It Happened on His Watch

A Sluggish Response
Part 1/7

The Trump administration’s initial response to the COVID-19 crisis in the US was sluggish and disorganized. This resulted in part from the President’s May 2018 decision to disband the Directorate of Global Health Security and Biodefense, a division of the National Security Council (NCS) specifically tasked with pandemic preparations.

After the Obama administration’s uncoordinated response to the Ebola crisis in 2014, the Directorate of Global Health Security and Biodefense was created within the NSC to monitor and assess international health threats and to focus and coordinate domestic response if and when those threats appeared in the homeland. Establishing this pandemic response team within the NSC created the infrastructure for a coordinated White House response to a future pandemic. By removing it, the Trump administration left the nation both more vulnerable to and less capable of addressing a pandemic.

The functions once held by the team were rolled into a new directorate with much broader functions, including arms control, nonproliferation, and weapons of mass destruction. The focus of the team was also changed from health security — addressing threats from things like pandemics — to global health — dealing with chronic health concerns and isolated outbreaks in developing nations. Thus, as COVID-19 spread internationally there was no group at the White House directly charged with assessing its threat to the homeland. There was no leader at the White House with direct lines of communication to key decision makers. And there was no team at the White House available to coordinate an effective response. Sadly, this marks but the first of many administration missteps that have cost American lives. We will be documenting these failures over the next few weeks.

Today is Tuesday, August 11, 2020. There are 5,138,068 cases of COVID-19 in the United States, and 164,681 American’s have died on the President’s watch.

Sources and references:

https://www.usatoday.com/story/news/world/2020/03/18/coronavirus-did-president-trumps-decision-disband-global-pandemic-office-hinder-response/5064881002/
https://www.justsecurity.org/69197/lessons-ignored-john-boltons-bogus-defense-of-streamlining-away-our-bio-readiness/
https://www.washingtonpost.com/news/to-your-health/wp/2018/05/10/top-white-house-official-in-charge-of-pandemic-response-exits-abruptly/
https://www.washingtonpost.com/outlook/nsc-pandemic-office-trump-closed/2020/03/13/a70de09c-6491-11ea-acca-80c22bbee96f_story.html
https://coronavirus.jhu.edu/map.html

Missed Warnings
Part 2/7

The Trump Administration ignored warnings about COVID-19 that could have saved American lives. Starting at the beginning of January, the US Intelligence Community warned the President at least a dozen times that the coronavirus outbreak was a grave threat to the US, and that China was withholding information from the WHO. Additionally, two weeks before any significant White House action Secretary of Health and Human Services Alex Azar briefed the President on the threat.

The President rejects these charges, saying he acted early and, as a result, saved “hundreds of thousands of lives.” He’s referring to travel restrictions he placed on China that went into effect on February 2nd. Sadly, these actions were neither timely nor effective. In the month that elapsed between the initial warnings and the imposition of restrictions, nearly 300,000 people entered the United States from China. More importantly, even after these restrictions were put in place, exemptions allow US citizens, the families of US citizens, and anyone traveling from Hong Kong or Macau to enter the US despite the President’s “ban”. By early April, nearly 40,000 additional people had traveled to the US from China. COVID-19 doesn’t care what color your passport is or whether you come from a special administrative zone or not.

The President also argues that no one could have imagined the impact of COVID-19. Again, this simply isn’t true. In fact, nearly every challenge we’ve faced during this pandemic — including ventilator and PPE shortages, ineffective anti-viral drugs, and an economic collapse — have been predicted by wargames for years. The Obama Administration took these warnings so seriously that they staged their own game — simulating an influenza pandemic — for incoming Trump staffers just before Inauguration Day. They also left behind a playbook with step by step instructions on early pandemic response.

As a result of the President’s inaction, precious time was lost. And in a pandemic, time costs lives. Today is Thursday, August 13, 2020. There are 5,240,650 cases of COVID-19 in the United States, and 166,956 American’s have died on the President’s watch.

Sources and references:

https://www.theatlantic.com/ideas/archive/2020/04/how-many-warnings-did-trump-ignore/610846/
https://www.nytimes.com/2020/04/11/us/politics/coronavirus-trump-response.html
https://www.washingtonpost.com/world/national-security/americans-at-world-health-organization-transmitted-real-time-information-about-coronavirus-to-trump-administration/2020/04/19/951c77fa-818c-11ea-9040-68981f488eed_story.html
https://thehill.com/policy/healthcare/482103-trump-health-officials-defend-coronavirus-quarantine-travel-restrictions
https://www.nytimes.com/2020/04/04/us/coronavirus-china-travel-restrictions.html
https://www.whitehouse.gov/presidential-actions/proclamation-suspension-entry-immigrants-nonimmigrants-persons-pose-risk-transmitting-2019-novel-coronavirus/
https://www.factcheck.org/2020/03/the-facts-on-trumps-travel-restrictions/
https://www.politico.com/news/2020/03/16/trump-inauguration-warning-scenario-pandemic-132797
https://www.politico.com/f/?id=00000170-e50c-d588-ab77-ed5ff3310000
https://khn.org/news/evidence-shows-obama-team-left-a-pandemic-game-plan-for-trump-administration/
https://www.npr.org/2020/05/19/853816473/years-before-the-pandemic-war-games-predicted-a-global-tempest
https://coronavirus.jhu.edu/map.html

Spinning the Crisis
Part 3/7

President Donald Trump’s primary response to the COVID-19 epidemic has been political spin. As the crisis has spiraled out of control, the President has used four tactics in an attempt to re-frame the reality of his failed response:

• Downplaying the threat: attempts to minimize the impacts of the disease and/or suggest that it will “disappear” soon.
• Misinforming the public: attempts to mislead the public into believing false narratives.
• Amplifying the administration’s response: attempts to make it seem as if the administration is performing better than could or should be expected.
• Deflecting responsibility: efforts to pass blame and judgement on to another party.

Spin tactics have evolved as the crisis has grown. From January to March, the primary tactic was to downplay the situation. “We have it totally under control…it’s going to be just fine” was what Trump said on January 22nd, when the first COVID case in the US was reported. Between January 22nd and March 30th, the President used some variation of this falsity in a public forum at least 31 times. Over that span, cases grew from one to 143,025, while 2,509 Americans died. As it became harder for Trump to reasonably maintain that COVID was “disappearing”, he shifted to misinforming the public. Several false narratives have cycled through, including that mask wearing was unpatriotic, that cases were increasing because testing was increasing, and that children are immune to COVID. Despite this shift, the President has continued (albeit at a lower level) to hold that COVID will soon disappear. Amplification of the administration’s response, involving bombastic self-praise and declarations of miracles, has been a steady background hum to the primary tactics. In brief moments of clarity, when realizing the enormity of the crisis, Trump has resorted to deflection, blaming everyone from China to the nation’s governors for his own shortcomings.

The tactics evolve, but the goal remains the same: confuse and distract the public from the very real impacts of the pandemic. Here are the facts though. Between Trump’s first promise that COVID was under control and his most recent prediction that it would soon disappear, the equivalent of 52 9/11’s happened. The last time Trump misinformed the public, the equivalent of nearly three Vietnam Wars had occurred. And the last time that Trump deflected blame, the COVID death toll was more than four times higher than the average flu season.

Today is Wednesday, August 19, 2020. There are 5,487,837 cases of COVID-19 in the United States, and 171,865 American’s have died on the President’s watch.

Sources and references:

https://twitter.com/realDonaldTrump?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor
https://ourworldindata.org/coronavirus/country/united-states?country=~USA
https://doggett.house.gov/media-center/blog-posts/timeline-trump-s-coronavirus-responses
https://www.whitehouse.gov/
https://coronavirus.jhu.edu/map.html

The Costs of Reopening
Part 4/7

Against expert medical advice, the President pressured states to reopen as quickly as possible. As a result of his actions, cases spiked across the Sunbelt, costing American lives and blunting economic recovery. The first indications that the President was tiring of the state-based patchwork of efforts that added up to a near nationwide lockdown came in late March, with the President arguing that the “cure” was “worse than the problem itself,” and indicating that he wanted the economy “open by Easter.” By mid-April, a multi-day Tweet-storm demanded that citizens “liberate” their states, where the restrictions were “too tough.”

Republican governors across the nation responded to pressure from the President and his supporters and initiated phased reopening plans, despite in most cases not satisfying CDC guidelines. Predictably, reopening led to a surge in cases. Four Sunbelt states, all with major population centers, were hit hard: Florida, Georgia, Texas, and Arizona. Overall, experts estimate that early reopening — before the disease was under control — will increase the overall death toll from COVID-19 by 18%. These deaths were avoidable.

Consider events in Texas, which began its phased reopening on May 5 despite not showing any decline in daily cases. Cases continued to increase during Phase 1 (1,192 new cases per day) and during Phase 2 (2,698 new cases per day). Over the next 30 days, the average number of new cases ballooned to 3,714 (a 200% increase over Phase 1 averages), leading the governor to pause reopening and issue a state-wide mask mandate. The damage, however, was already done. Over the subsequent 30 days, Texas would average 8,484 new cases per day before new guidelines could begin to mitigate the virus. Deaths followed cases: By 18 August, 10,250 Texans were dead, a 300% increase from the 2,525 dead the day the Governor issued the mask order, and a 1000% increase over the 906 who had died prior to reopening.

Rather than leading, Trump used his influence to urge states to reopen. Americans died as a result. Today is Thursday, August 20, 2020. There are 5,532,566 cases of COVID-19 in the United States, and 173,241 American’s have died on the President’s watch.

Sources and references:

https://www.cnn.com/2020/03/24/politics/trump-easter-economy-coronavirus/index.html
https://www.nbcnews.com/news/us-news/protesters-texas-other-states-demand-end-lockdowns-day-after-trump-n11
https://www.cdc.gov/media/releases/2020/s0520-cdc-resources-open.html
https://www.nbcnews.com/politics/donald-trump/trump-encourages-anti-lockdown-group-opposed-stay-home-order-minnesota-n1186331
https://thehill.com/homenews/administration/488965-trump-hints-at-changes-to-restrictions-we-cant-let-the-cure-be-worse
https://www.cnn.com/2020/07/28/politics/donald-trump-coronavirus-congress-stimulus-democrats/index.html
https://www.elpasotimes.com/story/news/2020/07/03/covid-texas-coronavirus-timeline-greg-abbott-close-reopen/5368894002/
https://www.healthline.com/health-news/covid-19-reopening-consequences-cases-rising
https://www.washingtonpost.com/graphics/2020/national/states-reopening-coronavirus-map/
https://covidtracking.com/data/state/texas#historical
https://coronavirus.jhu.edu/map.html

Miracle Cures and the Ongoing Crisis
Part 5/7

President Trump continues to champion hydroxychloroquine as a miracle drug that can both prevent and cure COVID-19. “What do you have to lose” has become the Presidential tagline of Trump’s role as medical advisor-in-chief. It’s clear that the President bypassed medical best practices in extolling the virtues of his miracle cure. It’s also clear that this politicization has cost lives and, ultimately, prolonged the COVID crisis.

The medical community has established best practices for the testing and approving drugs. These drug discovery and development steps — including preclinical research, clinical research, FDA review, and FDA monitoring — are intended to ensure that drugs approved for market are both safe and effective. Preclinical research screens candidate drugs and compounds and flags potential treatments for additional research. It’s only in clinical research, however, that the safety, proper dosage, and efficacy of a drug is determined. The gold standard of clinical research is a double-blind, controlled clinical trial. In this process, a placebo — rather than the actual drug — is given to some participants. Neither the experimenter nor the participant know whether the actual drug has been administered. The results of this kind of trial control for bias and other factors that may influence the outcome of a study. Only after these types of trials are complete does the FDA approve a drug for use.

That’s how it’s supposed to work. Here’s how it worked with hydroxychloroquine. A lawyer and an ophthalmologist wrote a “paper” — in this case a formatted Google Doc — arguing that hydroxychloroquine could “cure” COVID-19. The authors falsely claimed that their “research” was done in concert with two medical schools (it wasn’t), and that the National Academy of Sciences had reviewed their work (they didn’t), and that one of them was an advisor to Stanford University (he isn’t). This “paper”, combined with a discredited French study claiming a 100% cure rate (patients who died were excluded to rig the results), formed the basis of a Fox News story that appeared on Laura Ingraham’s show on March 16 and Tucker Carlson’s show on March 18. On March 19, the President, who is an avid consumer of Fox programming, started aggressively pushing hydroxychloroquine and clearing barriers at the FDA to get the drug approved as a treatment.

So what? you might ask. Isn’t it good to have more bullets to fire, regardless of how dubiously we may have come across them? First, the drug has potentially lethal side effects for a number of people, specifically those with heart conditions (who, as high risk individuals, are also more likely to be in a position to need treatments). Second, as the medical community catches up to the President, they’re discovering that mortality rate is higher in patients receiving hydroxychloroquine than in patients receiving standard supportive care. Third, and most importantly, the widespread belief in a miracle cure creates the conditions for Americans to disregard preventive measures that actually work, like wearing masks, social distancing, and washing your hands. We can beat this disease, but not until we all understand what we’re facing and not until we let science show us the way. False promises aren’t going to get us there.

Today is Tuesday, August 25, 2020. There are 5,773,776 cases of COVID-19 in the United States, and 178,326 American’s have died on the President’s watch.

Sources and references:

https://www.fda.gov/patients/drug-development-process/step-1-discovery-and-developmenthttps://www.recoverytrial.net/news/statement-from-the-chief-investigators-of-the-randomised-evaluation-of-covid-19-therapy-recovery-trial-on-hydroxychloroquine-5-june-2020-no-clinical-benefit-from-use-of-hydroxychloroquine-in-hospitalised-patients-with-covid-19https://www.nejm.org/doi/10.1056/NEJMoa2016638https://www.medicalnewstoday.com/articles/does-hydroxycholorquine-cut-covid-19-mortality-expert-urges-caution#Study-limitationshttps://medicalxpress.com/news/2020-08-hydroxychloroquine-azithromycin-cardiovascular.htmlhttps://www.bloomberg.com/news/articles/2020-08-21/hydroxychloroquine-shouldn-t-be-used-at-all-for-covid-isda-sayshttps://www.cnn.com/2020/04/21/health/hydroxychloroquine-veterans-study/index.htmlhttps://www.nbcnews.com/health/health-news/hydroxychloroquine-covid-19-scientists-say-it-s-time-stop-promoting-n1235347https://coronavirus.jhu.edu/map.html

The False Narrative
Part 6/7

Despite the ongoing COVID-19 crisis, the Trump administration has repeatedly declared victory over the pandemic. The President’s COVID talking points are full of hyperbolic declarations regarding this administration’s performance against the disease, which continues to kill thousands of Americans each and every day. This false narrative is not, however, supported by the numbers. Here, we dissect the President’s claims through an analysis of COVID-19 data from around the world.

• The United States is doing “much better” than other countries. In early August, the President sat for an Axios interview with Jonathan Swan. During the interview, the President claimed repeatedly that the US was doing “better than the world” when it came to handling the COVID pandemic. Similar claims litter the President’s Twitter feed. The numbers, however, don’t bear this out: the US has more cases and more deaths than any other country. When we control for population, this reality remains: the six hardest hit countries in Europe considered together match the US population, but report nearly 4.5 million fewer cases, and 52,355 fewer deaths (despite a much higher mortality rate). The Middle East performs even better, with the 11 hardest hit countries (again matching the US population) reporting 4 million fewer cases, 135,571 fewer deaths, and a lower mortality rate (2.45% compared to 3.09%). Asia is by far turning in the strongest performance: the five hardest hit countries report only 351,521 cases. More importantly, only 4,828 combined people in these countries have lost their lives to the pandemic, compared to over 180,000 in the US. Of the top 22 wealthiest countries in the world, only three have a higher number of cases per million than the US (Kuwait, Qatar, and Bahrain). Only three have a higher number of deaths per million than the US (Sweden, Belgium, and the UK). The claim that the US is doing much better than other countries is patently false.
• The United States has more cases than other countries because we have more testing. Again, the President’s twitter feed repeats this claim over and over again, and it has become a talking point throughout the administration. Numerous studies have debunked the concept, and, as with the claim above, the numbers don’t bear out the President’s narrative. While it’s true that the US has done more testing than any other country, two key metrics that control for the number of tests show that we simply have more disease than many other countries. Our testing has a 7.86% positive rate, with 78.62 cases per thousand tests. If Trump’s argument were true, other countries would show a similar positive rate and similar cases per thousand tests. Once again, the numbers are against Trump: of the top wealthiest countries in the world, only three exceed our rates: Kuwait, Qatar, and Sweden.
• The Trump administration has overcome the COVID-19 crisis. During the RNC this week, a parade of speakers talked about the COVID crisis in the past tense. The President has, likewise, declared victory over the disease several times. We are, however, far from through this dystopian nightmare. For each of the past five weeks, we’ve averaged around 1,000 COVID deaths per day. While this past week saw the lowest average new cases per day, that number still came in over 40,000. And many epidemiologists predict that a second wave is yet to come — as seen in the previous five influenza pandemics (2009, 1968, 1956, 1918, 1889).

The President’s false COVID narrative is meant to do one thing: prop up his sagging poll numbers in the leadup to the 2020 election. Something is seriously wrong with the US COVID response, but “we’ve done about as good as Ukraine and slightly better than Pakistan” doesn’t have the same ring to it as “we’re better than everyone.”

Today is Friday, August 28, 2020. There are 5,906,615 cases of COVID-19 in the United States, and 181,579 American’s have died on the President’s watch.

Sources and references:

https://www.washingtonpost.com/politics/2020/07/21/trump-wants-compare-us-coronavirus-problem-other-countries-he-may-want-rethink-that/
https://www.axios.com/full-axios-hbo-interview-donald-trump-cd5a67e1-6ba1-46c8-bb3d-8717ab9f3cc5.html
https://www.statnews.com/2020/07/20/trump-said-more-covid19-testing-creates-more-cases-we-did-the-math/
https://www.cnn.com/2020/07/09/politics/fact-check-coronavirus-cases-donald-trump-testing/index.html
https://www.factcheck.org/2020/06/trump-falsely-says-covid-19-surge-only-due-to-testing-misleads-on-deaths/
https://ourworldindata.org/coronavirus-testing
https://www.statista.com/statistics/1109066/coronavirus-testing-in-europe-by-country/
https://coronavirus.jhu.edu/map.html

The Trump Virus
Part 7/7

Donald Trump calls COVID-19 the “Chinese virus”, arguing that China should be held responsible for the pandemic now sweeping throughout the world. The facts, however, tell a different story: the Trump administration dismantled government infrastructure intended to enable a rapid pandemic response, ignored critical warnings, pushed states to open before it was safe to do so, and spent the bulk of its effort on spin, miracles cures, and the creation of a false narrative of success. By the President’s own logic, COVID-19 in the United States is and should be known as the Trump virus.

The costs of the Trump virus are staggering. Economically, the impact is catastrophic. Millions of jobs have been lost, many of which will not be coming back. The Congressional Budget Office (CBO) estimates that it will take a decade for the employment level to recover to pre-pandemic levels; over that time, the CBO projects that the overall costs of the pandemic will come to $7.9 trillion dollars. Socially, the Trump administration has used the pandemic to undermine the credibility of the US medical institution, which can now be added to the long list of once credible institutions torn down under this President. But most importantly, and most tragically, the human costs of the Trump virus are horrific.

The sheer volume of deaths — 183,649 and counting — makes it hard for people to process in context the human toll of the pandemic. Imagine, for a moment, if 9/11 had happened every three days since March 1st. Imagine if the Korean War had happened five times since March 1st. Imagine if we had five influenza seasons in the six months since this pandemic began. If World War I had happened in July and then the Vietnam War had happened in August, we’d still be short 8,924 lives. If you spend two minutes reading this post, another American will have died of COVID. If you watch an hour long television program tonight, during that time 36 Americans will pass away from this disease. It didn’t have to be this way, and we have to hold the Trump administration responsible.

Today is Tuesday, September 1, 2020. It’s taken 22 days to research, write, and post this series. During that time, 18,968 Americans — 862 per day — have died of the Trump Virus.

Sources and references:

https://www.theguardian.com/world/2020/apr/28/trump-says-china-could-have-stopped-covid-19-and-suggests-us-will-seek-damages
https://www.youtube.com/watch?v=Mr3QRE4Fz_g
https://www.forbes.com/sites/shaharziv/2020/06/02/coronavirus-pandemic-will-cost-us-economy-8-trillion/#5d5f49f215e4
https://www.cnn.com/2020/07/02/economy/congressional-budget-office-projections-economy/index.html
https://www.cnn.com/2020/07/07/economy/job-losses-coronavirus/index.html
https://www.npr.org/sections/coronavirus-live-updates/2020/07/30/896714437/3-months-of-hell-u-s-economys-worst-quarter-ever#:~:text=Twitter-,3%20Months%20Of%20Hell%3A%20U.S.%20Economy%20Drops%2032.9,In%20Worst%20GDP%20Report%20Ever&text=Hong%2FAP-,A%20movie%20theater%20is%20seen%20closed%20due%20to%20the%20coronavirus,tens%20of%20millions%20of%20jobs.
https://ourworldindata.org/coronavirus-testing
https://coronavirus.jhu.edu/map.html