Ill-Prepared for Virus, Administration Spreads Confusion

Half the world away in India as the coronavirus made landfall in the U.S. and the stock market tanked, President Trump experienced a rough week. While various administration figures issued contradictory statements, Trump himself made his own contribution at midweek, saying:

"Well, I don’t think it’s inevitable. It probably will, it possibly will. It could be at a very small level or it could be at a larger level. Whatever happens, we’re totally prepared.”

He was hoping to subsume the counseling of Nancy Messonnier, the director of the CDC’s (Center for Disease Control) National Center for Immunization and Respiratory Diseases, who in a briefing the day before warned that the virus’s spread to the United States was no longer a question of “if” but…

“exactly when this will happen. We are asking the American public to prepare for the expectation that this might be bad."

The president hoped to wish away the looming problem with improbable musings. On three different occasions in previous weeks he had put his faith in the virus behaving like annual flu:

 "There's a theory that in April, when it gets warm, historically that has been able to kill the virus."…
 "The virus. They're working hard. Looks like by April, you know in theory when it gets a little warmer it miraculously goes away."…"
 The virus that we're talking about having to do [sic], you know a lot of people think that goes away in April with the heat, as the heat comes in. Typically that will go away in April."

Trump counts on the economy to win for him re-election and is reportedly "furious about the stock market’s slide". He had said, "I know a lot about the stock market" and on Monday of the fateful week tweeted, “Stock Market starting to look very good to me”, only to see it nosedive 1,032 points that day. In that single week the Dow dropped 12% and has been gyrating since.

Trump's circle seemed to care more about stock prices than the contagion. His Director of the National Economic Council, Larry Kudlow, told The Washington Post late that Monday that investors should consider “buying these dips” in the stock market, take advantage of one-day slumps and “buy low”. Contradicting the worry of health officials, Kudlow's optimistic assessment on CNBC sounded as if the feared "community spreading" had already come and gone:

“We have contained this. I won’t say airtight, but pretty close to airtight. The business side and the economic side, I don’t think it’s going to be an economic tragedy at all...The numbers are saying the U.S. [is] holding up nicely.”

Commerce Secretary Wilbur Ross had a similar focus. Last month he told Fox Business, “I think it will help to accelerate the return of jobs to North America, some to [the] U.S., probably some to Mexico as well.”

At his news conference at midweek we heard a president too impatient to wait for April; he seemed to be trying to juice stock prices by declaring the global pandemic had been prevented in the U.S.:

"[W]hen you have 15 people — and the 15 within a couple of days is going to be down to close to zero — that’s a pretty good job we’ve done".

Early on that Wednesday, at the White House briefing on the coronavirus outbreak, Health and Human Services (HHS) Secretary Alex Azar said the opposite:

[W]hat every one of our experts and leaders have been saying for more than a month now remains true: The degree of risk has the potential to change quickly, and we can expect to see more cases in the United States".

Perhaps to calm fears, not least his own because he believes the lusty economy holds the key to his re-election, the president deeply misled the public. He has repeatedly said, "we're very close to a vaccine” and in that news conference said:

"We are rapidly developing a vaccine...The vaccine is coming along well, and in speaking to the doctors, we think this is something that we can develop very rapidly."

In fact, a candidate vaccine for Covid-19, the preferred name for the particular virus as one of a family of viruses named "corona", is only approaching first-step safety tests. Federal experts say anything for widespread use looks to be more than a year away. “We can't rely on a vaccine over the next several months,” said Dr. Anthony Fauci, the top infectious disease chief at the National Institutes of Health and probably the world.

Or maybe Trump didn't think a vaccine was needed, judging from his next thought. He also said on Wednesday about Covid-19 cases: “We're going down, not up. We’re going very substantially down, not up”.

At a time when preparedness should by the constant theme with the public, Mr. Trump was in full denial, tweeting:

“It’s going to disappear. One day — it’s like a miracle — it will disappear. And from our shores, we, you know, it could get worse before it gets better. It could maybe go away. We’ll see what happens. Nobody really knows. The fact is, the greatest experts, I’ve spoken to them all, nobody really knows.”

Pence, Newly-minted Epidemiologist

Rather than choosing a "czar" to oversee the health threat, as had Obama for Ebola, the president, thinking that some outside health expert might not be loyal — his primary test in a purge underway after impeachment — tapped Vice President Pence to run the defense against a pandemic. “He’s got a certain talent for this”, Trump said at the White House briefing.

He brings complications to this assignment. As late as 2000, he argued that smoking doesn't kill. In 2015 when governor of Indiana, he was faulted for his slow response when the state was struck with its worst HIV outbreak. In a federal government-funded inquiry, Yale University researchers found the epidemic could have been cut by 74% if Pence and state officials had acted faster. Instead they cut funding for the last HIV testing provider in the problem area. “It was a total collapse of public health leadership and a dereliction of duty in Indiana,” said the author of the Yale study. “They could have avoided this epidemic if science took the lead instead of ideology.” As cases spiked, Pence reportedly turned to prayer as the answer.

As soon as he took charge Pence ordered that all communication about the virus — no matter that they be from experts such as Fauci and Messionier — must first be cleared by his office.

That didn't stop President Trump. Weeks into the first cases reported in the U.S. the president is still spreading his own theories about Covid-19. When he called into Fox News in the first week of March, Sean Hannity informed him that the mortality rate for Covid-19 was thought to be 3.4%. Trump disagreed:

"Well, I think that 3.4% is really a false number. This is just my hunch, but based on a lot of conversations with a lot of people that do this [sic] because a lot of people will have this and it's very mild. They'll get better very rapidly. They don't even see a doctor. They don't even call a doctor...So we have hundreds of thousands of people who get better, by, you know, sitting around, even going to work, some of them going to work, but they get better...But they don't know about the easy cases because the easy cases don't go to the hospital. They don't report to doctors or the hospital in many cases, so I think that that number is very high. Personally I would say the number is way under 1%."~

the right stuff

The vice president quickly announced that Deborah Birx, leader of U.S. efforts to fight HIV/AIDS around the world, would be the “White House Coronavirus Response Coordinator”. It was a well-regarded choice and first step in what could be a long road as cases began to be reported in states around the country.

slings and arrows

President Trump and Democrats traded blame. At a rally he held the night before Saturday's Democratic primary in North Charlestown, South Carolina, the president called Democratic criticism of the administration's handling of the disease outbreak "a hoax", his all-purpose word that no longer comports to its dictionary meaning. Right wing media joined in. “How sick that these people seem almost happiest when Americans are hurting”, accused Fox News' Laura Ingraham, bashing Democrats for “relishing in this moment”. Democrats are “sadly politicizing and weaponizing an infectious disease as their next effort to bludgeon President Trump”, said Fox's Sean Hannity. For them, CDC's Messonnier, a professional in the field of infectious diseases, drew suspicion of a “deep state” conspiracy for her being sister of Rod Rosenstein, the former deputy attorney general who oversaw special counsel Robert Mueller’s Russia investigation.

Acting White House chief of staff Mick Mulvaney shamed the media at week's end, saying that the administration took “extraordinary steps four or five weeks ago” to prevent the spread of the virus by declaring a rare public health emergency to bar entry by most foreign citizens who had recently visited China.

" Why didn’t you hear about it? What was still going on four or five weeks ago? Impeachment. That’s all the press wanted to talk about.”

Just as Democrats sought to bring down the president by its intensive coverage of impeachment, Mulvaney said, so are they now trying the same with virus coverage.

^ The "weaponzing" referred to criticism from Democrats and the media for the administration's lack of preparedness for a pandemic. And poor choices that had been made. There was the inexplicable judgment of the State Department which had overridden the CDC's advice, loading 328 passengers from the cruise ship Diamond Princess, quarantined in Japan, onto a flight along with other unexposed passengers. After a State Department pledge that no one with the virus would be allowed on board the plane, 14 tested positive.

The blunder was compounded when a whistleblower from HHS reported that federal health workers had been “improperly deployed” to two military bases in California to process Americans who had been evacuated from Covid-19 hot zones without protective gear, and were then not themselves quarantined to counteract the error. Staff members worried about exposure said that agency higher-ups downplayed the incident calling it a “cover-up”.

Trump came to government under the influence of Steve Bannon, who brashly intended the deconstruction of the administrative state. That resonated with the new president, who had expressed confidence he could run both the country and the Trump Organization at the same time; he thought government bloated and ordered that its departments be stripped — a 30% reduction of the State Department, for example.

Part of that policy undercut preparedness against widespread disease contagion. The White House had an official in place who oversaw a team responsible for the U.S. response to the when-not-if inevitability of a pandemic, now that microbes are outrunning the effectiveness of drugs and drug development. But that team was set up by Barack Obama, so Donald Trump of course had then-National Security Adviser John Bolton get rid of the unit, in keeping with the president dismantling everything else Obama had accomplished.

Trump sees no problem with starting anew in the midst of what could quickly become a crisis. “We can get money and we can increase staff. We know all the people,” he said. “We can build up very very quickly.” He didn't get money; it was given to him. The administration had asked for $2.5 billion, far short of what a nation of almost 330 million might need. Congress voted over $8 billion.

Trump's budget's have repeatedly tried to decrease funding of the CDC, an organization that is respected as the gold standard worldwide for its infectious disease expertise, witness the defeat of the Ebola epidemic in 2014. In 2018, the CDC was forced to slash by 80% its program to prevent global disease outbreak for lack of funding. It had to reduce its focus to 10 countries and scale back the rest, including China.

Trump’s proposed budget for fiscal 2021 (beginning October 1) includes a nearly 16% cut in funding for the CDC and a 10% cut of Health and Human Services, the umbrella department of which the CDC and the National Institutes of Health are subdivisions.

Entirely new to this and with no advisers on hand, Trump asked for $2.5 billion to fight the virus — far too little — and half of this he would take from HHS's budget. Nancy Pelosi and House Democrats proposed $8.5 billion, more in keeping with past authorizations such as $6.1 billion for avian flu that Congress approved in two tranches in late 2005 and 2006, or the nearly $7.7 billion appropriated in 2009 to respond to the H1N1 virus outbreak.

With outbreaks recorded in 60 countries around the world, the president, by not staying with somber scientific assessments and instead concocting wishful illusions that the virus would simply go away, has undercut his own believability going forward. By continuing to mislead he runs the risk of losing the trust of even ardent followers who want the truth for the sake of their families. As Trump often says, "We'll see what happens", but he should take note of a line in the HBO series on Chernobyl, "Every lie incurs a debt to the truth and eventually that debt is paid".