Health Bureaucrats Botched the Response to Coronavirus. Trump Made It Even Worse.

“The single most important failure of the U.S. response to COVID-19, the disease caused by the novel coronavirus, has been the slow rollout of testing. This was an abject failure of bureaucracy. But it was also a failure of presidential leadership.
The countries that have had the most success in containing the outbreak, such as South Korea and Singapore, have done so through early, rapid, and widespread testing and contact tracing, followed by targeted quarantines. South Korea and the United States discovered initial cases of the coronavirus on the same day in January. Since then, some 290,000 people in South Korea have been tested and new daily cases have fallen from 909 to just 93. Despite a much larger population, the United States, tested just 60,000 people in the same period of time.”

“Much of the failure to make mass testing available lies with the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). As a Wall Street Journal report makes clear, the CDC, which managed the development of the initial test kits, botched the job in just about every possible way: The CDC not only produced a faulty test that had to be retracted but adopted narrow testing criteria that meant many people with symptoms simply couldn’t be tested.

Perhaps most disastrously, as The Washington Post reports, federal health agencies initially declined to certify tests produced by private companies that were better suited for rapid mass testing anyway. This is despite the fact that experts, including the former head of the FDA, were publicly recommending that they do so as early as February 2.

The CDC was following its usual protocols, developing initial diagnostic tests on its own in order to maintain quality control, as it usually does. But that’s exactly the problem.”

“But this was also a failure of political leadership, most notably from President Donald Trump. For weeks, Trump and senior White House officials actively downplayed the threat of the virus.

As late as February 25, National Economic Council adviser Larry Kudlow was offering assurances that the coronavirus was “contained” and that it was “pretty close to airtight.” Trump treated the virus with similar breeziness, suggesting that the virus was “going to disappear” and that while it might get worse, “nobody really knows.””

“The problem here is obvious: Trump, who as the head of the executive branch oversees federal agencies such as the FDA, did not view the virus as a serious problem—and did not want others to view it that way either. That, in turn, translated into a downstream lack of urgency, which meant that critical aspects of the response were not prioritized. According to The Wall Street Journal, health officials who have examined the testing calamity have concluded that it was a result of both bureaucratic bumbling and a “broader failure of imagination,” in which Trump and other administration officials “appeared unable or unwilling to envision a crisis of the scale that has now emerged.”

The job of a president is to make decisions, set priorities, and convey clear information to both the public and the staff of the executive branch. This is especially important in a moment of crisis, when the executive is in charge of acting both quickly and with sound judgment. In this outbreak, Trump has failed on every count. Not only did he fail to see the threat even when it was apparent to experts, but he actively undermined preparedness by downplaying its significance far long after the problem was apparent, and by providing false and misleading information as the mitigation effort proceeded.”

“The federal health bureaucracy deserves much of the blame for America’s faltering response to the coronavirus outbreak. But the president has made the fiasco worse.

The bureaucracy reports up to an executive, who is tasked with setting priorities and ensuring performance—and for taking responsibility when there are failures. Instead, Trump has inaccurately blamed the Obama administration for failures that occurred on Trump’s watch. (Indeed, under Barack Obama, diagnostic tests for swine flu were designed and approved in less than two weeks.) Asked whether any of this is his fault, the president rejected the idea, saying, “I don’t take responsibility at all.” Trump’s refusal to admit failures makes it more likely that he will repeat them, and that more Americans will pay the price.”

How to update the country on coronavirus: Thank Trump first

“At the White House podium over the last few weeks, each member of the Trump administration’s coronavirus task force has been cognizant of two messages: one for millions of Americans; another for the man just a few feet away. Even the health experts — many of them not political appointees — have made sure to deliver some praise to the president to help the medicine go down as they dish out some of the more dire predictions about the growing pandemic.
Critics have noted that aides have been premature at times to lavish compliments on the president as they continue to fight the virus. They compared the constant thank-yous to Trump’s televised Cabinet meetings, during which Trump went around the room and had each senior official praise him.

“It undermines the credibility of the experts. … What people need are the facts. They don’t need experts spending time fluffing up the commander in chief,” David Lapan, a former Pentagon spokesperson and vice president of communications at Bipartisan Policy Center said.”

“For those who know the president, public praise and flattery are a valuable political currency. Trump has been noticeably more gracious towards several Democratic governors during the coronavirus outbreak, often citing their praise of his current leadership.

The president on Sunday noted that state governors were “very, very complimentary” on a recent nationwide coronavirus call.

“I watched, over the last few days, Gov. [Andrew] Cuomo, I watched Gavin Newsom,” Trump said, referencing the Democratic governors in New York and California, two of the hardest-hit states. “I watched both of them. And they’ve been, you know, very complimentary.””

“The president is hyper aware of TV ratings, which are compiled weekly for him in the White House, and viewership of the briefings during the daytime hours have seen a notable spike as Americans anxiously watch from home.

Administration officials say it’s an opportunity for experts from the task force to answer questions, but it also gives the president a national platform to assure the public and offer himself a pat on the back.”

Intelligence reports warned about a pandemic in January. Trump reportedly ignored them.

“Top health officials first learned of the virus’s spread in China on January 3, US Health and Human Services Secretary Alex Azar said Friday. Throughout January and February, intelligence officials’ warnings became more and more urgent, according to the Post — and by early February, much of the Office of the Director of National Intelligence and the CIA’s intelligence reports were dedicated to warnings about Covid-19.

All the while, Trump downplayed the virus publicly, telling the public the coronavirus “is very well under control in our country,” and suggesting warm weather would neutralize the threat the virus poses.

Privately, Trump reportedly rebutted health and intelligence officials’ attempts to get him to take action to prepare communities in the US while rebuking officials who were delivering sober risk assessments.”

“Trump is finally taking the virus more seriously, but it’s still unclear how widespread the effects of delays in action will be.”

Before Trump’s inauguration, a warning: ‘The worst influenza pandemic since 1918’

“The briefing was intended to hammer home a new, terrifying reality facing the Trump administration, and the incoming president’s responsibility to protect Americans amid a crisis. But unlike the coronavirus pandemic currently ravaging the globe, this 2017 crisis didn’t really happen — it was among a handful of scenarios presented to Trump’s top aides as part of a legally required transition exercise with members of the outgoing administration of Barack Obama.”

“The Trump team was told it could face specific challenges, such as shortages of ventilators, anti-viral drugs and other medical essentials, and that having a coordinated, unified national response was “paramount” — warnings that seem eerily prescient given the ongoing coronavirus crisis.”

“But roughly two-thirds of the Trump representatives in that room are no longer serving in the administration. That extraordinary turnover in the months and years that followed is likely one reason his administration has struggled to handle the very real pandemic it faces now, former Obama administration officials said.”

“Obama aides, in op-eds and essays ripping the Trump administration’s handling of the coronavirus, officially called COVID-19, have pointed to the Jan. 13, 2017, session as a key example of their effort to press the importance of pandemic preparedness to their successors.
In a Friday op-ed, Susan Rice, Obama’s national security adviser, blasted Trump for comments such as “you can never really think” that a pandemic like the coronavirus “is going to happen.” She mentioned the 2017 session as one of many instances of the Obama administration’s efforts to help its successor be ready for such a challenge. She also slammed the Trump team for dismantling the National Security Council section that would play a lead role in organizing the U.S. response to a global pandemic.”

“Lisa Monaco, Obama’s homeland security adviser, explained the thinking behind the January 2017 session in a recent essay for Foreign Affairs. “Although the exercise was required, the specific scenarios we chose were not,” she wrote. “We included a pandemic scenario because I believed then, and I have warned since, that emerging infectious disease was likely to pose one of the gravest risks for the new administration.””

“The Trump campaign, like the rest of America, was shocked to win the November 2016 election. Soon afterward, Trump cast aside his team’s transition prep work that had happened already and started over; some of his aides described tossing carefully collected binders full of possible personnel picks into trash bins. It was days, sometimes weeks, before his nominees and their aides showed up to meet the people they were replacing — if they did so at all — or to engage in transition meetings. Obama aides said they left detailed memos for their successors, but that quite often it appeared those memos were never read. Many on the Obama side were genuinely surprised that so many actually showed up for the Jan. 13, 2017, exercise, and there were expectations that some would skip it. On the Obama side, several agencies were represented by their second-in-command at the meeting for reasons including a belief that Trump’s principals wouldn’t show.
The gathering was held to satisfy a requirement in a 2016 law that updated the procedures around presidential transitions to require, among other things, that the outgoing administration “prepare and host interagency emergency preparedness and response exercises.” Obama also mentioned it in a 2016 executive order laying out his transition goals.”

“some Obama aides who attended said they were left with the impression that many of the Trump aides showed up to simply check off a box more than to learn. The impression was boosted in part because the transition overall was going so poorly. Several Trump nominees had barely even spoken to their Obama counterparts.”

““The problem is that they came in very arrogant and convinced that they knew more than the outgoing administration — full swagger,” one former Obama administration official who attended said.”

“Asked whether information about the pandemic exercise reached the president-elect, a former senior Trump administration official who attended the meeting couldn’t say for sure but noted that it wasn’t “the kind of thing that really interested the president very much.”
“He was never interested in things that might happen. He’s totally focused on the stock market, the economy and always bashing his predecessor and giving him no credit,” the person said. “The possibility things were things he didn’t spend much time on or show much interest in.
“Even though we would put time on the schedule for things like that, if they happened at all, they would be very, very brief,” the former official continued. “To get the president to be focused on something like this would be quite hard.”
Anything associated with Obama or his administration was also a no-go zone for Trump aides. If you brought them up, “that would be an immediate rejection, like, ‘Why are they even here? Why the fuck did you ask them?’””

The biggest challenge to America’s coronavirus response? Trump.

“President Donald Trump’s handling of the coronavirus outbreak in the United States has so far been a disaster.

He initially downplayed the severity of the outbreak at home, directly contradicting his top health officials. He’s displayed a stunning lack of knowledge about basic things like how vaccines work and how quickly a coronavirus vaccine could realistically be developed and distributed to Americans. And he’s publicly spread misinformation about how deadly the disease, officially known as Covid-19, is.

All of that is extremely counterproductive to effective crisis response, especially for dealing with something so complicated as the novel coronavirus.”

““This isn’t a normal crisis,” Konyndyk said, “and atypical crises require real leadership from the top to solve.””

“I, along with others, got to meet President Obama for a few minutes in the Oval Office because of our Ebola work. The moment I walked in, he started quizzing me about the Ebola burial teams, which was an important but fairly detailed element of the overall response. The fact that he was aware of those teams, and could ask me detailed questions about them, absolutely blew my mind.

You just don’t see that attention to detail with Trump. I really sympathize with the people who are working on this response within the government right now. Remember: It’s many of the same people — in fact, it’s mostly the same people — that worked on Ebola and other crises. They’re all career people.

What that tells you is that the team isn’t a determining variable here. The president is.”

“Think back to when Hurricane Harvey and Hurricane Irma hit the US in 2017. Both of those were standard-issue, major hurricane events. They hit states in the mainland United States that were well prepared and had strong disaster management agencies. The government response therefore was mostly fine — bureaucracies were set up for moments like that.

But when you have nonstandard crises — like what Hurricane Maria did to Puerto Rico or this coronavirus outbreak — they require a president to get the government out of its comfort zone, to push it to do something it is not built to do. There’s really no one else in the government to do that.”

“There were all these different moving pieces that all sat in different parts of the federal government. They weren’t put together to facilitate a coherent response. It really took presidential leadership and the installation of a “czar” to finally bring order to that chaos. Ultimately, it was President Obama making very abundantly clear, to the entire federal bureaucracy, that this was a first-tier priority for him and that everyone needed to step up.

The other really important element to that was also not accepting business-as-usual rationales from the agencies.

There were many times during the Ebola response in 2014 when I, on behalf of my team, or others in the government, would be getting pressed by the White House to do something. We would say, “Look, we can’t do that,” or, “We’re working as hard as we can.” And the White House, to their credit, would come back with some variation of, “Well, that’s all well and good, but it’s not getting the job done.””

“President Trump’s insistence that the strategy of keeping the disease out of the country was succeeding really handicapped the rest of the response. Here’s why: It makes it harder for the government to plan for the moment the strategy stops working. That’s critical in this kind of situation.

The whole point of an overseas containment strategy is to buy you time. It delays the arrival of an outbreak in a country, but it cannot ultimately stop it. You’re not, or you shouldn’t be, hoping that that will be all that you need to do.

I don’t think the president understands that, and I don’t know how openly his team dissuades him of that view.”

“The first time a US official talked about a pivot to preparedness was when the Centers for Disease Control’s Nancy Messonnier detailed last month how she’d started talking to her kids about the disruption they might face in their lives. And the president and his allies went ballistic. It’s a microcosm of the dynamic at play here, that even acknowledging the reality that this strategy might not fully work or might not be fully sufficient set the president off.”

The Trump administration’s botched coronavirus response, explained

“It began in April 2018 — more than a year and a half before the SARS-CoV-2 virus and the disease it causes, Covid-19, sickened enough people in China that authorities realized they were dealing with a new disease.

The Trump administration, with John Bolton newly at the helm of the White House National Security Council, began dismantling the team in charge of pandemic response, firing its leadership and disbanding the team in spring 2018.
The cuts, coupled with the administration’s repeated calls to cut the budget for the Centers for Disease Control and Prevention (CDC) and other public health agencies, made it clear that the Trump administration wasn’t prioritizing the federal government’s ability to respond to disease outbreaks.
That lack of attention to preparedness, experts say, helps explain why the Trump administration has botched its response to the coronavirus pandemic.”

“Several weeks after the first community transmission within the US, the country has tested more than 16,000 people as of March 13, according to the Covid Tracking Project. By comparison, South Korea had tested more than 66,000 people within a week of its first case of community transmission.”

“Testing is crucial to slowing epidemics. First, it lets public health officials identify sick people and subsequently isolate them. Second, they can trace that sick person’s recent contacts to make sure those people aren’t sick and to get them into quarantine as well. It’s one of the best tools we have for an outbreak like this.”

“it’s the kind of thing that the Trump administration has screwed up, while instead trying to downplay the threat of Covid-19. Trump himself has tweeted comparisons of Covid-19 to the common flu — which Jha describes as “really unhelpful,” because the novel coronavirus appears to be much worse. Trump also called concerns about the virus a “hoax.” He said on national television that, based on nothing more than a self-admitted “hunch,” the death rate of the disease is much lower than public health officials projected.
And Trump has rejected any accountability for the botched testing process: “I don’t take responsibility at all,” he said on Friday.”

“In April 2018, Bolton fired Tom Bossert, then the homeland security adviser, who, the Washington Post reported, “had called for a comprehensive biodefense strategy against pandemics and biological attacks.” Then, that May, Bolton let go the head of pandemic response, Rear Adm. Timothy Ziemer, and his global health security team. The team, the Directorate for Global Health Security and Biodefense, was never replaced.”

“Since the federal government is sprawling and large, it helps to have centralized leadership in case of a crisis. That leadership could ensure all federal agencies are doing the most they can and working toward a single set of goals.”

“it’s important to have this kind of agency set up before an outbreak. Setting up an agency takes time; it requires hiring staff, handing out tasks and expected workloads, creating internal policies, and so on. A preexisting agency is also going to have plans worked out before an outbreak, with likely contingencies in place for what to do. That’s why it was so important to have this agency in place even during years, like 2018, when disease pandemics didn’t seem like a nearby threat to everyone.”

“By repeatedly undercutting outbreak preparedness, Jha said, the Trump administration signaled “to the government and all the agencies this is not a priority. And that means that even other agencies end up not putting as much attention and energy on it. So I think this has been a longstanding problem of the White House.”

Trump, for his part, has defended his record, arguing, “I’m a businessperson. I don’t like having thousands of people around when you don’t need them. When we need them, we can get them back very quickly.”

But experts argue that’s not how pandemic preparedness should work. “You build a fire department ahead of time,” Tom Inglesby, director of the Johns Hopkins Center for Health Security, told the Washington Post. “You don’t wait for a fire.””

“Not all of this is necessarily the Trump administration’s fault. When the CDC rolled out its tests, a component in them turned out to be faulty. That was unfortunate, but it put a big spotlight on the CDC’s decision to use its own test kit instead of test kits other countries have used, reportedly in an effort to create a more accurate test.”

“But this is exactly the kind of situation that proper preparedness, well, prepares federal agencies for. If the Trump administration had prioritized outbreak prevention before the coronavirus pandemic, it might have used the time prior to Covid-19’s appearance — or even January and February, when the global threat was increasingly clear — to establish contingencies in case something went wrong.”

“This is, after all, something the federal government has done before for outbreaks, from H1N1 to Zika. A big difference from then to now is that Trump is in charge.”

“Trump has consistently downplayed the coronavirus, comparing it to the common flu and claiming that his administration is doing a “GREAT job” and keeping things under control. Even on Friday, when announcing his administration’s goal to get 5 million test kits out, Trump said, “I doubt we’ll need anywhere near that.”

Some of that may be political. Politico reporter Dan Diamond told NPR host Terry Gross that, based on his own reporting, Trump “did not push to do aggressive additional testing in recent weeks, and that’s partly because more testing might have led to more cases being discovered of coronavirus outbreak, and the president had made clear — the lower the numbers on coronavirus, the better for the president, the better for his potential re-election this fall.”
Some of it could also be a result of too much optimism. Trump in February said of the coronavirus, “One day it’s like a miracle, it will disappear.” (As of March 13, the US has nearly 2,000 confirmed cases, up from fewer than 100 at the beginning of the month, according to Johns Hopkins University.)

The administration more broadly seems to have underestimated the threat, requesting $2.5 billion in emergency funding for the crisis — a fraction of what both Democrats and Republicans said is necessary and ultimately passed.”

“What Trump has done is focus on travel restrictions, first against China and most recently against most of Europe. While this likely bought the US a little time with China, the Trump administration didn’t use that time properly.
And in the case of Europe, the restrictions will likely do little to nothing. There’s one simple reason for that, Kates told me: “The virus is already here.” Since the coronavirus is already spreading within communities, the concern is no longer the virus coming in from outside the US.

Even conservatives have been critical of Trump’s response. The National Review editorial board wrote:

“[Trump] resisted making the response to the epidemic a priority for as long as he could — refusing briefings, downplaying the problem, and wasting precious time. He has failed to properly empower his subordinates and refused to trust the information they provided him — often offering up unsubstantiated claims and figures from cable television instead. He has spoken about the crisis in crude political and personal terms. He has stood in the way of public understanding of the plausible course of the epidemic, trafficking instead in dismissive clichés. He has denied his administration’s missteps, making it more difficult to address them.””

“On Wednesday night, Trump appeared to finally confront the reality of the crisis in a televised statement from the Oval Office”

“The speech was also riddled with errors, leading the administration and others to later issue several corrections”

“Trump on Friday declared a national emergency, which will unlock billions of dollars in disaster aid to help combat the virus. The administration previously declared a public health emergency in January, but that didn’t tap into as much money as the new declaration under the 1988 Stafford Act”

The 4 Key Reasons the U.S. Is So Behind on Coronavirus Testing

“The Food and Drug Administration has a protocol called emergency use authorization, or EUA, through which it clears tests from labs around the country for use in an outbreak. Getting more of these tests up and running would greatly increase the capacity of doctors and public-health officials to screen patients for the coronavirus.

Former FDA officials I spoke with said that during past outbreaks, EUAs could be granted in just a couple of days. But this time, the requirements for getting an EUA were so complicated that it would have taken weeks to receive one..clinical labs were not allowed to begin testing at all before they had received the EUA, even if they had already internally made sure their tests worked. Though these regulations are in place to ensure that faulty lab tests don’t get used on patients, several microbiologists told me they felt the precautions were excessive for a fast-moving outbreak of this scale.”

““Labs and companies need samples of the virus itself in order to make their tests, but delays in getting access to samples further slowed down the test-development process. The coronavirus originated in China, and as several microbiologists told me, the Chinese government does not allow specimens to be shipped outside its borders.”

“Even when working with nonauthoritarian countries, a combination of government processes, researcher reticence, complex shipping regulations, and patient-privacy concerns makes getting samples difficult for diagnostic companies like his.”

““Even though some hospitals actually have the new, functional CDC tests, the extraction machines and reagents that are used to perform them are in short supply.”

“For months, President Trump has made light of the coronavirus, telling attendees at a Black History Month reception, for instance, that perhaps the virus could miraculously disappear. He claimed on Twitter that the U.S. has done a “great job” handling the outbreak. Such a cavalier attitude seems unlikely to have motivated health officials to take things seriously.”

“Containing a new infectious disease requires a lot of close collaboration between the president, the CDC, the FDA, and other parts of the Department of Health and Human Services, several Obama-era health officials told me. “One reason we were able to move quickly [during the Ebola outbreak] was that there was a great deal of coordination and issue spotting and troubleshooting that went on,” Hamburg, the former FDA commissioner, told me.”

Trump’s mismanagement helped fuel coronavirus crisis

“For six weeks behind the scenes, and now increasingly in public, Trump has undermined his administration’s own efforts to fight the coronavirus outbreak — resisting attempts to plan for worst-case scenarios, overturning a public-health plan upon request from political allies and repeating only the warnings that he chose to hear. Members of Congress have grilled top officials like Health and Human Services Secretary Alex Azar and Centers for Disease Control Director Robert Redfield over the government’s biggest mistake: failing to secure enough testing to head off a coronavirus outbreak in the United States. But many current and former Trump administration officials say the true management failure was Trump’s.”

““Interviews with 13 current and former officials, as well as individuals close to the White House, painted a picture of a president who rewards those underlings who tell him what he wants to hear while shunning those who deliver bad news.”

Trump’s explanation for abruptly replacing the acting intel director with a loyalist doesn’t make sense

“the talking point the Trump administration is using to dispel concerns that Maguire’s dismissal was politically motivated doesn’t carry water.”

“Maguire’s ouster may be part of Trump’s broader effort to get rid of government officials he perceives as being insufficiently loyal. On Sunday, Jonathan Swan reported for Axios that the Trump administration has “assembled detailed lists of disloyal government officials to oust — and trusted pro-Trump people to replace them.””