How to Get Us Back to Normal and Prevent Us from Being Controlled by Foreign Nations

Please note things are moving fast and we are updating this plan as often as time allows us.  It was first drafted on March 10th and updated: March 20th and April 3rd.

We will continue to update as we move forward.

Summary of Action Plan

With this plan of action, we can protect lives and become less dependent on foreign nations.  This plan can all be accomplished in a manner that ensures our economy is not crippled during the next global pandemic.  We need a clear understanding of what we have done well and what we could have done better. No blame is assigned because that prevents us from learning how to improve. 

 

To ensure we can implement this plan, we push back against special interest groups that would rather protect their own interest by sacrificing the health and economy of the American people. 

I believe if we are honest, transparent, and direct, we can work towards a common goal and achieve anything. And if we work towards REAL SOLUTIONS we can safely return to our normal lives and prepare for the future. 

Dr george flinn logo small for web-01 (1

- Dr. George Flinn

Conservative Republican

U.S. Senate Candidate

"China and other nations supply too much of our critical medical supplies. Depending on other nations to supply our critical needs has proven again, we need to take action. It is time to make our critical supplies here at home."

The first series of solutions deals directly with COVID-19 and determining who is safe and who is still at risk.  Thereby allowing “safe” groups that can neither infect others nor become infected to return to their normal routine. 

 

The second series of solutions make certain that we are ready for the next possible outbreak.  We will also become less dependent on foreign countries for our critical infrastructure items.  These solutions begin the process of work towards the ultimate goal of us returning to our normal lives now and protecting us from this type of disaster and future hardships.

 

The road to return to normalcy will be longer than anyone wants. Remember, it took 40-50 years of neglect to get us here, but the road back, if we work together on these solutions, will be much shorter. Progress will reward us now and in the future.

 

“The best time to plant a tree was 20 years ago; The second-best time to plant a tree is NOW!”

Goals

  • Protect lives.

  • Get Americans back to normal as safely and as quickly as possible.

  • End our dependence on foreign countries for our critical infrastructure needs.

  • Hold nations accountable that withhold information that results in harm to our citizens.

  • Prepare for future pandemics in a way that will not derail our lives.

Summary of Solutions

A. Right to sue foreign nations - Enact an exception to sovereign immunity for the health and welfare of our citizens.

  • Expand the Foreign Sovereign Immunities Act (FSIA) of 1976. This is a United States law, codified at Title 28, §§ 1330, 1332, 1391(f), 1441(d), and 1602–1611 of the United States Code, to allow an exception to sovereign immunity for the health and welfare of its citizens by requiring the free open and timely exchange of information that may harm our citizens. 

  • Amend all treaties to allow an exception to sovereign immunity for the health and welfare of its citizens by requiring the free, open, and timely exchange of information that may harm our citizens.

 

B. ​Initiate more comprehensive testing beyond the Nasal Swab Test that will allow many of us to return to normal. 

Specifically, initiate Blood Serology tests in addition to nasal swab tests. With both tests, we can determine who has an active infection, who may have already developed immunity to COVID-19, and those who are susceptible to the virus with no immunity.

 

C. End our dependence on Foreign Countries for our critical needs.

 

  • Support President Trump’s “Buy America” Executive Order that adjusts the bidding process that evaluates how the U.S. Government buys its products.

  • Leverage the U.S. Government’s $500 billion dollars a year buying power to get companies to move the production of “critical” goods and services back to the United States.

 

D. Fully fund and fill the National Strategic Medical Stockpile

 

E. Jobs in the New Economy

  • Regulatory Reform

  • Innovative Investment

  • Trade

Outline

I. Brief Summary of COVID-19

            A. U.S. Reaction

            B. CARES Act

 

II. Where We Failed – The Lack of a Strategic Medical Supply Stockpile

 

III. We Face Supply Shortages Because of Our Dependence on Foreign Nations

 

IV. Current Status of Health and Economy

        A. Health

        B. Economy

        C. Employment

 

V.  Solutions

        A. Give us the Truth or Face the Consequences. 

        B. Ending Social Distancing and Returning Us to Normal.

        C. End Our Dependence on Foreign Countries for Our Critical Needs.  

        D. Fully Fund and Fill the National Strategic Medical Stockpile.

        E. Jobs in the New Economy

I. Brief Summary of COVID-19

COVID-19 is a corona virus that causes Severe Acute Respiratory Syndrome or SARS. In general, SARS begins with a high fever (temperature greater than 100.4°F). Other symptoms may include headache, an overall feeling of discomfort, and body aches. Some people also have mild respiratory symptoms at the outset. About 10 percent to 20 percent of patients have diarrhea. After 2 to 7 days, SARS patients may develop a dry cough. Most patients develop pneumonia. The COVID-19 virus appears to come from Wuhan, China. The Chinese government first reported cases of the disease on December 1, 2019. The United States reported its first known case on January 20, 2020.

 

An intelligence report from the military's National Center for Medical Intelligence in November, compiled through wire and computer intercepting and satellite imagery, reported the existence of a health event happening in China and concluded that an outbreak of the virus "could be a cataclysmic event." Reports from China state that the first known case was a 55-year-old individual from Hubei province (Wuhan is a city in Hubei province). China also indicated that the virus impacted about one to five persons per day and that by December 20, 2019, there were 60 confirmed cases. When China reported the outbreak to the World Health Organization (WHO) on December 31, 2019, it indicated they had cases of pneumonia type illnesses from a virus of unknown origin and four days later reported 44 such cases. But intelligent reports were already saying by December 31, 2019, the outbreak was “full blown” and not isolated.

The U.S. reported its first case on January 20, 2020, and on January 31, 2020, the President declared a National Health Emergency. Through February, the spread of the virus was in isolated areas and closely linked to direct contact with persons who had traveled to areas in the world with known infection rates. However, a Kirkland Washington nursing home became the epicenter on February 29, 2020, and persons who lived and worked there as well as first responders and visitors were carrying the virus around the country. The first week in March 2020 marked the last normal week of social behavior in the U.S. In the following days, social distancing was initiated, schools began extended spring breaks, and slowly, places of social gatherings were asked to close. Sheltering-in-place and eventually Stay-at-home orders were proclaimed by governors across the U.S. by the end of March.

A. U.S. Reaction

 

The first case of COVID-19, reported on January 20, 2020, in the U.S. was a man who returned to the state of Washington after traveling to Wuhan China. It was his contact with people upon arrival in the U.S. that led to both the spread of the virus in the Seattle area but also elsewhere in the U.S. On January 31, 2020, the President issued restrictions on persons returning from China, and on February 29, upped those restrictions to people traveling from Italy, Iran and South Korea. Meanwhile, the few cases being reported in the U.S. were generally being handled by state and local health agencies and hospitals.

 

The first week of March saw a major shift in U.S. response. There were now 12 deaths of U.S. citizens who had contracted the disease through community contact not associated with a known infected person. California and Washington State became the hot spots for the disease in the U.S.

 

On March 6, President Trump signed the first COVID-19 aid bill to provide testing for individuals and research funds for the CDC and NIH. As the second week of March started so did the slow shut-down of the Country. Sports leagues and entertainment events were being canceled and schools began announcing extended spring breaks. By March 15, there were more countries added to the restrictive travel list including most of Europe and Asia.

 

The week of March 16, 2020, started the steep climb in the number of COVID-19 cases in the U.S. State and local governments were asking non-essential companies to work from home, and a restriction on gathering of 50 or more persons was being reduced to 10 persons, which placed significant restrictions on restaurants and bars from in-house service. Through the week of March 23 to the end of March, the Trump Administration had extended the social distancing recommendations until the end of April, and shelter-in-place and stay-at-home orders were being issued by governors that placed us in a semi-state of quarantine.

 

B. CARES Act

 

After a contentious debate in the U.S. Senate, the CARES Act (COVID-19 Aid, Relief and Economic Stimulus Act) was passed on March 25th and sent to the House. The measure passed the House two days later on March 27 and was signed hours later by President Trump. The CARES Act addresses key points:

 

  1. Enhanced unemployment insurance,

  2. Payment to individuals and families,

  3. Aid to hospitals,

  4. Aid to small businesses,

  5. Aid to corporations

 

All of these points are targeted to individuals and employees. For those laid off and in need of unemployment insurance, this bill gives an extra $600 per week for the first 8 weeks of unemployment. Payments to individuals provides up to $1,200 per individual or up to $3,300 per family of four.

 

The aid to small businesses is a loan program for small companies that keep employees on their payroll, even if they have been furloughed. This means people will be able to receive their paychecks and keep their company benefits. Small businesses who apply for and use this money for these purposes may have the loans forgiven, if they follow the ever-changing guidelines. The banks making the Paycheck Protection Program Loans have been caught between the Small Business Administration NOT wanting to process the loans and the Treasury Department WANTING to process the loans. The loan programs have been delayed by typical bureaucracy “red tape” with businesses closing rapidly sending the US into a more rapid economic downward spiral.

 

The aid to corporations is similar to the small business program, except there is no loan program. Instead, the large company would receive tax credits for the amount paid in wages and salaries for workers kept on the payroll.

 

II. Where We Failed - The Lack of Strategic Medical Supply Stockpile

 

In addition to general government reaction, state, local and federal governments were responding medically. One important part of the federal response should be the use of the Strategic National Stockpile, (SNS). The SNS's role is to supplement state and local supplies during public health emergencies. Many states have products stockpiled, as well. The supplies, medicines, and devices for life-saving care contained in the stockpile can be used as a short-term stopgap buffer when the immediate supply of adequate amounts of these materials may not be immediately available. The SNS was created in 1999 to address the country’s needs should we face a bioterrorism attack. Following 9/11, its role was expanded to cover general health emergencies such as pandemics and natural disasters.

 

Strategic National Stockpile Depletion

  • 9/11 and Anthrax Attack

    • 2001

  • Hurricanes Katrina and Rita

    • 2005

  • Hurricanes Gustav and Ike

    • 2008

  • H1N1 Flu Pandemic

    • 2009

  • Hurricane Alex

    • 2010

  • Hurricane Irene

    • 2011

  • Hurricanes Isaac and Sandy

    • 2012

  • Botulism and Ebola

    • 2014 and 2015

  • Zika Virus

    • 2016 and 2017

  • Hurricane Harvey, Irma and Maria

    • 2017

  • Hurricane Dorian

    • 2019

  • COVID-19

    • 2020

As President Trump declared emergencies state by state across the nation, supplies in the SNS should have become available to those state and local governments.

 

We have learned the current and past administrations have not adequately restocked the SNS as needed. N95 masks and other Personal Protective Equipment were significantly depleted in the response to the H1N1 pandemic of 2009. In the eleven years since, the administrations and Congress have failed to appropriate the funds needed to replenish these stocks. A recent article now indicates a significant portion of the SNS medical equipment has been depleted.

 

Of all people, President Obama has become critical in the public forum and news organizations of the shortages and lack of readiness of our National Stockpiles. While President Obama was “kicking the can”, he now does not want to be held accountable and is trying to shift the focus of blame of our current shortages from his administration to President Trump.

 

Rather than playing the “blame game” and wasting valuable time, we need to focus on solutions and FIX THE PROBLEM. Thus, anyone who has a stockpile of masks, either N95 or surgical, and other personal protection equipment should take them to the nearest major health care facility. This will assist in meeting your local demand for these products and protecting the healthcare workers who may be just the ones called on to save the life of one of your loved ones.

 

III. We Face Supply Shortages Because of Our Dependence on Foreign Nations

 

  • China is the second-largest exporter of drugs and biologicals (drugs from natural sources) to the U.S.

  • China produces over 95% of the U.S. supply of antibiotics.

  • Asian Countries produce 95% of our ibuprofen and 91% of hydrocortisone.

  • China is the largest supplier of medical devices and supplies:

  • Class 1: Bandages and gloves​

  • Class 2: Scissors, forceps, and other surgical supplies

  • Class 3: Pacemakers and ventilators

  • Class 4: Imaging devices

  • About 80 percent of Active Pharmaceutical Ingredients come from China and India.

  • The U.S. relies upon China for 90 percent of our generic prescription medicine

  • India provides over 40 percent of the over-the-counter drugs to the U.S.

  • India depends heavily upon China for the ingredients in their drug production.

From a supply chain perspective, India is dependent upon China, factories in China have been closed to deal with the coronavirus, so India has been forced to slow production of its products coming to the U.S. Further, the Indian government has stopped the export of twenty-six pharmaceutical products, mostly antibiotics to ensure adequate supplies remain in their own country.  This decision makes drug shortages a potential here in the U.S. particularly, antibiotics.

Drugs that are at risk for supply chain disruption have not been disclosed by the Federal Drug Administration. But, since China produces nearly 97 percent of the U.S. supply of antibiotics, those are a prime example of drugs that can be disrupted. Additionally, China produces 90 percent of U.S. used vitamin C, 95 percent of our ibuprofen, and 91 percent of hydrocortisone. China also produces generic drugs for U.S. distribution including HIV/AIDS, diabetes, epilepsy, and Parkinson’s disease. In other words, the U.S. is heavily dependent upon foreign sources of our prescription and over-the-counter, (OTC) drug supply. A supply that may be at risk the longer the impacts of the coronavirus in China impact manufacturing.

We know the Federal Drug Administration (FDA) has asked drug companies to evaluate their supply chains with China and India and take steps to mitigate potential shortages. The question is, are U.S. manufacturers gearing up to compensate for the foreign shortfalls? Do we know the time required to start up production and to make an impact on the U.S supply for prescription and OTC drugs?

The dependence upon foreign countries for drugs is not the only medical supply item impacted. There are major medical devices that are manufactured in China. Firms in the medical device manufacturing industry produce diagnostic, medical monitoring, and treatment equipment. Surgical masks are also predominately made in China, and testing kits are made in Europe.  And, the Center for Disease Control warns that we are in short supply of masks and testing kits.

 

IV. Current Status of Health and Economy

 

A. Health

 

The landscape of COVID-19 is changing daily, and we have provided links to credible websites in order that you can see the status at the time you read this. The statistics provided here are as of the date this paper is written and does not reflect current conditions.

 

Provided in the chart below are the statistics for COVID-19 worldwide, the United States and Tennessee. The chart reports total cases, total deaths, active cases, severe cases, and recovered. The data comes from the website Worldometers.info and is regularly updated. For more detailed data for Tennessee, you can visit the State website. The map on the Tennessee site provides a geographic breakdown of where the virus is within the state and a table of counties with the number of cases, deaths, and recovered.

 

The most significant statistics in the State of Tennessee are that the two most populous counties, Davidson and Shelby, at this time have death rates of less than 2 percent. Hamilton County has a death rate of almost 10 percent. In Sumner County, a nursing home has a significant level of infections raising the number of deaths in the county, and they now have a overall death rate of 5 percent. In Hamilton County, nine of the 10 deaths were persons aged 61 and older and all had underlining health conditions, the other was a juvenile under the age of 10.

 

B. Economy

 

The U.S. economy grew in the fourth quarter of 2019 by 2.1 percent, maintaining a steady growth rate throughout 2019. First quarter 2020 projections from various economist had the economy slowing slightly to about 1.8 percent before the impacts of the COVID-19 virus. At the end of March 2020, those economists were revising that projection to 1.2 percent. In the mid-COVID-19 economic environment, Economists have forecasted a GDP decline of over eight (8) percent for 2020 with a slow recovery starting by year-end and picking up in 2021.

 

The idea of just restarting the economy of the United States, and that of the world in the next couple of weeks is not what is being put forth here. Discussed is, how we go about that task. At this time, the question of when is a politically philosophical debate.

 

The debate is a broad discussion of the question of health vs wealth. It includes a range of the subparts of health and wealth. Those parts are poverty, race, racism, education, health care, and mental health, all of which will suffer socially the longer our economy sits stalled. In a recent discussion held by the New York Times Magazine, most participants recognized the need to find some ways to restart the economy. Citing some of the administration’s estimates, even if you look at the conservative models that the president and the White House Coronavirus Task Force are putting out, they’re talking about 10 to 20 million Americans being infected, and therefore most likely being immune for some amount of time. That is a very powerful cohort that you don’t want just sitting at home on the sidelines if you can restart parts of the economy with them. But, if we continue to debate all of the parts of the health vs. wealth argument and leave the economy in a stall, then we allow much more dangerous discussions to grow. The discussions that plagued Europe 100 years ago. Economic recovery on the other hand, in the shorter term, allows all Americans to assess the transformation this pandemic has had on our society and make structural changes.

 

Getting persons back to work entails the “testing” protocols, discussed later, and the issuance of some form of immunity passport. Testing that clearly identifies those who are immune to the virus, those who are at high risk of severe effects, and those who may seek to choose a level of risk in order to resume societal behavior. With these standards in place, how then do we proceed, and begin implementing them. Yes, we risk a new surge if we start too early. If we wait too long, the cure for the virus will be greater on our society than the virus itself. An additional factor is the overall behavior of persons and households, and their individual level of risk taking given what we know about how those persons and households may be impacted by the virus.

 

Many economists see a continued suppression of the economy through May. At this writing, that provides about six weeks to establish the mass testing procedures needed to produce a stable work force. Testing however doesn’t ensure that waves of the virus don’t strike later in the year. There will still be millions of persons who have not contracted the virus and a segment of those who may be impacted severely. The cycle of the virus is seen subsiding in June and re-emerging in October and November. The impact on business and social behavior may look something like as follows:

Source: https://www.morningstar.com/articles/976107/coronavirus-update-long-term-economic-impact-forecast-to-be-less-than-2008-recession

 

There is a correlation between the number of new infections and the impact on the public. As such, demand for increased activity will drive many decisions as it relates to the economy moving forward. That is why it is key that governmental action is now ahead of the curve in addressing the virus. The actions of the government need to provide the economic sector and society in general, a safe workforce. Again, that comes in distinct parts: those who show immunity to the virus, those not exposed but are part of a well-defined group for whom the impacts of the virus is not severe, those at high risk of severe effects so that as the virus peaks again in the fall, they can take appropriate measures.

 

C. Employment 

 

On Friday March 6, 2020, the February employment figures were released. It showed that in February 2020, the economy added 273,000 jobs and an unemployment rate of 3.5 percent. Also included in those numbers were hourly wages growing by over 3 percent. But even as those numbers were announced, the threat of the coronavirus hung in the air. On April 3, 2020, the March employment figures were announced. Total employment fell by 701,000 persons and the unemployment rate rose to 4.4 percent. What was hidden in these numbers were the actual numbers of people being laid off. In the last two weeks of over 10 million people filed for unemployment insurance. In the first week of April, an additional 6.6 million people have filed new claims. This job loss over the past four weeks is unprecedented.

 

The actions of the federal government to provide some form of relief may lessen the overall impact, but the economy has to get back to producing things in order to restore economic stability. That means we need to find ways to being to open the economy.

 

V. Solutions

           

A. Give Us the Truth or Face the Consequences:  Right to Sue Foreign Nations

 

The United States was ill prepared for COVID-19.  This was due largely to lack of transparency and misinformation from China.  Learning the truth faster could have helped saved lives and prevented an economy crippling “full lock down” of the United States.  

 

Early information from China was, not only inadequate, but also misleading, all designed to make China look good and ‘“save face”.  Crucial facts China hid form us and the world included knowing how long someone could be infected and spread the disease before they became sick with the disease.  We were also not told about asymptomatic carriers of the disease (those that can spread the disease without showing any fever or other symptoms). 

 

Also, we were not informed that many people who contract the virus may never show signs of having it at all. We’ve had to learn from our own experience, at least in the United States, a significant number of those who have the disease are between 21 and 40 years old. Yes, the most severe cases that may lead to death are in our older population, but the people most prone to spreading the disease are younger adults.

 

It would have been much less medically and economically devastating to have had the truth and allow us time to prepare.  This attack has been so much worse because of the associated “sneak attack” of withholding critical, lifesaving information.

 

Given these more up-to-date facts, it becomes obvious that we are “reacting” to this viral pandemic rather than calmly “responding” to the COVID-19 viral problem.  We must require, and if needed, penalize those nations that would rather protect their reputation and “save their national face” at the expense of our safety. 

 

Right to sue foreign nations - Enact an exception to sovereign immunity for the health and welfare of our citizens.

 

Despite harm caused by foreign nations/governments, we, as American Citizens, have very limited rights to hold those governments accountable.  This is because most nations are covered by sovereign immunity which allows them to escape responsibility for even the most hideous of actions.  It’s time we change this. 

Sovereign immunity has been an accepted practice for hundreds of years in this nation.  There are limited exceptions to this immunity in the U.S. but none of them protect us from a deceitful nation withholding information that could potential harm our citizens.

So, while foreign governments do have sovereign immunity, they do surrender some of that in exchange for ability to engage in international trade.  My solution is simple - expand the exceptions to sovereign immunity for the health and welfare of our citizens. 

 

First, expand the Foreign Sovereign Immunities Act (FSIA) of 1976. This is a United States law, codified at Title 28, §§ 1330, 1332, 1391(f), 1441(d), and 1602–1611 of the United States Code, to allow an exception to sovereign immunity for the health and welfare of its citizens by requiring the free, open, and timely exchange of information that  may harm our citizens. 

Second, amend all treaties to allow an exception to sovereign immunity for the health and welfare of its citizens by requiring the free, open, and timely exchange of information that may harm our citizens.

B. Ending Social Distancing and Returning Us to Normal: Improved TESTING beyond the Nasal Swab Test

 

We need to first focus on our national health, but then work on economic restoration. We need to maintain our homes, endure the hardship of not visiting family, and get a plan for restarting our economy. We have an opportunity to create a plan that will implement pro-active measures to get us up and running. The core of this plan is TESTING.

 

Improved TESTING Beyond the Nasal Swab Test - The first and most important step in healthcare treatment and prevention AND re-starting the economy is additional types of testing. 

 

The Nasal Swab Test is critical and must be done, but to get us back to normal we must go beyond this type of testing.  The Nasal Swab Test lets us know who has the illness. Additional types of testing will let us know: 

 

(1) Those who have the active virus with symptoms

(2) Those who have the active virus with NO symptoms

(3) Those who actively have the disease and are still fighting the disease

(4) Those that have fought the virus and now have antibodies

(5) Those still vulnerable to the virus and have no immunity

 

Until we have increased knowledge of test results, we are just guessing at diagnosis and treatment(s).

There are two types of tests to be given in order to identify the groups above. To successfully test, we must test everyone with BOTH types of tests (the nasal swab test and the serological blood test).

A. The Nasal and Throat Swab

Tests we are using presently will determine who has the active disease and who might be an asymptomatic carrier of the disease. The positive nasal swab test means a person has active live virus and is able to spread the disease to others. Initially the test took about 3-5 days to receive results. Recently, “point of care” equipment was approved for in-office testing with results in approximately 10 minutes.

 

B. The Blood Serology

Test (with a blood sample similar to a diabetes blood sugar finger stick test) can be used to determine who is having mid-term active disease or who has previously had the viral infection and has developed immunity to COVID-19. This test reveals results in approximately 10 minutes.

 

The first order of testing for COVID-19 remains the same and nasal swab testing is the initial test for acute or suspected disease. Those present with symptoms of the virus remain the priority. These symptoms include temperature over 100.4 degrees Fahrenheit, cough, general malaise, aches and other “flu-like” symptoms. After being tested, the person should remain quarantined until the test results are obtained. A negative test result would indicate an immediate release from quarantine and a positive test would indicate a 14-day quarantine time to be observed. Previously, the test results were reported in3-5 days. A new test with 10-15-minute results has become available and is being implemented as of Mid-April 2020.

 

Second priority would be a person who was in contact with someone who tested positive for COVID-19. The person exposed might not yet have clinical symptoms of infection but should be tested for active virus. Once again, the person tested should remain in quarantine until the test returns and is negative. If the swab test is positive, the person should adhere to the 14-day quarantine time frame.

 

Third priority is members of the general public. It is important to consider people who are asymptomatic (with no fever, cough or other symptoms of viral illness) and surprisingly test positive to the nasal swab test for live virus. These asymptomatic people can spread the disease, yet do not know they are contagious, except for a positive nasal swab test. The recent estimates are that approximately 25% of infections are asymptomatic carriers. These asymptomatic carriers must be identified and properly quarantined to stop the viral disease spread. (Note, there are studies to determine how contagious that asymptomatic carriers actually are, as some postulate that asymptomatic carriers are not as contagious as those with symptomatic COVID-19 viral disease.)

 

It is easily seen that more rapid test results will eliminate unnecessary quarantine time and the new “point of care” 10-15-minute results will give good data and enhance compliance. Lack of quarantine time while awaiting test results will encourage more testing by the population.

 

If we can perform blood tests on all persons, especially those who have not tested positive with the nasal swab test, crucial information will be obtained. The blood test may also be given to persons in contact with someone who has tested positive but never showed signs infection.

 

From the two separate tests results, nasal swab and blood tests, the population can be divided into seven categories of disease or risks:

 

A. Positive Nasal Swab Tests:

Exposed patients who are actively infected with the virus and are still actively infected as tested by the nasal swab. These individuals should be quarantined for 14 days and re-tested with the nasal swab to confidently say that they are no longer contagious.

 

B. Negative Nasal Swab After COVID-19 Exposure:

These patients have been exposed, but not infected and have no active virus. These people should be instructed to be aware of any of the signs of infection, but not quarantined as they are not contagious. They should be cautioned to continue prevention measures, such as social distancing, mask wearing, and frequent hand washing.

 

C. Positive Serology Blood Test For IgM COVID-19 Antibodies:

This is seen in nations with active infection and EARLY antibody response to the COVID-19 viral infection. It means that the person has the disease and their immune system recognizes the viral antigen COVID-19 RNA and is producing antibodies to overcome the virus.

 

D. Positive Serology Blood Test For IgM AND IgG COVID-19 Antibodies:

The patient is in mid phase of the disease when the immune system has the early immune response (IgM) and later immune response (IgG) are both forming antibodies to the viral COVID-19 antigen. The IgM provides early immune reaction, while the IgG is the defense for long term immunity to this specific COVID-19 virus.

 

E. Positive Serology Blood Test For IgG Antobody And Negative IgM Antibody For COVID-19:

This combination is seen when the patient is in the later stage of recovery from COVID-19 viral infection. At present, as with other infectious disease processes, it is believed that IgG provides long term immunity. As yet, we do not know how long the IgG antibodies will provide. These individuals are immune and not contagious. They are able to resume their normal lives and re-join the workforce and normal activities.

 

(OPINION NOTE: This is a new disease for the medical community, and we are learning by current experience, rather than relying on the past. We should rely on the scientific method to get to true answers to this and other questions. Of course, during the acute phase of the pandemic, we need to be open to scientifically based theories and save human lives with modified clinical trials. 

 

This brings medical and social ethics to the ultimate test. As a humanity, we are responding with appropriate modification of clinical trials, realizing that we are forgoing watching the disease progress without treatment. MY MEDICAL PROFESSIONAL OPINION IS THAT THIS IS NOT ACCEPTABLE IN OUR UNITED STATES. It was not the correct scientific model in the Tuskegee Airman Study and has been justly criticized today. We are dealing with humans, not laboratory animals, and the chance for treatment and cure should NOT BE WITHHELD from any person.) 

 

F. No Known Exposure To The Virus But Has Developed IgG Antibodies. 

This occurs in asymptomatic carriers who had the disease with no clinical symptoms and have recovered with active longer-term immunity. These individuals are immune and not contagious. They are safe to go about their normal lives and re-join the workforce

 

G. No Exposure To The Virus And No Antibodies

These people are at risk for infection and should take maximum precautions with risk factors related to age and underlying medical conditions. When a vaccine is developed, these individuals should be first to be vaccinated.

 

*Antibodies of the two types described in this paper are *IgM (immunoglobulin M), and *IgG (immunoglobulin G). *IgM is are associated with EARLY phase or acute infection and, provides an IMMEDIATE response when an antigen (virus in this case) enters the body. *IgG (immunoglobulin G) responds LATER with permanent eradication of the antigen (virus in this case) and produces long-term immunity. 

 

 

C. End Our Dependence on Foreign Countries for Our Critical Needs

 

The main thing this pandemic has taught us is the vulnerability of U.S. to strategic supplies needed for the health and welfare of the country. Since the 1990s, U.S. companies have increasingly imported pharmaceutical products from China and India. The ingredients and labor are cheaper, and regulations are fewer in those countries. Result, we are now heavily dependent upon these countries for our drug and medical supplies.

 

The basic facts about our supply chain of drugs in the country are:

 

  • China is the second largest exporter of drugs, biologicals, (drugs from natural sources) to the U.S.

  • China is the largest supplier of medical devises.

    • Class 1: Bandages and gloves

    • Class 2: Scissors, forceps and other surgical supplies

    • Class 3: Pacemakers and ventilators

    • Class 4: Imaging devices

  • About 80 percent of Active Pharmaceutical Ingredients come from China and India

  • The U.S. relies upon China for 90 percent of our generic prescription medicine

  • India provides over 40 percent of the over-the-county drugs to the U.S.

  • India depends heavily upon China for the ingredients in their drug production

 

From a supply chain perspective, India is dependent upon China, factories in China have been closed to deal with the coronavirus, so India has been forced to slow production of its products coming to the U.S. Further, the Indian government has stopped the export of twenty-six pharmaceutical products, mostly antibiotics to ensure adequate supplies remain in their own country.  This decision makes drug shortages a potential here in the U.S. particularly, antibiotics.

 

Drugs that are at risk for supply chain disruption has not been disclosed by the Federal Drug Administration. But, since China produces nearly 97 percent of the U.S. supply of antibiotics, those are a prime example of drugs that can be disrupted. Additionally, China produces 90 percent of U.S. used vitamin C, 95 percent of our ibuprofen, and 91 percent of hydrocortisone. China also produces generic drugs for U.S. distribution including HIV/AIDS, diabetes, epilepsy and Parkinson’s disease. In other words, the U.S. is heavily dependent upon foreign sources of our prescription and over-the-counter, (OTC) drug supply. A supply that may be at risk the longer the impacts of the coronavirus in China impact manufacturing.

 

We know the Federal Drug Administration, (FDA) has asked drug companies to evaluate their supply chains with China and India and take steps to mitigate potential shortages. The question is, are U.S. manufacturers gearing up to compensate for the foreign shortfalls. Do we know the time required to start up production and to make an impact on the U.S supply for prescription and OTC drugs?

 

The dependence upon foreign countries for drugs in not the only medical supply item impacted. There are major medical devices that are manufactured in China. Firms in the medical devise manufacturing industry produce diagnostic, medical monitoring, and treatment equipment. Surgical masks are also predominately made in China, and testing kits are made in Europe.  And, the Center for Disease Control warns that we are in short supply of masks and testing kits.

 

We have spent decades allowing policies that have slowly moved U.S. manufacturing to Asia. Many private sector firms talk like “our customers are number one, and “employees are our most important asset” and “we are committed to being good corporate citizens” and “our firm is committed to environmental sustainability”. And yet everyone in those firms knows that when it comes to the crunch, what really matters is the short-term profit for shareholders. Even though the firm appears to have multiple goals, it actually has a de facto single bottom line. This overall industrial policy that the bottom line is the most important factor in business means, that corporate profit has outweighed even certain strategic issues of our country. The health and welfare of the citizens of the U.S. is a strategic issue. Yet, we allow most of most important medical supplies come from counties that are not strategic allies.

 

Support President Trump’s “Buy America” Executive Order that adjusts the bidding process that evaluates how the U.S. Government buys its products.

 

On July 15, 2019, President Trump signed an Executive Order requiring regulations implementing the Buy American Act be changed. The Buy American Act was adopted during the Great Depression, so it has been operational for the past 80 plus years. The act itself contains many exemptions, and as recently as 2017 there were attempts to expand those exemptions. The basis for exemptions is:

 

  • Public interest. “This exception applies when an agency has an agreement with a foreign government that provides a blanket exception to the Buy American Act.” The most common exception is through the DOD, which has blanket agreements with many countries for a public interest exception to the BAA. This DOD public interest exception amounted to nearly $2.9 billion for fiscal 2017.

  • Domestic non-availability. “Articles, materials, or supplies, either as a class or individually, are not mined, produced, or manufactured in the United States in sufficient and reasonably available commercial quantities and of a satisfactory quality.” 

  • Unreasonable cost. “Purchasing the material domestically would burden the government with an unreasonable cost. If a domestic offer is not the low offer, this exception applies an evaluation factor to foreign offers: 6 percent is added if the lowest domestic offer is a large business and 12 percent is added if it is a small business.” 

  • Commercial information technology. 

  • Commissary resale.

 

The Executive Order signed by President Trump places two tests on goods procured by the federal government when dealing with foreign products. What is the percentage of foreign components of the goods being purchased, and the evaluation process for deciding between bids that may be whole or partially foreign made. The fact remains, many products today, due to materials and supplies, or unreasonable costs, are not made in the U.S. And simply having a law requiring “Buy American” does not make it happen. 

 

There needs to be manufacturers here in the U.S. and policies of the U.S., need to bring those manufacturing plants and jobs back to our soil.

 

Leverage the U.S. Governments $500 billion dollars a year buying power to get companies to move the productions of “critical” goods and services back to the United States.

 

One of the most important lessons we have learned from this COVID-19 pandemic is that we desperately need NEW “buy American” laws. The new laws need to have teeth and incentives to get the manufacturers to be in business here in the States.  We must create jobs here and ensure we produce goods here at home, especially those of a critical nature. 

 

The U.S. Government in 2017 purchased about $500 billion in goods and services. That amount is larger than the GDP of Sweden, and it carries a lot of financial and political power. The federal government buys lots of various items, from guns and butter, to copy paper and toilet paper. Our government buys computers, drugs, drug raw materials, and medical supplies. That “power of the purse” as to where purchases are made, can dictate significant economic power and ensure, at a minimum, that our critical needs are met by U.S. based manufacturers.

 

When the United States adopts strategic goals like the Strategic Petroleum, we change the face of our economy. Long dependent upon oil drilled in other parts of the world, The U.S. suddenly recognized its strategic need in 1973 when OPEC (Organization of Petroleum Exporting Counties) cut production and forced a significant rise in oil prices that sent the U.S. into a recession. To fight back, we adopted several policy steps that led to the U.S. to now being the largest producer of petroleum.  No longer are we dependent upon other counties. 

 

Similar policies for other strategic supplies, including our healthcare supplies, are now needed.  We see the “choke hold” the non-cooperating and dishonest countries, such as China, are applying to us.  We can fix these problems, but not until we as Americans act and decide to put our United States FOOT DOWN and stop being bullied by foreign countries. 

 

Congress will finally listen and amend the “Buy American Act” if we show our representatives that we mean business.  Further restrictions on the purchase of critical goods and services from foreign nations need to be placed.  The biggest problem with our current “Buy American” laws is that there are simply too many exceptions.  Exceptions to the “Buy American” law have allowed more and more business to relocate overseas. They take jobs and the goods and services we need with them.  

 

Even more troubling is the fact that a number of critical items like medical supplies, medicines and ventilators are now almost exclusive made overseas.  If our supply lines are cut off (and we currently have no back up or reserve systems in place) we could face a catastrophe much worse than the current global pandemic.

 

The key is creating back-up systems that can temporally fill our needs in times of disruptions.  In short, we must designate certain items as critical and the U.S. government must, no exceptions, buy those critical products from businesses in the U.S.    

 

This does not mean that we would require all critical goods to be made in the U.S., just those goods that the government buys.  To put this in perspective the total estimated buying power of all individuals, businesses, governments, etc. in the U.S. is over $20 Trillion dollars.  If the U.S. Government were required, with no exceptions, to spend their $500 Billion dollars worth of buying power on U.S. made goods, there would be a significant positive impact on the total U.S. economy.  And, while this is only a portion of overall U.S. buying power it is certainly enough to create some back-up systems to protect our future.  

 

If companies knew they had a potential $500 billion-dollar customer with no competition from overseas, they would be foolish to not return some of their operations to the States.  This has the benefit of creating Jobs and ensures that some of the critical goods and services, we need as a nation, are made here at home.  

 

The US government could use the “carrot” policy rather than the “stick” with American Companies.  Luring businesses to manufacture in the US could be done with tax incentives as a reward for manufacturing in the US.  Much like PILOTS (Payment in lieu of taxes) are used by local and state governments, the Federal Government could have a Federal PILOT for businesses to move back to the US and to incentivize those already in the US to continue manufacturing here.   The jobs saved and created, as well as, the economic comfort of knowing that the United States is self-sufficient again would be well worth the slight decrease in tax revenue that this program would cost.

 

D. Fully Fund and Fill the National Strategic Medical Stockpile

 

The United States needs to ensure that the American people are provided for in times national health emergencies or other national impactful health events. The Department of Health and Human Services, (HHS) should seek Congressional approval and fully fund and keep up to date a Strategic Medical Stockpile, (SMS).

 

Similar to the Strategic Petroleum Supply, the SMS would be designed to provide a basic supply of critical drugs during periods of supply chain disruption. The disruption could be either the final drug products or the active prescription ingredients.

 

The SMS warehouse facilities would store key medical supplies and medicines to cover planned disruptions in the supply chain of medical products. The facilities should be located in areas that permit overnight distribution, such as the FedEx facilities in Memphis, TN. This would be separate from the SMS which is designed to be a rapid response unit for medical emergencies.

 

The SMS would establish standards for the acquisition and storage of medical supplies for general public and medical facility consumption. The quantity of products stored would take into account the needs of medical supply companies and pharmaceutical companies as well as other related industries to react to and begin local manufacture of these goods.

 

In the case of pharmaceuticals, not only would supplies of finished drugs be stored, but also the Active Pharmaceutical Ingredients, allowing the companies time to start up local manufacturing and provide raw materials while establishing new supply chains.

 

The storage of test kits, surgical masks and similar protective equipment again would be based upon providing sufficient quantities until new supply chain manufacturing could be provided, either locally or from alternative foreign sources.

 

The U.S. needs to become as independent as possible in the production of pharmaceutical and medical devices.

 

Congress and the Executive Branch need to pass federal incentives for pharmaceutical and medical supply companies to locate new manufacturing facilities here in the U.S

 

States and local governments should include in their economic development incentives the fulfillment of federal economic independence policies.

 

When a state of emergency happens, these supplies would be issued across the country to hospitals and medical organizations.  As we are seeing now, there is a huge rise in prices for some of these essential medical supplies.  With government issued supplies, we wouldn’t see price gouging and those in need could get what they need.

 

E. Jobs in the New Economy

 

In the past two decades since China was admitted to the World Trade Organization (WTO), the United States has lost 3.7 million jobs to China. From 2017 to 2019 we lost 700,000 of those jobs, or about 19 percent. In Tennessee since the year 2000, that accounts of about 2.4 percent of the state’s total employment, or about 74,000 jobs. While it certainly isn’t as high as California, Oregon or North Carolina, it is on par with many rust belt states like Pennsylvania, Ohio and Michigan. 

 

A key contributor of this loss of jobs is the low wage production that China promotes. Two factors are at play with China’s wages. First, the size of the Chinese workforce and the manipulation of currency so that prices remain low for Chinese goods. As a result, American manufacturers find it more profitable to their bottom line to move jobs off shore. 

 

When China was admitted to the WTO it was promoted that it would create American jobs as exports to China would grow. President Bush, hoped that China would be a responsible member of the world community and play with the rules. However, China has not. They engage in unfair trade practices and have limited growth of U.S. exports. The U.S. trade deficit has increased annually by $18 billion dollars since 2001.

 

The U.S. Economy had been growing at a dynamic pace prior to COVID-19. Rebooting the economy, we need pro-people, and pro-market policies that both fast track the rebound, and have long lasting impact. Better solutions are possible, and the great American free enterprise system—with its vast marketplace of goods, services and, perhaps most importantly, ideas—is just the institution to provide them. Preserving that system requires continuing commitment to free-market principles. In a time of crisis, economic freedom matters more than ever. And, the U.S. needs to leverage its strengths of freedom, civil society and free enterprise to revive our vitality.

 

There are three policies that need to be accomplished by the administration and congress to ignite and sustain our economy. We must implement regulatory reform, promote innovative investments and develop new trade relationships.

 

  • Regulatory Reform

 

Entrepreneurs, in small and medium sized businesses, can drive the economic recovery. They will accomplish this not only by reopening existing businesses but look to take new risks to move forward. Regulatory reform must promote economic freedom, and remove barriers that slow the startup of new companies and new products.

 

  • Place a 24-month moratorium on new regulations. Businesses do not need to be burdened on trying to reopen and learn new regulations dealing with the overall operations of their businesses during the recovery period.

  • Propose legislation that any regulation suspended by the federal or state governments due to the pandemic, needs to be reviewed for its effectiveness and impact before being reinstated to assure it was necessary in the first place.

  • Establish a commission of business owners and government agencies to review all regulations and report the findings on business regulations within 18 months of the impacts and effectiveness of the regulations.

  • Provide funding to state and local governments to undertake regulatory commissions to review and eliminate outdated regulations.  

 

  • Innovative Investments

 

Companies large and small need incentives for innovation. Research and development are costly elements of any new business venture. The U.S. needs innovation in order to bring jobs back from overseas and create new manufacturing techniques. Federal, state and local governments need to encourage innovation and provide investments to assist companies that are moving ahead in this new economic world.

 

  • Appropriate funds through the nation’s “Land Grant Universities” that gives priority to research and development of new manufacturing technologies for use by U.S. manufacturers.

  •  Amend the Federal Tax Code to provide:

    • Tax Credits for Research and Development of new technologies

    • Instant depreciation of new manufacturing equipment 

  • Adopt Immigration Reform that promotes a skilled immigration workforce.

  • Reallocate Federal Job Training dollars to trade schools, and community colleges that provide local manufacturers with coordinated job training programs designed to meet their particular jobs skills.

 

  • Trade

 

The heartland of the U.S. including Tennessee is a resource in the rebalancing of the world of commerce in a post-China economy. This re-awaking of the heartland, will clearly be due to the fear that China now monopolizes essential U.S. and the free world goods and this monopoly must end. Spurring this re-awakening is the development of new and strong trade alliances for long term sustainable growth. 

 

Trade needs to be based upon the new realignment of the world in a post globalization economy. Pandemic globalization has become synonymous with China. Their ability to monopolize critical goods of the U.S. and many of our strategic partners is dangerous. The realignment will likely fall into three camps: (1) the free world, resilient against Chinese meddling; (2) the balancers, nations that recognize the key to their prosperity and security is engaging with both the United States and China, protecting their independence and minimizing the likelihood that they will become theaters of competition between great powers, and (3) contested space, where the U.S., China, and others compete for influence across the spectrum of economic, political, security, and information spheres. Dealing with these three camps means new trade policies.

 

  • Use the Most Favored Nation Status (MFN) of the World Trade Organization to promote trade only with our strategic partners in the Free World Camp and promote balanced trade and agreements for critical goods needed by the U.S. and our partners.

  • Over the next ten (10) years reduce by 50 percent trade conducted with countries that fail to adhere to human rights standards, economic and political freedoms, transparency and information on issues that impact world health.

  • Promote trade policies with those nations who need to engage in significant trade with both the U.S. and China, to minimize any potential threat to them of becoming theaters of economic conflict in the future.

  • Grant conditional MFN status to countries that demonstrate the willingness adopt human, economic and political rights standards and grant full MFN status upon attaining those standards and become responsible members of the world community. This policy needs to be promoted throughout Latin America and Africa. 

 

This combination of new policies will open the U.S and Tennessee to world markets, with home based manufacturing that is designed to be responsive and innovative to our home market and the markets around the world.

Refrences

  1. https://www.cdc.gov/sars/index.html

  2. https://www.cdc.gov/sars/about/fs-sars.html

  3. https://www.forbes.com/sites/mattperez/2020/04/08/report-us-intelligence-officials-warned-about-coronavirus-in-wuhan-in-late-november/#1b381df2a1eb

  4. http://chicksonright.com/blog/2020/02/18/biden-proclaims-that-nobody-will-be-deported-until-they-have-committed-a-felony/?fbclid=IwAR0mKj9A-ze0RaOUz3O0KroghkYtDy9AOzFPdMklRuT-FHgK8GTQ1ab2mDs

  5. Op. Cit. Forbes

  6. https://graphics.reuters.com/HEALTH-CORONAVIRUS/USA/qmypmkmwpra/

  7. https://www.nationalreview.com/2020/03/coronavirus-outbreak-how-it-spread-nationwide-from-washington-state-nursing-home/

  8. https://www.nbcnews.com/politics/congress/senate-passes-8-3-billion-emergency-bill-combat-coronavirus-n1150521

  9. Ibid.

  10. https://www.phe.gov/about/sns/Pages/default.aspx

  11. https://www.phe.gov/about/sns/Pages/responses.aspx

  12. https://www.google.com/url?q=https://www.rollcall.com/2020/04/09/the-national-stockpile-is-out-of-supplies-to-give-to-the-states/&sa=D&source=hangouts&ust=1588880631525000&usg=AFQjCNEwTWeu62gsAgnh7ZWZI2awmlIv1w

  13. https://www.worldometers.info/coronavirus/

  14. https://www.tn.gov/health/cedep/ncov.html

  15. https://www.bea.gov/news/2020/gross-domestic-product-fourth-quarter-and-year-2019-second-estimate

  16. https://www2.deloitte.com/us/en/insights/economy/us-economic-forecast/united-states-outlook-analysis.html

  17. Ibid.

  18. https://www.nytimes.com/2020/04/10/magazine/coronavirus-economy-debate.html

  19. ibid.

  20. https://www.bloomberg.com/opinion/articles/2020-04-08/coronavirus-how-would-you-decide-to-restart-the-economy

  21. https://www.morningstar.com/articles/976107/coronavirus-update-long-term-economic-impact-forecast-to-be-less-than-2008-recession

  22. https://www.businessinsider.com/coronavirus-layoffs-furloughs-hospitality-service-travel-unemployment-2020

  23. https://www.marketwatch.com/story/jobless-claims-soar-66-million-in-early-april-as-coronavirus-layoffs-swell-above-15-million-2020-04-09

  24. The Schooner Exchange v. M'Faddon, 11 U.S. 116 (1812), 

  25. Typical exceptions are the commercial activity exception, at 28 U.S.C. § 1605(a)(2), and the domestic personal injury exception, at 28 U.S.C. § 1605(a)(5). 

  26. https://www.ibisworld.com/china/market-research-reports/medical-device-manufacturing-industry/

  27. https://www.ibisworld.com/china/market-research-reports/medical-device-manufacturing-industry/

  28. https://www.cnn.com/2020/03/06/business/medical-masks-china-shortage-suppliers/index.html

  29. https://www.npr.org/sections/health-shots/2020/03/05/811387424/face-masks-not-enough-are-made-in-america-to-deal-with-coronavirus

  30. https://www.forbes.com/sites/stevedenning/2011/12/21/why-a-firm-has-only-one-bottom-line/#61c06e591167

  31. Ibid.

  32. https://www.governmentcontractslawblog.com/2019/07/articles/baa-and-taa/baa-buy-american-again/

  33. https://smallgovcon.com/statutes-and-regulations/gao-investigates-buy-american-act-exceptions-and-waivers/

  34. Op. Cit. Government Contract Blog

  35. https://www.americanmanufacturing.org/blog/entry/manufacturing-job-loss-to-china-swells-to-3.7-million

  36. Ibid

  37. Ibid

  38. https://www.epi.org/press/the-growing-trade-deficit-with-china-has-led-to-a-loss-of-3-4-million-u-s-jobs-between-2001-and-2017/

  39. https://www.heritage.org/markets-and-finance/commentary/trump-and-congress-must-work-together-revive-us-economy-free-market

  40.  Ibid.

  41. https://www.forbes.com/sites/susandudley/2020/05/14/regulatory-reform-to-get-the-economy-moving/#531d8d311681

  42. https://www.heritage.org/asia/commentary/the-great-us-china-divorce-has-arrived

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