An Open Letter to my fellow Americans

Subject: An Open Letter to my fellow Americans
From: P.K.
Date: 17 Mar 2020

An Open Letter to my fellow Americans

We stand at the brink of catastrophe. Public health experts now concur that the American hospital system will be overrun with millions of critically ill COVID-19 patients. With a shortage of intensive care units and ventilators in America - to say nothing of even more advanced life support technology like ECMO (ExtraCorporeal Membrane Oxygenation) systems - it is certain that in the near future, on a massive scale around the country, medical caregivers will be forced to pick out a sizeable majority of their patients to let die.

Meanwhile, even those awake and aware are largely sitting by and watching this disaster come.

Unless we, as a whole, step up to meet this challenge, unless we mobilize at every level and stop wasting time waiting for solutions to descend from a government that by its own admission is focused only on defraying the financial costs of this pandemic and could care less for the human costs (an administration that has dragged its feet every step of the way, encouraged sick people to carry on as usual, thus spreading the virus, and has only delivered delayed ineffectual half-measures rather than the decisive actions necessary to fight a pandemic, oscillating wildly between mind numbing denial, baseless reassurances that undermine public safety, and empty promises - with self-aggrandizement and petty partisan jabs remaining the only common denominator to all three), we face catastrophe the likes of which our nation has never seen before.

Corporations need to step up.

Tech firms with precision assembly lines need to shelve entertainment devices in favor of refitting their assembly lines to build ventilators and other types of advanced life support and intensive care monitoring units. People need to survive now more than they need a new Gameboy, a faster tablet, or fancier home automation. When the coronavirus first reared its ugly head, Chinese tech firms including Foxconn, Xiaomi and Oppo switched their production to medical supplies. Do American tech firms care less for their consumer base than these companies overseas?

The same is true for domestic automotive manufacturers (who are stepping up in the UK but still sit silent and apathetic here in America) and the same is absolutely true of the Defense/Aerospace industries. Before you of the latter persuasion spout off the predictable lines about military readiness, let's face the facts: we already have an enormous stockpile of machinery for war. If DOD aligned corporations truly exist to protect American lives by technologically assisting those who defend our country from all threats, foreign and domestic, then get into gear and do it. The front lines are right here in the American heartland, right now, manned by our doctors and medical personnel, strewn with the bodies of American citizens who have already fallen prey to our greatest domestic threat yet (SARS-COV-2, the ruthless relentless enemy that causes COVID-19 disease), and you are doing nothing.

If all the deaths your inventions have spread have ever truly been in the service of protecting American civilians and America as a whole, then now is the time to defend, to save lives, and to prove that there is some mote of a noble purpose buried in the sprawling American military-industrial complex.

Put another way, China did it. The nation we continually castigate for undervaluing human lives, turned the energies of its war machine to saving lives, both with the deployment of several thousand military doctors to fight the coronavirus in Wuhan, and with the military contractor Chengdu Aircraft Industry Group refitting some of its assembly lines (in just three days, with the brain power of over 250 engineers) to produce medical equipment instead of parts for stealth jets.

Are we Americans, the self-proclaimed champions of human rights - we who claim to value equally and fully every human life and have repeatedly gone to war for that reason so very often - truly going to do less now that our time to shine has come? Do we only value human lives as a rhetorical tool to justify ending lives, but not have any interest in saving them?

Chemical (and petrochemical) manufacturers need to step up and convert their supply lines to producing products that will protect the healthcare workers who stand at the highest risk on the front lines, and their patients. As a nation, we need hand-sanitizer, virucidal disinfectants, gloves, and non-woven filter fabric for N95 masks more than we need perfumes and plastic thingamabobs. French cosmetics conglomerate LMVH is shelving production of three lines of luxury scents and cosmetics to provide twelve tons free hand sanitizer to French hospitals this week, with more to follow, and the Chinese petrochemical Sinopec shelved a variety of plastic products and opened new production lines to produce enough non-woven material for 1.2 million N95 respirators daily. Are we going to continue sitting with hands folded and letting people die because we cannot be troubled to manufacture something well within our capabilities that would have saved them?

Luxury goods and textile manufacturers need to shelve the fancy clothes and quilts in favor of manufacturing masks and haz-mat suits. Doctors and healthcare workers are dying while we sit idly by. Right now, America does not need a giant pile of fancy throw pillows. We need our medical caregivers to stay healthy. We need our hospitals to not turn into giant petri-dishes or death-rows as basic protective gear runs out.

Even if your factories are overseas, that did not stop Australia's Eagle Health from expanding its overseas production lines to ensure an adequate supply of masks for Australian citizens, not should it stop you. Trump-esque labor wars need to take second place to fighting a pandemic here and now, so are you really going to continue making lame excuses?

Now is the time to step up and meet this challenge with a focus on saving lives rather than turning a corporate profit. Now is the time to give, not sell. Jack Ma of Alibaba fame has just gifted 500,000 COVID-19 test kits to America and a million masks, and is similarly supporting European countries fighting coronavirus. If he can give to save people utterly foreign to him, are we going to pinch pennies instead of saving our own citizens?

The healthcare system is stretched thin, starved by the powers that be, so now is not the time to be watching your bottom line. Save lives today and your corporations will profit tomorrow as a grateful public remembers that you were there for them in their time of need. Focus on profit today and everybody looses.

It might seem tempting to step back and turn a blind eye, to say that it is too late and we cannot possibly do enough fast enough for such endeavors to be worth it. The fact is, this is another pathetic excuse.

It is true that a lack of timely accurate testing caused by deep-seated political apathy in the USA has enabled the spread of this virus from coast to coast, and that because of this, now we are facing an imminent long-duration disaster in which (for the foreseeable future) orders of magnitude more Americans will need mechanical ventilators (and more advanced life support systems) than our healthcare system now has the capacity to deliver. But even if a single company can crank out a few thousand ventilators after refitting its assembly lines in a marathon week of dedication and innovation, are those thousands of lives so worthless to you that you cannot be troubled to invest a week and fight for them?

What about the number of lives you can save by running that assembly line for a month? At what number of people do their lives start to be worth your trouble?

In America, more so than anywhere else in the world, we have embraced wholeheartedly the Capitalist individualist system. Now that we face catastrophe, at last we will find out if this system deserved the authority we have vested in it.

We have empowered corporations over ourselves. We have even made our healthcare into a for-profit corporate conglomerate instead of a publicly owned asset. We have empowered you, your companies, your world of consumer goods and competition over cooperation, because we believed that capitalism would most effectively enhance human progress, and we have done all this with nigh-manic devotion, ruthlessly stomping out any misgivings that ever arise.

Today, now, this crisis is your chance to prove to us that you were worthy of our support, that you deserved the faith and trust we placed in you, and the immense power we handed to you, kneeling in deference as you used it to shape our policies, cultural identity, and future.

In the interim, the military must step up. Yes, military hospitals are few (though every hospital ought open its doors and save lives at a time like this), but more significantly, our military personnel are trained to face biochemical warfare hazards. Since even when administrations (particularly this present one) financially strangle every other department, they keep Defense spending cushy, this translates logically to a sizeable stockpile of hazmat protective gear, as well as military doctors and field medics who can contribute to the coronavirus response something that many civilian medical providers sorely lack: the equipment and training to deal with highly infectious pathogens under stressful conditions.

We eventually renamed our Department of War as the "Department of Defense", wanting to project the image that it exists and acts to defend the American public.

Well, then. Wake up and smell the death and decay.

You are needed. Right here, right now, to defend the civilians you have sworn to protect. The threat is right here, among us, inside us. Do the lives of American citizens cease mattering to you without a target to be lined up for blame? Is it perfectly fine to sit there twiddling your thumbs and napping on stockpiles of biohazard response gear while doctors fight and die on the front lines, just because for once your enemy is some-thing instead of some-one?

Does the Department of Defense only take interest in "defending" when it can be done by killing Homo Sapiens, rather than saving Homo Sapiens?

Because as you are doing squat right now, that's what it looks like.

The CDC and NHS need to step up and come clean.

Let's face it. The CDC screwed up. The American government screwed up.

With the capability of COVID-19 to spread at an exponential rate already demonstrated beyond any doubt in Wuhan - and this despite the local authorities no-holds barred 'overkill' approach to containing the virus - how can it ever be considered even remotely responsible that when America was offered the field-tested reliable and already available SARS-COV-2 tests distributed by the World Health Organization to almost sixty nations, instead of accepting, you were either leading or complicit with the official choice by the Pence-helmed coronavirus task force that opted to delay testing, endangering the lives of American citizens, just so you could develop your own tests.

A responsible public health agency fighting a rapidly spreading pandemic would immediately begin aggressive comprehensive testing with any working test from anywhere, and develop alternatives alongside. A responsible public health agency would not have sacrificed the lives of an unknowable number of American citizens to pander to the ego games of a nationalist cryptofascist president with absolutely no regard for human life, and no comprehension of science.

But then our CDC has not emerged as a responsible public health agency.

How many American citizens are going to die because while you wasted critical time choosing not to use the immediately available WHO test (then wasted more time epically botching the tests that you produced, then wasted another week in a tailspin over this catastrophe, and yet another week or two after that sent out incomplete test kits that lacked some or all of the reagents), the virus spread and multiplied among us without any attempts at detection or containment?

Was it worth it?

One assumes that educated health officials could not possibly agree with such a moronic choice, so what was it then? Did you loose your nerve after having budget cuts serially rammed down your throat by a technophobe moron of a president (who had thus already effectively crippled your ability to perform your most basic duty of controlling and preventing disease) and quietly cowered in fear of a volatile autocrat who is notorious for firing anyone who disagrees with his myopic uneducated views?

Was playing along with a clearly disastrous policy that assured testing delays more valuable than the people who will die because of this chain of catastrophes?

Whatever the answer to the preceding, it is the answer to the following question that is infinitely more important: What are you going to do about COVID-19 going forward?

Presently you teeter-totter between following the party line of an ineffectual apathetic government that breathes denial and only thinks of lining its pockets, and trying to do your fundamental duty of saving lives. The two are mutually exclusive, and the sooner you face the facts, the better.

Wake up. Stand up. Stop failing your public.

Hospitals around America are waiting for you to show leadership, courage, and initiative. So far, this is sorely lacking.

The CDC is not supposed to function as the Center for Deflections and Cover-ups, or as a catch-all fall-guy for a failed administration. It is time to grow backbones and level with the public.

Level with the healthcare providers who still are being hamstrung by your slow ineffectual responses and your compliance with unconscionable gag-orders. Stop telling people not to worry about asymptomatic transmission until you are absolutely sure that it is not a threat - and odds are you will never be sure of that since recent research is pointing to asymptomatic/presymptomatic transmission as a leading cause of contagion.

People need to adhere to social distancing as a general practice, not just avoid the obviously sick, but will they do that without you explaining to them why they need to stay away from people who appear healthy? And sure this means less revenue for theaters and restaurants. Sure this is inconvenient to a political system that gauges everything against the litmus test of financial profitability. None of this ought matter to you because it will save lives. Truth and transparency will help you control and prevent disease. So decide whether or not you deserve the title, grow a spine, and make a stand.

Stop trying to manage us. Stop trying to pacify us.

Stop minimizing a pandemic and hushing up the facts that are matters of life and death each time our top unscientific ignoramus (who suffers in equal measure from distilled idiocy and pathological arrogance) tells you to keep the infection statistics quiet for fear that they will shake the stock market and aggravate his electoral dysfunction.

And for God's sake, for America's sake. Show some initiative. America needs more tests, by the millions, yesterday. Instead of prostrating yourselves before a wannabe autocrat who would rather watch Americans die by the thousands to millions than use imported test kits, acquire the sense to realize that right now we need millions of tests, not nationalist bullshit. Are you too arrogant to accept that other people might already have a working product and the means to deploy it rapidly? Do the lives of countless American citizens mean less than toeing the party line of an administration that is anathema to everything you are supposed to stand for, and the bloated egos of a few antiscientific idiots who are vested with power in equal measure to their colossal stupidity?

Or are you, yet again, financially hamstrung by this failed hypocritical government that promises emergency funding but has a track record of blatant lies? Because if you are, the public has a right to know the truth of why they are being abandoned to die. Only then might there exist the political will to get the CDC the funding needed for an aggressive comprehensive testing regimen (that just might stave off a pandemic catastrophe here in the USA), because our political system cares nothing for morality, only popularity.

As long as the misdeeds of this failed administration are covered up or minimized by you and agencies like you, you are complicit in perpetuating the lackluster response in this nation which is killing people.

Hospitals, University and private laboratories, and State healthcare systems need to step up.

You are rationing tests. Faces with rolling shortages of test kits, and failed by the federal agencies that are unable or unwilling to rise to this challenge and provide enough tests to effectively combat the exponential spread of this disease, you are being given a terrible choice. You are forced to choose what tiny minority of people needing a test will actually get tested, and what majority will be allowed to carry on in ignorance, putting themselves and others at risk. Do you test the individuals at highest risk of dying from this pandemic - because they will most likely need critical medical care and knowing how many such patients are inbound is vital to allocating medical resources and saving lives - or do you test the younger, fitter individuals who are more likely to become only mildly ill and each can spread the disease to tens or even hundreds of new patients, as either they or their employers are more likely to linger in elective denial without a positive test.

In the meanwhile, you on the front lines - doctors, nurses, technicians, etc. - are at elevated risk because of a lack of sufficient protective gear. You might die trying to save lives, and worse, you might die in vain unless the medical community as a whole rethinks how it is approaching this pandemic. Because soon you will be facing a series of far worse choices: Soon you will have to select what majority of your patients you are going to have to let die.

Our administration is failing you and failing us. Unless immediate steps are taken to detect and quarantine those afflicted with the virus on a massive scale - even those presymptomatic or asymptomatic - there will be orders of magnitude too many in need of critical care (and even life support) to do anything other than allow the majority to die, and alongside the unfolding of this tragedy, more and more medical personnel will die as exhaustion, stress, and repeated exposure take a toll on your immune systems and attentiveness with regard to sanitary barriers.

Right now, you are stuck rationing tests and watching the coming catastrophe. Right now you know that with every day, the number of your patients you'll inevitably triage out to die grows, exponentially, with every day of inadequate testing, while you wait on inadequate promises from apathetic government agencies who keep delivering: too few, too late, and thus keep dooming more people.

Meanwhile, alternate testing methods are being ignored. Flu surveillance samples and studies have proven adequate for coronavirus detection, but the powers that be do not permit it. Well, tough. Now is a time to save lives and ask for forgiveness rather than permission, because people die while permission lingers in the realm of red tape, empty promises, intellectual property squabbles, and political apathy.

The present testing system remains doubly ineffective because the CDC insists on verifying every positive test conducted by a state, hospital, or private laboratory, using two test kits for one person and thus halving the overall number of people who can be tested. With an ongoing shortage of tests, this is inexcusable.

How can this be addressed?

First: Testing needs to be expanded rapidly and aggressively without wasting limited tests on double testing. For as long as the status quo is sending the majority of positive patients home to self-quarantine, a false positive will not endanger anyone's health while failure to detect is deadly. Any labs with the capacity to test via PCR amplification or other efficacious methods (the WHO protocol is available freely, for instance) need to get testing, and issue presumptive positives to all positive cases they detect. (Symptomatic presentation, or the exclusion of other likely causes can be used by medical professionals who are becoming familiar with the disease to issue a near-certain positive). Presumptive positives can be added to a queue for later retesting if tests are available in surplus, but as long as presumptive positive patients are self-quarantined, contagion risks are minimized.

States need to order mandatory self-quarantine for these patients until a retest or symptomatic development confirm a definite positive.

Second: Home quarantine is a terrible idea for confirmed or likely positive cases since they will definitely infect the other members of their family or housemates. States need to step up and rapidly set aside quarantine spaces for large numbers of COVID-19 patients where they can receive medical monitoring and be queued for treatment if their condition worsens, while not risking adding any more close contacts to the number of patients that the healthcare system is unprepared to handle. For example, in China, large public spaces like stadiums were converted to quarantine facilities for confirmed positive patients with symptoms mild enough to not need supplemental oxygen, thereby minimizing the risk of contagion to patients' families and communities. High risk patients (either severely ill or elderly or with preexisting conditions) were sent to isolation units in hospitals to ensure the most rapid possible care. To facilitate this, the hospitals with the most advanced life support systems were emptied, ventilators and ICU units acquired and installed, elective operations cancelled, at least one new hospital built in a matter of days, and hospital wings refitted to create isolation wards bracketed by clean zones at opposite ends so healthcare personnel could suit up at one end, enter the isolation ward to care for patients and the exit at the opposite end for decontamination.

Do our States, here in the greatest nation on earth falter at the thought of expending whatever resources it takes to give our citizens the same quality care?

Third: Presumably every hospital in the US has Computerized Axial Tomography imaging (CAT or CT scans for short). When tests ran low in China, doctors there switched to looking for "ground-glass opacities" in thoracic CT scans, enabling them to decide definite negative or preliminary positive in under ten minutes. While tests are available, confirmation is a good idea. The CT scan method has a possibility of false positive, since it very effectively diagnoses even very early stage pneumonia, including in presymptomatic patients, and it would be a terrible idea to put someone with bacterial pneumonia in an isolation ward with COVID-19 patients, but with the ability to screen hundreds of patients a day, CT scan prescreening enables testing facilities to focus their limited test kits on likely positive patients, thereby quarantining them from the general population with orders of magnitude greater efficiency. In the event that SARS-NCOV-2 tests run out, medical personnel can diagnose likely positive from a ground-glass-opacity CT scan and the elimination of other common causes via influenza test and bacterial culture or microscopy, so testing can still carry on as at this point even a false positive is less catastrophic than a failure to detect a single true positive.

Fourth: How else can testing be ramped up to adequate levels? The WHO has working tests. Philanthropists from around the world are donating tests and medical equipment to nations that need them, including to the USA, with 500,000 tests gifted to us on March 13th, 2020 by the Jack Ma charitable foundation. These philanthropic organizations are supporting medical providers around the world, so we need to do our part, and expand testing ability and medical manufacturing to the best of our abilities at the highest rate possible, but for as long as our own capabilities are still coming up to speed, it is only decent - only faithful to the Hippocratic oath you have sworn - to join hands with medical aid organizations around the world, and to hell with the arrogant stranglehold that puts the whims of our pathologically egotistical dark-triad president over the lives of millions.

Now is not the time to pander to a nationalist psychopath who would rather see American citizens die than see them saved by foreign-made medical equipment.

Now is the time to stop waiting for the vacant promises of a failed government to materialize and instead reach out and request supplies of the necessary tests and protective equipment - and should this not be possible because of red tape, that is where our Red Cross can liaise with other similar organizations based in other countries, and where medical organizations that transcend borders can come into play to build the bridges that save lives. There is nothing disloyal in this, nothing mutinous. A virus knows no borders, and before such a relentless pitiless enemy, the entire human race is one. It is only the hopelessly nationalist who insist, under such circumstances, to put their petty egotistical bigotry over hundreds of millions of human lives the world over, and that by its very nature makes them unworthy of obedience or respect. "Just following orders" makes one no less culpable when those orders are purely and clearly evil.

Fifth: As stop-gap measures that are surely picking a lesser evil than failure to test, perhaps samples from individuals who live together can be mixed and tested with one kit since a group of people living together are likely all functionally positive if one is, (so long as our States refuse to step up and provide quarantine facilities that will keep patients' families safe) and while that will not prevent spread inside a household, it can at least minimize public contagion. This lesser-evil approach may not be a good idea under any circumstance. I'm not a doctor, but you are.

You are the people we need brainstorming. You are the ones on the front lines. You and your colleagues around the world who are all fighting the same virus and have faced or are facing many of the same obstacles all have vital contributions to make. Peer-reviewed journal articles are the backbone of scientific progress but they can be slow and the exchange of ideas pertaining to them even slower.

You have to break free of the confines of waiting for an ineffectual CDC (playing along the party lines of a pathologically indifferent government) to give you the green light and instead reach out, cross-pollinating ideas - even the seeming long-shots - with your fellow researchers and doctors around the globe, for novel effective ways to diagnose, isolate, and treat this disease. And I do say treat because while no cure exists at present, staying abreast of how your colleagues are using novel drugs, ECMO, and convalescent plasma therapy will put you in the best position to be the best doctors you can be.

You need to share ideas, experience, and even equipment, not just with the colleague in the next ward or the researcher in the next university but with everyone fighting the same fight that you are.

You need to stop asking for permission (waiting to be led by the hand like children, by an immoral administration), stop settling for being powerless, and pool the collective genius of yourselves and your colleagues across the world to start innovating solutions today instead of waiting for vague promises tomorrow. You need to figure out what these solutions require in order to be made a reality and make these needs known so that organizations and individuals who are prepared to step up and make a difference can deliver the resources that you need.

Religious leaders need to step up. They need to encourage those who put faith in their guidance to not sacrifice scientific caution and civic responsibility in the name of religious conviction.

Many, the world over, have already made these responsible decent moves, reminding us that protecting the health and lives of our families and communities is a greater piety than displays of faith that put at risk an uncountable number of our fellow human beings.

A few of dishonorable mention (like the majority of American Anglican church leaders and the majority of Eastern Orthodox church leaders), however, continue to willfully and knowingly facilitate massive gatherings, close contact, and fluid exchanges all of which rapidly spread death via COVID-19 - not only to the members of their flocks but to all those who these faithful will sicken when they fall ill.

All you religious leaders who are facilitating the spread of this deadly pandemic: your lives are yours to risk.

But encouraging your flock to attend your services is choosing to endanger not only their lives but those of their families and their close contacts and so on in a geometric progression of viral contagion (in the fashion of Patient 31 who spread coronavirus with religious piety to thousands in South Korea), adding up to a vast majority of people who have not consented to attend your ill-conceived services and yet who you have placed in deadly danger all the same.

With every choice you make to call your followers to your services, you are killing people. This is extremist fanaticism masquerading as piety, and evil masquerading as holiness.

Finally, we the people need to stand up. We easily think of the danger other people may pose to us (that they might sicken us, that they may be infected and shedding coronavirus but not know it) but rarely remember that we are just as much threats to them. We go out, even feeling ill, determined to live our lives as normally as we can, just like we would with a flu. But this is not influenza. This has killed more than 7000 people globally of just over 180,000 infected - almost 4 in a hundred. The flu kills one in a thousand. Under these circumstances, denial and apathy are deadly.

In simple terms, in refusing to inconvenience ourselves, we're willing to kill the people around us.

When we choose to travel, or go bar-hopping, or go to a theater in an area with known positive cases of COVID-19, we are endangering more than ourselves. We are endangering the people with whom we live and work, and the people of our community. When we choose to ignore medical advice to self-quarantine while waiting for a test result (a test we have taken because we know we're not feeling right), we're deciding that we are willing to risk spreading our illness to others (and from each of them to many more), some of whom might be older and frailer or already fighting another health condition, some of whom will die because of us.

Are their lives worth less to us than our own whims and pleasure?

When we - being human, all too human - elect to live in denial, choosing to ignore scientific fact and public health experts in favor of staying unruffled and incautious (because in truth we're scared of facing reality and our own mortality and it's less frightening to subvert our own reason and better judgment and believe what we already know is untrue) and then worse, we encourage others close to us to do the same, again we are giving this pandemic a helping hand. We are putting at risk the people we claim to care about, and in turn making them into involuntary accomplices to our apathy, our self-deception, and our selfishness.

Are the lives of the people we call dear to us - and those dear to them - worth less than the discomfort of facing our fears?

To follow up this necessary reflection with another: If we preach incaution and denial, not out of fear alone, but out of our personal allegiance to a dogma (political or religious) that demands blind faith in its unscientific reality-denying claims or party lines, are we not even more inhumane still?

Some of us bring people together and to us. In our restaurants and craft stores, in parties we host, in all manner of businesses, in worship, and on the campaign trail. We tend not to think twice about acting as we please. In relative health, we tend to underestimate the fragility of the human body, and at the instinctual level we tend to assume that COVID-19 just won't happen to us.

So far, personal caution is a personal choice. But when we cause others to gather around us, we acquire a duty of care to them. This is when we ought to think of their lives over our convenience, because in times of pandemic, it is not only our lives in our hands, but those of everyone around us.

This is not a time for people to think with partisan biases, bigotry, and their egos. Nor is it a time for complacency, denial, and baseless hopes.

This is not a time to wait for direction and permission to trickle down from a serially failed apathetic and indifferent leadership. This is a time to take the future into our own hands.

This is not a time to ask "what's in it for me?", but rather to ask "What is good for the whole?"

COVID-19 threatens all peoples of the earth, and now is the time for humanity to get off our collective behinds, stop telling ourselves that we can sit back and do nothing because it's somebody else's problem, stop thinking selfishly, and defeat this relentless invisible enemy.

P. K.

Epilogue: And where has the Government gone?

Our American government needs to (grow some semblance of a spine and) step up. Of all the steps needed that we may rise to this challenge, this is the one that could make every other act of courage infinitely more fruitful and possible. Frankly, it is also (based on the evidence to date) less likely than pigs sprouting wings and flying.

The problem is that the other steps rely on real people: individuals who do not all suffer from the pathological ignorance and arrogant selfishness that characterizes the administration presently infesting our White House.

Moreover, it's utterly unsurprising that the Dementor-in-Chief has continually hamstrung the official American response to coronavirus, viciously attacking officials making the right moves, spreading misinformation including his criminally malicious encouragement to COVID-19 victims to carry on as usual, going to work, etc (thus maximally spreading the virus), censoring Public Health officials, all while stroking his overly engorged rigid ego, of course.

Consider the obvious: Here is a president whose regime has spent years trying to ruthlessly prune back the welfare state, taking away nutrition support and medical coverage from America's most vulnerable citizens and ranting and raving about the costs of providing healthcare to the elderly and those with preexisting conditions.

Well, viola! Now we have a disease that predominantly kills the very people Trump would rather not have around and alive enough to need healthcare.

When Covid-19 has ran its ghoulish course, Trump and those of the same mind, will not have to take fire for their greedy hoarding - for telling the past generations of Americans who built our present and founded our future "you raised us, now we'll discard you" - for pruning back the welfare state, because an enormous percent of Welfare State beneficiaries will be too dead to be Trump's (and the Republicans') problem anymore, and much too dead to stand in the way of this administration lining its pockets with these so very convenient cost savings.

It is you, Trump (the metastasic tumor at the heart of American politics) who dismantled the Pandemic Response Unit on our National Security Council. You who repeatedly cut funding to the CDC even when the CDC publicly reported to you that going ahead with your budget cuts would reduce their ability to combat an epidemic by 80%.

It is you who destroyed existing healthcare protections for elderly Americans and those with preexisting conditions, and you who sucked dry funding that was allocated to education and scientific research.

In this crisis, instead of showing leadership or even any trace of integrity enough to own your serial failures, you have done nothing but damage America every step of the way. You encouraged your citizens to engage in deadly behaviors, called a pandemic a hoax, validated racist and nationalist rhetoric, silenced public health authorities, feuded with officials more responsible and intelligent than your vacuous neophobic self, and incessantly lied about the availability of tests, learning nothing from your embarrassing serial failures, finally decreeing that you " don’t want people to take a test if — if" you "feel that they shouldn’t be doing it". Not our doctors, our healthcare providers, or - what a novel thought - ourselves, citizens of the land of the free. Oh no. We're not an autocracy... except the choices over our lives and the safety of our communities all lie solely with you and your serially failed administration, from which unenviable group, you have already culled everyone with a few functioning brain cells and some portion of a heart and a spine (for fear that they might contradict your willful idiocy), insufferable egotistical egomaniac that you are.

You placed tens of millions of Americans squarely in the crosshairs of this pandemic by taking away every healthcare protection they had, while your apathy and indifference is adding more of your citizens to the target zone every day.

You proudly announced how happy you were for likely COVID-19 patients to remain without tests or medical care, putting more people at deadly risk, so as to keep the official numbers of the infected in America down, because you'd rather enable SARS-NCOV-2 in killing your own citizens than risk a few percentage points in the polls or your re-election prospects.

Let us put aside, for a moment, discussion of all the American citizens currently without any form of health coverage, all because of you. The people who have serious conditions now that adequate healthcare could have mitigated or prevented. The people you have helped to slowly but surely murder, because they are already sick with COVID-19, already heading towards death, and they cannot afford going to the doctor or clinic, paying for every other test first before they can be tested for the coronavirus - because of your moronic regulations that serve only to limit the number of Americans who can be tested at all, and your serial failures which have made these tests so rare as to justify these disastrous limits - and probably contract some other contagion or two at an overcrowded understaffed low-cost clinic, only to be sent home to die at the end, because of the endemic shortages in our healthcare system that are exacerbated by your vampiric leaching of funding from public healthcare, and your delay, deny, deflect, (and doom-the nation) strategies of presidential failure.

Unless America wakes up immediately and realizes just how utterly useless and dangerous you are, these people are already doomed, because of you.

Now let's look at the Americans who have some health coverage, (and incidentally a large hunk of the population you ought to thank for your seizure of power). Those comfortably middle-class of our people who were happy to see you prune back the Affordable Care Act, because why should we pay for our fellowman, and who needs a cushy public healthcare system when we can afford provider choice?

When this pandemic starts sickening people by the tens of millions, and it will, because you destroyed America's Pandemic Response Unit, and delayed, lied, and denied, do you have the backbone to face the reality of what will happen in an America that has less than a fiftieth of the ventilators it will need?

No. Your track record is that of a vacuous blunderer incapable of absorbing scientific fact crossed with a pathological liar incapable of ever facing any tiny amount of factual truth that has somehow trickled through your industrially reinforced skull.

Your average American (and indeed your average human being) is orders of magnitude more intelligent and honest than you, however, and the results of this catastrophe are obvious: With orders of magnitude too few ventilators, patients will be triaged for treatment, and in an America polluted by rightwing rhetoric in the era of Trumpocracy and the selfishness that Trump has managed to make contagious, where a greedy run for power and money and utter irreverence for responsibility has become our callsign, domestically and abroad, it is inevitable that the young able-bodied worker will be prioritized over the individuals who have been portrayed as burdens to society by conservative elements for years now - because the latter aren't useful anymore to a system that blatantly measures everything against the metric of profitability: they have already worked their 5-6 decades, they already paid their taxes and propped up the economy and they have no money left to give a vampire state, or they are disabled from the start and equally unprofitable.

Anyone can see exactly where this is going.

Which brings us back to you, Mr. "I Take No Responsibility", Mr. Egotistical Egoist, Mr. 'Leader of the free world' whose every speech proves you fundamentally retarded (literally lagging behind the entire planet) in you willingness to respond adequately to any situation, let alone a crisis.

Since, as you claim, thanks to you, the American economy is stronger than it has ever been, and in fact the strongest in the world, now is the time, for once to stop lying, stop making vacuous promises and put your money where your mouth is.

Now is the time to build temporary hospitals and isolation zones. China managed it in a matter of days. Can you, Mr genius manage to do that in the same time, or less, since you are so much better than anyone else alive? Care to live up to that insufferable ego of yours? Or is your genius, like so many other of your claims another blast from the wrong end of an over inflated windbag.

Now is the time to build or buy ventilators by the hundreds of thousands - whichever is faster - and set up ICU units to rise to the occasion. Now it the time to stop pinching pennies (a feat for a man who shorted kids who played for your rallies), and for once, just once, realize that the lives of your citizens are worth more than the money you prize over all other things.

Now is the time to offer business incentives to American manufacturers to convert their supply chains to manufacturing ventilators and other advanced life support equipment, hazmat suits, masks, gloves, hand sanitizer, and disinfectants. China did it. Will an America defined by your presidency choose to do less for our citizens?

Now is the time to realize that America needs ventilators more than census-takers and open Government jobs with competitive salary, paid training, guaranteed healthcare, and COVID-19 screening (since pandemics spread fast in factories), to build the ventilators that American patients will need.

Now is the time to stop being a useless whiner, a ranting partisan tweeter, and an egomaniac schoolyard bully always looking to pick a fight and play the 'witch-hunt' self-pity card when held to accountability. Instead, grow a spine, some portion of a heart and a brain, and for once in your utterly undistinguished life, be a leader.

In our favorite bogeyman nation of China, no expense was spared to give every patient the highest chance of survival, and every healthy citizen the highest chance of remaining healthy. They mobilized to fight this pandemic without excuses or delays.

We Americans deserve this much and more from our government, here in the greatest nation in the world. Do not forget that we put you in the exalted position of power you hold.

We are not asking you to turn back the clock and respond to a crisis that blindsided you. China was blindsided. America has had months of ample warnings and yet you, the head of our executive refuses to act.

We are not asking you to govern 'for the people' coming from a position of economic recession and an actual lack of means. We are asking you to use your vaunted economic success to govern for the people, and save the lives of countless American citizens who right now are being valued by you below the dollars you are unwilling to spend to save your citizens.

When we write your history, we will not care to memorialize the shape of our economy when it was never used to save American lives. We will not thank you for supporting your favored oil and travel industries while you left your own citizens to die without a fighting chance at recovery because we were not worth the price of medical equipment, or you putting a temporary hold on your nationalist mania, and allowing us to freely use imported medical equipment to save lives.

We'll write the history of your regime in the memories of watching our friends and family fight for every shallow excruciating breath, faster and faster, more and more desperate, until they drowned in blood-flecked phlegm.

We'll remember you for the weeks of gut-wrenching uncertainty while we waited for tests to be made available in our communities, and all your promises turned out to be lies over and over and over again.

We will remember you as the traitor who destroyed our Pandemic Response Unit, because the health of America does not fit into your pathologically myopic understanding of national security, who hamstrung the CDC, took away healthcare from our fellow Americans, put your popularity and re-election ambitions over the most fundamental right of your citizens - the right to live - and then topped this off by assuring us, while you sat twiddling your thumbs (under the continuous care of your personal physician) and watching your citizens dying, that you could not muster enough conscience and integrity to take responsibility for your ever-expanding serialized failures to be the leader that we Americans needed and deserved.

We will remember that here in the land of free speech, you censored any public health information that made you look as inadequate as you are, and thus prevented public health officials from being able to effectively combat this pandemic, as well as preventing them from being able to talk to us, citizens of America, about our health in a life-and-death crisis.

In these times, we need a President Kennedy. A leader who was selfless, honest, and gave tirelessly of himself to protecting human lives. We don't need our present caricature of presidency: a conman whose selfishness runs so deep that he stole money from children with cancer to line his well-padded pockets.

We need our government to stop obstructing the agencies and healthcare providers trying to save lives. We need a CDC and nationwide healthcare system that has the freedom and finances to perform their duties without tripping on the bloated ego, virulent fixations, and pathological selfishness of a substanceless blowhard every step of the way.

We need competent leadership.

Step up, Mr. Trump... Or Step Down!