Did "public health" shut down rural Minnesota to save urban NYC? No.
Early on when virtually nothing was known about a disease that was massively flooding ERs (& morgues) around the world, US states implemented stay-at-home guidance for a few months to protect their hospitals.
Governors made those decisions, and they did weigh econ & other factors alongside.
Turns out it's not good economics for a hospital system to collapse!
And there was no reason to assume that what was hitting big cities wouldn't ultimately hit rural areas too.
BTW rural communities in 2020 had similar COVID death rates to urban metros.
Lower than huge cities, higher than other metro areas, and higher than the overall national average.
By early May 2020, the CDC (public health!) had prepared detailed guidance for risk-based, phased re-opening of schools, business, day cares, etc. Not a simple open/closed binary.
There was plenty of debate at the time about trade-offs. CDC actually did issue guidance on safely re-opening schools - which Trump then trashed publicly.
Rather than attempt to support and resource safe re-opening, he just pushed a return to normal ops. cnn.com/2020/07/08/pol…
The choice didn't have to be open vs closed: it could have been to invest in safely reopening schools (more testing, enhanced support to schools, etc etc). I wrote about this at the time:
Not going to further relitigate the schools debate here but the essential point is: these were not binary options.
Public health guidance sought to manage risk in order to reopen in a safe & incremental way.
Trump rejected that, and pushed a false binary choice.
So Collins gets the history wrong and the public health wrong. It was not "public health" pushing the choice between open vs closed, it was Trump.
"Public health" was trying to reconcile COVID precautions with restarting schools, biz, etc - and that guidance was shot down.
It's easy to second-guess hard decisions made in the fog-of-crisis period when stakes are high and good info is scarce. And plenty we should learn.
But don't rewrite history in the process...
There is a concerted disinfo effort on the right to undermine "public health" by blaming it for all COVID-related grievances and airbrushing what Trump and other pols actually did.
Collins' answer naively plays into that. Unfortunate.
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On claim after claim about @USAID / foreign aid, Elon is just making shit up as he goes along. No truth to any of it.
This claim is demonstrably false. Deaths have already been documented from the aid freeze. And the so called "sanity check" is a clown show of incompetence.
This is not a "brief pause." Aid orgs doing critical lifesaving work are being denied reimbursement for work already completed, and can't access USG payments to continue operations.
Many had their programs waived from the freeze, then terminated, then un-terminated.
A farce.
This is all hugely disruptive and the practical effect is global drawdown of lifesaving humanitarian and health activities.
Our @RefugeesIntl teams in the field over the past two weeks have documented widespread breakdowns of lifesaving relief operations in Syria & Bangladesh.
So - I've actually led Ebola outbreak response at @USAID.
This is bunk from Elon. They have laid off most of the experts, they're bankrupting most of the partner orgs, have withdrawn from WHO, and muzzled CDC.
What's left is a fig-leaf effort to cover their asses politically.
Normally there would be:
- resources rapidly pushed to partners & host govt
- robust interagency (USAID/CDC/DOD) teams deployed to field, backstopped by Ops Centers in DC and Atlanta
- real-time operational cooperation and info-sharing with WHO
It is clear as day that Marocco has made no effort to comply with multiple orders from the court to lift the arbitrary & capricious aid freeze.
He is likewise defying @SecRubio's order to waive lifesaving assistance.
Virtually no money has been unlocked by either order.
And Marocco's ongoing purge of @USAID personnel means it's functionally impossible to comply with these orders.
He and DOGE have pushed out nearly the entire workforce that would normally process these payments, knowing full well this makes compliance with the orders impossible.
Stephen Miller said on Fox today that USAID is a rogue slush fund. Trump & Elon have made the same accusation.
FALSE. They're either ignorant of how USAID spends money, or willfully lying about it. Or...
Anyway, caffeinate and read on.
🧵
Buckle in for a roller coaster ride through the USAID budget process. To keep you reading, I will use memes.
Step 1.
Every year, the White House (via OMB) puts together a federal budget proposal to Congress. Every federal agency (incl USAID) sends OMB their budget wishlist.
OMB goes over everything and begins cutting down Agency requests and reviewing them for alignment with the president's priorities.
So to be clear: every dollar that USAID requests from Congress goes through White House review.