We have all the evidence we need to make the statement: this is the “US Pandemic.” Despite the poor form to lay blame on a single country, the US government earns the right to wear the crown, and more so every week. In the end, the US will top the charts (and graphs) in cases, total deaths from COVID-19, and absolute worst centralized response coordination and funding imaginable. Our testing rate will be among the lowest per capita among developed nations. It didn’t have to be this way.
By February, the US had abandoned the development of better or even useful testing. Our President refused to use any foreign-produced tests because that would take away a super opportunity for US Pharma to profit from what was at the time just a budding epidemic. The US CDC eventually created their notoriously inaccurate test that took days to analyze. And with that, President Trump decided he was finished. Nothing more was needed. The novel coronavirus was just another flu, he said, and it would be gone soon. That was why the administration was satisfied with a testing infrastructure that could only handle a few hundred tests a day. ‘Why bother with more?’ Trump thought. ‘That won’t get me re-elected in November.’ Instead, he used our money to bail out the airline and cruise line industries. And, he said, we should never forget about small-business stimulus. And then Republicans and Trump left small businesses out of the SBA stimulus package.
Epidemiologists and infectious disease experts howled for a massive increase in testing volume and quality. Trump, of course, focused on a higher priority: weaponizing politics for the upcoming Presidential election. Doctors, Hospitals, front-line nursing staff, and emergency care clinicians urgently warned us we weren’t ready. First, it was crucial for America to dramatically increase testing volume, accuracy, and response time to keep the health care system above water. Second, we needed to start contact-tracing so that when someone tested positive, we could help the people they might have also infected. Third, every front-line worker — nurses to pizza delivery medical needed more Personal Protective Equipment (PPE). Fourth, there wasn’t enough critical medical equipment to prevent a hospital and front-line care worker swamp-out. The term “overloaded” would not adequately explain the coming health care catastrophe. Health care workers and marginal patients would bear the worst burden and death toll due to the overload. The health care system, under the crushing and deadly pressure, would eventually resort to scoring systems for incoming patient triage, such as the situation used effectively by South Korea, but at an increased cost in American lives that no one wants to detail.
The White House Coronavirus Task Force, led by Vice President Pence, didn’t approach or even mention the widely reported death tolls in poorer areas and in communities of color, or within elderly centers or our jails. And yes, dealing with these difficult situations will require large and costly efforts, but these hot spots are driving the greater pandemic. Trump sees no political gain in addressing the spread through the most vulnerable, causing massive death rates. The White House Coronavirus Task Force responsibilities seem to end at photo ops and the Vice President pointedly not wearing a mask talking to vulnerable people. The Task Force doesn’t even recognize that the poor bear the brunt of disease and higher mortality rates.
Trump gave up. Maybe it was too hard for him? Instead, an admitted germophobe decided to ignore the pandemic risks, claimed that sheltering wasn’t needed, and demanded we resume his economy.
First, though, Trump needed to move the spotlight, so he needed a new boogeyman: China. China, Trump insisted, was the real pandemic villain. Against most common sense and all available evidence, the White House suggested that the virus was created in a lab in Wuhan as a weapon, then mistakenly released in China. When the World Health Organization (WHO) kept reporting unpleasant realities, Trump used the same rhetorical cudgel to Tweet-beat the WHO. None of that was true or accurate, but honesty wasn’t the point. It was Trump’s excuse to end the lockdown that threatened stock values and, hence, his re-election. Then he rolled out his political strategy: “Nothing’s wrong folks, y’all go back to your jobs, nothing to see here.”
It wasn’t as if Trump provided alternatives. The Trump team provided no specific strategy or guidelines for the nation, the regions, or even at state levels. Trump praised the existing efforts — social isolation and careful hygiene — but in the same speech, said that we could simply stop now. Trump, a man who lives in highly protected isolation, demanded we risk ourselves for ‘the economy.’
The Republicans who still hold federal jobs stand and salute with “Yes, Mr. Trump!” while Mitch McConnell and the Republican Party look on approvingly. It’s the Republican interpretation of RBF.
I’ll include a caveat: China did hide the Coronavirus epidemic at first. And yes, many foreign governments grossly under-report case statistics and mortality data. Russia, for example, is always quick to manage their intelligence on an international scale, have been cited as early offenders of deceptive COVID-19 reporting. The resulting lack of accurate Coronavirus reporting helped obscure their failures in pandemic response.
Trump created the White House Coronavirus Task Force under Vice-President Pence to centrally manage the US effort. Perhaps, we hoped, they would formulate plans for mobilizing businesses that successfully socially distanced with focus on producing necessary, lower-cost goods in volume. Maybe they could create multi-faceted plans that could take into account less-challenging rural areas versus the intense urban challenges. Did they publish a detailed set of strategies and recommendations in their Task Force Pandemic Plan? Was their plan granular enough for such a diverse nation, adjusted for the vast regional differences required in an effective and targeted pandemic response? Oh, well no, not quite.
Instead, touring health care facilities and factories, led by fully-masked teams of executives and clinical leaders, Vice President Pence famously makes headlines. In, of all places, the Mayo Clinic, Mr. Pence toured the medical treatment and research center, calmly surveying the vulnerable patients without a mask, serene in not needing one. One might guess that Pence planned to demonstrate how the pandemic is really just a bad cold. Mainly, Pence took his direction from President Trump, who wanted this political photo-op to unequivocally make the point that “there’s no problem here, folks.”
It is now June of 2020. The pandemic, by more accurate estimates, still grows at a steady or even still accelerating rate, after taking into account the massive under-reporting due to inadequate testing, among other expected data issues. Published reports indicate the pandemic began at least six months ago in December, and likely earlier in October or even September. The US is only modestly closer to knowing where we are in the curve and what our rates are then we did in February. We fly the US airship blind. Wait, who is flying this thing anyway?
By the way, the textbook definition of data selection bias is only testing people who aren’t representative of the general population. For example, only including people who come into the hospital with matching symptoms and who agree to be tested. Did anyone rush to produce a high volume, quick-result, inexpensive home test? One that patients can report accurately, online and anonymously? That might remove the fear of being tracked by COVID-19 data collection and protect people’s medical privacy.
Nah, we don’t need it. Let’s get back to the golf course.
Thank you, Mr. President. Let us hope you go down in history for it, but your list of gaffes in Presidential leadership is just so long, we can’t pin the medal on just yet.
