s second book on Donald Trump commanded attention when it was released in September 2020. Based upon seventeen conversations the president freely undertook with America’s most famous investigative journalist,[3] as well as discussions with administration officials and Republicans in Congress. Rage turned the COVID-19 story upside down when it reported Trump’s recorded declaration on March 19, 2020 that he had known from the start that a pandemic was going to savage America, but he publicly denied it for months, he said, to prevent panic. Many people apparently believed Trump because the explanation was so utterly damning to him it seemed he never would have made it up to protect himself. After all, he was confessing to being someone in a rooming house who discovered the building was on fire, and then told no one because he did not want the victims to panic. So the sheer idiocy of the rationalization, oddly enough, gave it verisimilitude. But one can find a straighter explanation of the president’s behavior that fits him to a T. The “prevent panic” excuse was actually less damaging to Trump than the truth, which was that he had ignored a whole bucket of warnings for weeks about what was going to happen. He not only kept denying the “building” was on fire, he just let it burn away. And when the fire department came to the door, he sent it away."

"What Did the President Know and When Did He Know It? COVID-19 appeared in Wuhan, China in December 2019 and the government, as it had some years earlier with the SARS virus, hid this from the rest of the world. But by December 31 China described mysterious “pneumonia” cases in Wuhan to the World Health Organization. The U.S. Center for Disease Control immediately tried to get more information from Chinese medical authorities, who stonewalled. The CDC nevertheless noticed the disease was quickly spreading, and by January 13 a case turned up in Thailand. The virus evidently could pass from person to person. So on January 18 the CDC instituted screening of all air passengers arriving from Wuhan in Los Angeles, San Francisco, and New York. On this same day the Secretary of Health and Human Services, Alex Azar, telephoned Trump at his Mar-a-Lago home in Florida to explain how serious a threat the disease posed to the United States. Trump however proved uninterested and changed the subject. On January 21 a Seattle man recently returned from Wuhan became America’s first known COVID-19 patient and the next day Trump made his first statement on the disease, dismissing its importance: “It’s one person coming in from China, and we have it under control. It’s going to be just fine.” When more cases appeared, he tweeted on January 24 “It will work out well.” But on January 28 Trump’s Chief Trade Advisor Peter Navarro sent a memo around the West Wing warning the virus could have very dire consequences. Azar phoned Trump again that day to warn him of the disaster afoot, and was again rebuffed. But that afternoon Trump met with the top officials of the National Security Council and was told the new coronavirus would be the biggest national security threat he would face in his presidency. That got his attention, but he still did nothing."

"I don’t think I’m contagious at all."

"All the king’s horses and all the king’s men in the Oval Office agreed that the United States had to keep persons from China from entering the country. Trump agreed, and that night he issued his “Travel Ban on China.” Trump has ladled glory on himself from stem to stern for issuing this proclamation, saying everyone in the room was against the travel ban but he insisted on it to protect the country. (It’s a good example of how he often lies by completely reversing the facts. Doing it that way takes very little mental effort.) Actually, it looks like the CDC packed the Oval Office with over a dozen Trump advisors to force him to take the matter seriously. Smaller groups could not penetrate his willful blindness.) Moreover, the “China ban” fits distinctly sideways with Trump’s story that he had lied to Americans to keep them from panicking. Declaring a travel ban, and insisting Americans returning from China be quarantined, definitely implies an invisible, spreading danger. Furthermore, if you believe Trump actually knew “all along” the country was in danger but played (COVID-19) down to prevent panic, why did he leave America unprotected when he could have quietly prepared the country for the pandemic heading its way? For example, the Department of Health and Human Services asked the White House’s Office of Management and Budget for $136 million at the end of January and at the beginning of February to combat the disease, and was refused both times. Later Trump would complain that the Obama administration had left the shelves bare of testing materials, respirators, and so on. If this were true, would restocking the shelves have induced panic? Hardly. As many governors and mayors learned later, the president did almost nothing, even “on the quiet,” to prepare the nation he led for the crisis ahead. I think instead that the “candid admission” to Woodward of lying about the danger from the start was just the best lie that Trump could hit upon to cloak his real motivation, which was even more damning, namely to keep the road to his re-election smooth and straight. He had planned from Day One to run on a flourishing national economy, and here his medical advisors were talking closures, quarantines, and self-isolations that would slow everything down to a crawl, and drive the re-election bus into the ditch. So he decided instead to tell the American people they were perfectly safe and life should continue as usual. As the infection spread and began overwhelming the healthcare system, he retreated to saying “Never mind, the virus will disappear once the weather warms up,” which he probably got from some fringe news source."

"As many have noted, Donald Trump has a startling inability to accept reality when he wants to believe something else, for reasons I tried to explain in Authoritarian Nightmare. He will seek out bizarre sources and toady yes-men to help him lie to himself. He wanted the virus to just go away, so he believed it would be killed by April warmth, or be cured by hydroxychloroquine, or destroyed by bleach, or be prevented by a vaccine that would be ready by October. And no sooner had he finally admitted how serious the situation was, he began pressuring states to “reopen” and return to normalcy, which some did to their sorrow. And he insisted on holding normal political re-election rallies and discouraging the wearing of masks and forcing schools to open in the fall and pushing poorly tested vaccines on the public to rejuvenate the economy and buoy his chances for re-election. Blaming China. President Trump needed a scapegoat as well as sacrificial lambs. He teed up China, saying he had secret evidence it had created the virus and then negligently allowed it to spread around the world. He had been deceived by China’s President Xi early on, he explained, who had assured him over the phone that the disease was under control. Trump called him on February 6, offering to send CDC scientists to China to help eradicate the disease. He thought Xi would agree to this previously rejected offer because he and the Chinese leader had a personal relationship. But Xi was uninterested. He did give the impression that everything was under control in China, according to Matt Pottinger, Deputy Director of the National Security Council who listened in on the call (Rage, pp. 241-243). But China had taken dramatic steps to control the disease. By February 6, Wuhan and the province it sat in had been isolated from the rest of China and locked down with stringent quarantine regulations for two weeks. Some 40,000 healthcare workers had been sent to the area, hospitals were being rapidly built, and the infection curve was flattening out. The Chinese government certainly did nothing to stop the spread of the disease abroad for a long time. But virologists around the world are virtually unanimous that COVID-19 evolved in nature, and was not manufactured in a laboratory. The United States became the world leader in coronavirus deaths not because Xi lied to Trump about how well China was containing the threat, but because Trump ignored for weeks and weeks the strongest warnings from his own experts to defend the country, and then most purposefully lied to the American people himself about what they should do. The blood is on his hands more than on anyone else’s, and deep down inside, beneath layers of excuses, denials, blame-shifting, and rationalizations, he probably knows it."

"...if you look at mortality rates it's up 95%, or 85%..."

"In a spring meeting, Birx seemed fixated on applying the lessons of HIV/AIDS in a small African nation to COVID-19 in the United States, says a CDC official who was present. “Birx was able to get data from every hospital on every case” in Malawi, the official says. “She couldn’t understand why that wasn’t happening in the United States” with COVID-19. Birx didn’t seem to see the difference between a slow-moving HIV outbreak and a raging respiratory pandemic. “[CDC Principal Deputy Director] Anne Schuchat had to say, ‘Debbi, this is not HIV.’ Birx got unhappy with that.”"

"My plan: we’re gonna crush the virus very quickly. It’s happening already. It’s happening. And Mexico is paying for the wall, by the way. You know that. I’ve been saying it. They hate to hear that. But they’re paying. We passed VA Choice."

"I’m OK with masks. I tell people, wear a mask. But just the other day they came out with a statement that 85% of the people that wear masks catch it."

"Fauci is a disaster. People are tired of coronavirus. People are tired of hearing Fauci and all these idiots."

"We're not entering a dark winter, we are entering the final turn and the light at the end of the tunnel"

"We believe we can reduce overall healthcare costs. The pandemic has accelerated elements of our transformation."

"We’re rounding the turn,our numbers are incredible."

"COVID COVID COVID.. we are rounding the turn all they want to talk about is COVID by the way on Nov 4 you won't be hearing much more about it..Cases are up because we TEST TEST TEST"

"Out of what should be an incredibly positive story, [the IRS] just kept getting black eye after black eye after black eye"

"You know in Germany, if you have a bad heart and you’re ready to die, or if you have cancer and you’re going to be dying soon and you catch Covid, that happens: we mark it down to Covid. You know, our doctors get more money if somebody dies from Covid. You know that, right? I mean our doctors are very smart people. So what they do is, they say, "I’m sorry, but you know everybody dies of Covid." But in Germany and other places, if you have a heart attack, or if you have cancer, you’re terminally ill, you catch Covid, they say you died of cancer, you died of a heart attack. With us? When in doubt, choose Covid. Now, it’s true. Now, they’ll say ‘oh, it’s terrible what he said’, but that’s true. It’s like $2,000 more."

"In late 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first detected in China and has since caused a pandemic of coronavirus disease 2019 (COVID-19). The first case of COVID-19 in New York City was officially confirmed on 1 March 2020 followed by a severe local epidemic1. Here, to understand seroprevalence dynamics, we conduct a retrospective, repeated cross-sectional analysis of anti-SARS-CoV-2 spike antibodies in weekly intervals from the beginning of February to July 2020 using more than 10,000 plasma samples from patients at Mount Sinai Hospital in New York City. We describe the dynamics of seroprevalence in an ‘urgent care’ group, which is enriched in cases of COVID-19 during the epidemic, and a ‘routine care’ group, which more closely represents the general population. Seroprevalence increased at different rates in both groups; seropositive samples were found as early as mid-February, and levelled out at slightly above 20% in both groups after the epidemic wave subsided by the end of May. From May to July, seroprevalence remained stable, suggesting lasting antibody levels in the population. Our data suggest that SARS-CoV-2 was introduced in New York City earlier than previously documented and describe the dynamics of seroconversion over the full course of the first wave of the pandemic in a major metropolitan area."

"This will be our ."

"In pre-ACA days, a bout with a virus might not have been considered a preexisting condition. That's because many people tend to recover quickly from viruses. But in a blog post last week, researchers at the Rand Corp. suggested that COVID-19 could be seen differently by insurers. "Given the chronic problems [which can include organ damage, fatigue and confusion] associated with some COVID-19 cases, it is possible that some insurers would place restrictions on anyone who had a confirmed case of COVID-19," wrote Carter C. Price, Rand's senior mathematician, and Raffaele Vardavas, a mathematician at Rand who specializes in infectious disease models. The researchers said that exclusion might also extend to people who didn't have a positive coronavirus test but did test positive for antibodies to the virus, which indicates they had it or were previously exposed. "While a mild case of COVID-19 might not be subject to a preexisting clause, that would be up to insurers to determine," said Karen Pollitz, senior fellow, health reform and private insurance at the Kaiser Family Foundation."

"Someone who developed anxiety and/or depression since the start of the pandemic might also be considered to have a preexisting condition. Twenty years ago, Kaiser surveyed health insurance underwriters and asked about a similar situation: a hypothetical applicant in perfect health except for "situational depression" following the death of a spouse. According to the survey, "in 60 applications for coverage, this applicant was denied a quarter of the time, and offered coverage with a surcharged premium and/or benefit exclusions 60% of the time." So both experts and consumers are concerned that invalidating the Affordable Care Act could mean that once again, individuals with preexisting conditions might not be covered — and such conditions could include COVID-19."

"If the CDC was worried about a shortage of ultra-cold freezers, it hasn’t happened yet. One company, Helmer, reached capacity and now can’t deliver new freezers until March but, for the most part, suppliers are delivering ultra-cold freezers in two to six weeks, said Behlim. Much like for vaccines, though, the distribution of ultra-cold freezers isn’t even across the country. One local Wisconsin hospital looked into acquiring freezers, said Size, but was told delivery would take two to three months. Larger hospitals with the budgets for multiple purchases come first, he said. “It’s another good example of how all our rural hospitals are at the end of a supply chain with less leverage to make important purchases,” he said. “It’s the wild west of the supply chain; that’s not how you fight a pandemic.”"

"Rural populations are precisely those that are vulnerable to Covid-19 and most in need of a vaccine, noted Morgan: “Hundreds of rural, small towns all across the U.S. have a higher percentage of elderly, low-income [residents], a higher percentage of the community with multiple chronic health issues.”"

"I don't think it's unlikely in the next week or two that we won't be having a million cases a week in this country."

"Please cancel these in-person dinners, @SpeakerPelosi & @kevinomccarthy to keep everyone safe from #covid19 - yourselves, your new members, servers, the Capitol police and all of their families and contacts. And, to show public health leadership."

"New Mexico is at the breaking point."

"We are in the worst moment of this pandemic to date. The situation has never been more dire. We are at the precipice and we need to take some action."

"The only way this stops is if people rise up. You get what you accept. #FreedomMatters #StepUp"

"New York City has reached the 3% testing positivity 7-day average threshold. Unfortunately, this means public school buildings will be closed as of tomorrow, Thursday Nov. 19, out an abundance of caution."

"We must fight back the second wave of COVID-19."

"I've never seen a particular situation during my professional experience anything like this..."

"I'm not convinced at all that we have enough information to know how to deal with this type of problem"

"The incoming Biden administration must be prepared to tackle the COVID-19 pandemic head on and distribute a vaccine to over 300 million people in a short amount of time"

"The more the president elect and the president are speaking from the same playbook, the more confidence folks will have taking that vaccine"

"Numerous polls suggest that COVID-19 is a profoundly partisan issue in the United States. Using the geotracking data of 15 million smartphones per day, we found that US counties that voted for Donald Trump (Republican) over Hillary Clinton (Democrat) in the 2016 presidential election exhibited 14% less physical distancing between March and May 2020. Partisanship was more strongly associated with physical distancing than numerous other factors, including counties’ COVID-19 cases, population density, median income, and racial and age demographics. Contrary to our predictions, the observed partisan gap strengthened over time and remained when stay-at-home orders were active. Additionally, county-level consumption of conservative media (Fox News) was related to reduced physical distancing. Finally, the observed partisan differences in distancing were associated with subsequently higher COVID-19 infection and fatality growth rates in pro-Trump counties. Taken together, these data suggest that US citizens’ responses to COVID-19 are subject to a deep—and consequential—partisan divide."

"In the current pandemic, epidemiologists and public health officials have strongly encouraged people to physically distance from one another. Numerous studies have shown that physical distancing effectively stopped the exponential spread of COVID-19 at its onset, preventing the inundation of healthcare providers and saving numerous lives. To determine whether physical distancing differs as a function of partisanship, we examined whether the political leaning of over 3,000 counties in the United States is linked to the extent to which residents of those counties practised physical distancing behaviours during the first few months of the pandemic (March–May 2020). Specifically, we analysed the aggregated Global Positioning System (GPS) coordinates of approximately 15 million people across the United States per day (tracked via smartphone location coordinates) to quantify the degree of physical distancing in each US county. Physical distancing was measured in terms of reduction in general movement and reduction in visiting non-essential services (for example, restaurants). Furthermore, to examine the association between party identity and public health, we tested whether partisan differences in physical distancing mediate the relationship between partisanship and COVID-19 infection and fatality growth rates. Critically, in testing these questions we anticipated that what could appear to be partisan differences in physical distancing may actually reflect social or economic third variables. For instance, liberal areas in the United States experienced higher levels of COVID-19 infections and fatalities at the start of the pandemic (early March 2020) and thus may have perceived COVID-19 as more dangerous and engaged in greater preventative measures. To account for this and other possible explanations, we included numerous covariates in our models when testing partisan differences in physical distancing and health outcomes."

"We found that the more a county favoured Donald Trump over Hillary Clinton in the 2016 election, the less that county exhibited physical distancing between 9 March and 29 May 2020. Specifically, for every 1 percentage point increase in vote share for Donald Trump over Hillary Clinton, counties exhibited 0.11 percentage points less physical distancing in terms of reducing their general movement and 0.13 percentage points less physical distancing in terms of reducing their visiting of non-essential services. Model marginal R2 was 0.46 for the movement model and 0.54 for the visitation model. Collapsing counties into pro-Trump versus pro-Clinton bins, Trump-voting counties reduced their general movement 9.5 percentage points less and reduced their visiting of non-essential services 19.4 percentage points less than Clinton-voting counties (average reduction, 14.5 percentage points) across the study duration. Illustrating the relative power of the observed links, partisanship was more strongly associated with physical distancing in our main models (when z-scoring all the included variables) than any of the other included variables (aside from the time terms, the weekend factor, and median age in the case of visitation). To put this into context, partisanship was more strongly associated with distancing than counties’ number of COVID-19 cases per capita, median income, percentage employment, average travel time to work, governor political affiliation, and racial make-up, as well as the other variables noted above. Additionally demonstrating the robustness of our findings, partisanship was associated with reduced physical distancing even after adjusting for the interactions between each of the included covariates and partisanship, when including in the analyses counties’ percentage of employment in various types of profession, when adding specific state policies to the analyses."

"Possibly, local stay-at-home policies attenuate the observed partisan differences in physical distancing because these policies send out clear signals about the dangers of COVID-19. In line with this reasoning, we predicted that state-level stay-at-home orders would potentially reduce the observed partisan differences. Our data did not support this prediction. The link between voting for Trump and reduced physical distancing was actually stronger when stay-at-home orders were in effect, as evidenced by negative interactions between vote gap (with higher values indicating greater pro-Trump lean) and state policy: Bmovement = −0.017, 95% CI [−0.022, −0.013], P < 0.001 and Bvisitation = −0.009, 95% CI [−0.016, −0.001], P = 0.030. These results align with recent work finding that Democratic counties responded more quickly to stay-at-home orders than Republican counties at the start of the pandemic. We considered the possibility that variability in state stay-at-home policies explains our findings rather than county-level partisanship. For instance, stay-at-home orders may have been more stringent and remained in place longer in Democratic states or in states with Democratic governors, in turn leading Republican-leaning counties (which are more common in Republican states) to exhibit less physical distancing. Three supplementary analyses argued against this possibility, however. First, our results remained when adjusting for whether state policies were in effect on a specific date, state governors’ political affiliation, and interactions between these variables and partisanship. Second, we also confirmed that our results remained when adding specific state policies (including closing restaurants, closing childcare, closing K–12 schools, closing non-essential business more generally, and closing religious institutions/gatherings), and the interactions between these policies and governor political party and partisanship, to our models. And third, while there was some variation in our findings between states, most states were in line with the population average of the observed partisan differences. In sum, though differences in state policies contribute to variation in county-level physical distancing, our results indicate that county-level partisanship nonetheless explains unique variance in physical distancing."

"The present work used the geotracking data of approximately 15 million people per day across the United States to examine whether partisan identity is linked to objective measures of physical distancing during the coronavirus pandemic. We found that Republican-leaning counties exhibited lower physical distancing than Democratic-leaning counties, both in terms of reducing their overall movement and reducing their visiting of non-essential services (e.g., restaurants, clothing stores). Counties that voted for Trump in the 2016 election exhibited a ~24% drop in general movement and visiting non-essential services between 9 March and 29 May 2020, while counties that voted for Clinton exhibited a ~38% drop (a 14% difference in physical distancing). Moreover, this partisan gap remained consistent after adjusting for numerous third variables, including counties’ number of COVID-19 cases per capita, population density, median income, wealth distribution, travel time to work, and racial and age make-up, among other factors. These data suggest that partisan differences in self-reported attitudes toward COVID-19 (refs) are mirrored by behavioural differences at the US county level."

"We also linked the observed partisan differences in physical distancing to COVID-19 infections and fatalities. Mediation analyses revealed that reduced physical distancing in counties was linked to a subsequent increase in COVID-19 infection and fatality growth rates roughly 17–23 and 25–31 days later, respectively. These results imply that Trump-leaning counties could have curbed their infection and fatality growth rates if they had distanced to the same degree as Clinton-leaning counties did. Such findings provide evidence that partisanship in the United States during the COVID-19 pandemic may have had meaningful—and severe—health-related consequences. Partisanship may therefore be an important risk factor during a public health crisis, one that is probably especially relevant when the electorate is highly polarized and leaders fail to generate bipartisan support for public health measures. The observed partisan differences appear to be relatively strong as well as highly robust. Partisanship was more strongly associated with physical distancing than most of the covariates included in our models, including more traditionally examined health-related variables such as economic and social indicators. The relationship between partisanship and distancing also held after statistically adjusting for numerous control variables, and for interactions between partisanship and these control variables. The robustness of these findings is consistent with findings from independent research groups who have also observed links between partisanship and physical distancing using different data sources. Taken together, these findings provide a more complete picture of partisanship during a pandemic and establish it as an important risk factor for COVID-19 in the United States."

"The observed partisan gap in physical distancing was not limited to the beginning of the COVID-19 pandemic. Although we had expected that this difference would attenuate as the pandemic worsened after 23 March 2020, we instead found that the partisan gap actually increased over time. We also expected that intervention by local government would attenuate the observed partisan differences. Again, instead we found that stay-at-home orders actually exacerbated the observed partisan gap; that is, stay-at-home orders appeared to be more successful in encouraging Democratic counties to physically distance than Republican ones. This difference may be driven by more Republican-leaning counties ignoring local stay-at-home orders in light of national messaging from right-wing media and federal leaders; or, Republicans may simply hold a greater distrust of government than Democrats. These issues require further investigation to determine how to intervene locally to ensure greater compliance with public health recommendations."

"In our view, a more likely, albeit partial, explanation for the observed results is media polarization or a ‘broadcasting effect’. Republican-leaning media outlets appear to have downplayed the dangers of the coronavirus as compared to more Democratic outlets. For instance, in early March, Fox News repeatedly claimed that the coronavirus was less dangerous than influenza and even referred to other media reports as a hoax (although some commentators took it more seriously than others, and the organization took the pandemic more seriously by mid-March 2020). Consistent with this messaging about COVID-19, we found that US counties that consumed more Fox News than Democratic-leaning outlets (MSNBC and CNN) exhibited less physical distancing. These findings also remained significant when controlling for counties’ partisanship in terms of 2016 voting. These results, along with self-report data indicating similar findings and evidence indicating a causal link between Fox News viewership and decreased social distancing, suggest that Republican-leaning media downplaying the virus at the start of the pandemic may have signalled to Republicans that they should not take the virus very seriously, in turn potentially in part causing the observed partisan differences. This possibility underscores the importance of considering communication and mass media when designing public health messaging."

"Finally, we consider that conservative versus liberal political ideologies may lead individuals to respond differently to threat or specifically to the threat of a viral pandemic. We find this conclusion unlikely, however, given that conservatives were actually more likely than liberals to report being worried about the potential spread of a different virus—Ebola—in the United States in 2014. As such, it seems that our findings are more likely to be driven by modelling the behaviour of political role models and political identity (that is, political group loyalty) than by political ideology (that is, political values). Indeed, Democrats are not only more likely than Republicans to say they prioritize stay-at-home orders, but this partisan difference is most pronounced among highly identified group members."