29 March 2020
How Trump Squandered an Opportunity to Contain Coronavirus
Dr. Leif Rosenberger
During this moment of global trauma, it’s hard to think about anything else except the deadly Coronavirus. Americans are stuck in their house afraid that if they even go for a walk around the block and get too close to someone, the virus could end up killing them next. Doctors and nurses without personal protection equipment (PPE) face more and more Americans struggling to breathe. And yet hospitals don’t have enough ventilators to keep all of these patients alive.
As American doctors and nurses face a life and death situation everyday of not enough PPE supplies for themselves and not enough ventilators to keep their patients alive, it’s demoralizing for the American people to learn that President Trump sent 17.8 tons of supplies to China. Instead of putting America first, Trump put the lives of American doctors, nurses and patients last. The only good news is China is sending back some of these medical supplies. But it’s too little, too late to get ahead of the power curve.
Donald Trump says the coronavirus “came out of nowhere … and blindsided the world.” This falsehood plays well at the president’s rallies. But the truth is totally different. U.S. national security and public health experts have been warning Trump for years that a pandemic like Coronavirus was on the way.
During Obama/Trump transition, Obama officials warned Trump’s officials to get ready for a deadly pandemic. The U.S. national intelligence worldwide threat assessment warned that a flu pandemic or other large-scale outbreak of a contagious disease could lead to massive rates of death and disability that would severely affect the world economy. A 2019 study by the Center for Strategic and International Studies (CSIS) at Georgetown University said that the U.S. was extremely vulnerable to global health security threats.
No Big Deal?
But Trump dismissed these warnings and saw the situation totally differently. His public message was the virus was no big deal. During a 28 February campaign rally in South Carolina Trump called the virus a Democratic Party created “hoax.” In press conferences and tweets Trump downplayed the severity of the virus. Trump said, “Everything is going to be great (because) we pretty much shut down (the virus) coming in from China.” He also made false claims that the number of coronavirus cases was falling. He said the virus was “very much under control … We’re very, very ready for this.”
Despite Trump’s reassurance, the Trump administration did not shut down the coronavirus. By mid-January it was obvious that the virus was spreading well beyond China. Trump’s response was woefully deficient given the severity of the threat. Obama’s national security adviser Susan Rice wrote an article in the New York Times that said:
“So far, the Trump administration has failed miserably. … The number of cases in the United States is growing exponentially and our health system is ill equipped to determine the scope of the disease or to treat the explosion of serious cases that will almost certainly (occur).”
Global Pandemics a Low Priority?
As Trump officials flailed away during Trump’s January and February denial phase, it wasn’t clear who was in charge of managing the pandemic. There was no clear chain of command and no single figure with access to the president to move the machinery of government. In this regard, Trump’s was his is own worst enemy. In sharp contrast with the experts in the pandemic field, Trump deemed pandemics a low priority.
In 2018 Trump drastically cut the size of the U.S. government’s capacity to fight pandemics. Trump cut 80% of CDC funding used to fight global pandemics. Homeland security adviser Tom Bossert, whose portfolio included global pandemics, left. U.S. national security adviser John Bolton disbanded the NSC’s global health unit. Rear Adm Tim Ziemer, top NSC official in charge of a pandemic response at NSC, left.Dr. Luciana Borio, NSC Director for Medical and Biodefense Preparedness, also left.
Beth Cameron, who ran the NSC pandemic office at the NSC in the Obama administration, said the NSC pandemic office was set up to be the “Smoke alarm” and get ahead of emergencies and sound a warning at the earliest sign of fire – all with the goal of avoiding a 6-alarm fire. Cameron was mystified when Trump and Bolton closed the office. That ill-advised decision left huge vulnerabilities in the U.S. global preparedness.
Critical Time Lost
Trump’s mindset that the virus was “no big deal” and his elimination of NSC experts to sound the alarm bells was a deadly combination for the American people. Without presidential leadership and a decisive NSC early warning system, critical time was lost to get ahead of the U.S. infection rate. Senior CSIS vice president J. Stephen Morrison stresses that “Time is the most important element. The loss of time is the most dangerous thing in an epidemic.” In short, coronavirus got way ahead of the power curve and Trump was now playing catch-up.
In addition, Trump made lots of false claims. Trump said, “Anybody that needs a test gets a test.” In fact, the lack of testing was huge problem. To make matters worse, the initial tests approved by the CDC were faulty. As a result, the U.S. was far behind most industrialized nations in understanding the extent of the infections within its borders. As of 2 March, less than 500 people had been tested for coronavirus in the United States. That was a small fraction of 13,911 tests in the UK, a much smaller country as of 2 March.
Trump’s advisers told NBC News that their failure to focus on widespread testing was their biggest misstep. When NBC’s Kristen Welker asked Trump whether he took responsibility for the delay in widespread testing Trump answered: “I don’t take responsibility at all.”
While Trump was still in his “the virus is no big deal” mindset, there was a flurry of op-eds. Former pandemic expert Dr. Luciano Borio, wrote a 28 January WSJ op-ed entitled “Act Now to Prevent an American Epidemic.” She said the virus was spreading at alarming rates and called for widespread testing and beefing up hospital preparedness. Tom Bossert, Trump’s former homeland security adviser, wrote a Washington Post op-ed and said the U.S. needed to take dramatic action to stop a looming public health crisis. Dr. Nancy Messonnier, National Center for Immunization and Respiratory Diseases Director, spoke of the need to mitigate the damage rather than contain its spread.
Pence: “Risk of Infection Remains Low.” Really?
Trump was furious. Nobody at the White House was saying anything like this in public. Messonnier’s remarks forced the White House to play catch-up. Previously the White House had treated the virus outbreak as a foreign threat and blamed China. The administration struggled to pivot to the problem of mitigating the virus inside the U.S. But Trump could not bring himself to sound the alarm. He blamed the media for blowing the outbreak out of proportion. Trump tried to put a muzzle on bad news coming from the experts.
Instead, he picked Vice President Mike Pence -- who allowed the outbreak of HIV to rapidly spread in Indiana during his time as governor there -- to control all White House official statements on the virus. Pence refused to refute Donald Trump Jr.’s claim that Democrats wanted the virus to spread and kill Americans. Pence flattered “President Trump’s great leadership” and gave the American people the false claim that risk of coronavirus infection “remains low.” In late February, Trump’s National Economic Council director Larry Kudlow echoed more false claims by saying ““we have contained the virus … pretty much airtight.”
While the Trump administration deserves much of the blame for not taking this pandemic seriously enough, hospital problems did not begin in the Trump era. They go way back in time. Take the ill-advised economic mindset at hospitals. Hospital administrators are often accountants from the private sector with no health care experience. Instead of rewarding nurses for the quality of their health care, they give bonuses to nurse managers to cut costs. When the number of patients decline, they send nurses home. Try managing a family budget when you can’t count on a 40-hour work week. These MBA trained” hospital managers also overwork the nurses when the number of patients rise. As a result, the nurses burn out and opt to find occupations that treat them as national assets rather than financial liabilities.
To make matters worse, MBA trained administrators come to their job with another ill-advised economic mindset to cut costs rather than save lives. Go to any hospital and open the supply rooms. You will find just enough supplies for that moment and possibly a few days ahead. This supply chain management system and “just in time” inventory management cuts costs and saves money at Wal Mart. But when the pandemic hits the hospitals, two things happen.
First, there is not enough personal protective equipment (PPE) to protect doctors and nurses when the pandemic occurs and Coronavirus patients come racing through the doors. Second, there is a huge shortfall of ventilators to save the lives of patients with the virus. At this point someone like New York Governor Andrew Cuomo rightly complains that New York only has a small fraction of the ventilators it needs to save the lives of coronavirus patients struggling to breathe.
“I’m not a Supply Clerk”
For a day or two, President Trump compared dealing with Coronavirus to a fighting a war. But he soon flip-flopped on that analogy and argued that the 50 governors were the ones in charge and took no responsibility for being behind the power curve. When asked if the federal government could do more to provide ventilators and masks to the governors Trump said, “Look, I’m not a supply clerk.”
In addition, a still ill-advised President Trump is now afraid the cure (social distancing and staying at home) is worse than the coronavirus. Trump is also afraid a weak economy could shatter his re-election chances. Trump initially said he would love to see the churches filled up on Easter Sunday. When Trump came out with this nonsense, Tony Fauci – one of the few U.S. pandemic officials who is not a Trump sycophant -- rolled his eyes. On 29 March Trump changed his narrative. Instead of calling the coronavirus a Democratic Party hoax, Trump is now saying “If the virus only ends up killing 100,000 Americans,” he did “a great job.” That’s quite a switch in his public relations narrative.
$2 Trillion Bipartisan Bailout
The only good news is Democrats and Republicans put aside their differences and agreed on a $2 trillion bailout in late March. First, money will help buy ventilators to save patient lives and buy desperately needed personal protective equipment (PPEs) for our first responder heroes in harm’s way. Second, there will be direct payments to Americans and expanded unemployment insurance. Third, there will be loans to small businesses, industries as well as state governments.
Sources: New York Times, Washington Post, Wall Street Journal, Financial Times, The Economist, Time magazine, CNN and NBC News.