Inside Trump’s Failure: The Rush to Abandon Leadership Role on the Virus

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https://www.nytimes.com/2020/07/18/u...eadership.html
Inside Trump’s Failure: The Rush to Abandon Leadership Role on the Virus
The roots of the nation’s current inability to control the pandemic can be traced to mid-April, when the White House embraced overly rosy projections to proclaim victory and move on.

By Michael D. Shear, Noah Weiland, Eric Lipton, Maggie Haberman and David E. Sanger
July 18, 2020

WASHINGTON — Each morning at 8 as the coronavirus crisis was raging in April, Mark Meadows, the White House chief of staff, convened a small group of aides to steer the administration through what had become a public health, economic and political disaster.

Seated around Mr. Meadows’s conference table and on a couch in his office down the hall from the Oval Office, they saw their immediate role as practical problem solvers. Produce more ventilators. Find more personal protective equipment. Provide more testing.

But their ultimate goal was to shift responsibility for leading the fight against the pandemic from the White House to the states. They referred to this as “state authority handoff,” and it was at the heart of what would become at once a catastrophic policy blunder and an attempt to escape blame for a crisis that had engulfed the country — perhaps one of the greatest failures of presidential leadership in generations.

Over a critical period beginning in mid-April, President Trump and his team convinced themselves that the outbreak was fading, that they had given state governments all the resources they needed to contain its remaining “embers” and that it was time to ease up on the lockdown.

In doing so, he was ignoring warnings that the numbers would continue to drop only if social distancing was kept in place, rushing instead to restart the economy and tend to his battered re-election hopes.

Casting the decision in ideological terms, Mr. Meadows would tell people: “Only in Washington, D.C., do they think that they have the answer for all of America.”

For scientific affirmation, they turned to Dr. Deborah L. Birx, the sole public health professional in the Meadows group. A highly regarded infectious diseases expert, she was a constant source of upbeat news for the president and his aides, walking the halls with charts emphasizing that outbreaks were gradually easing. The country, she insisted, was likely to resemble Italy, where virus cases declined steadily from frightening heights.

On April 11, she told the coronavirus task force in the Situation Room that the nation was in good shape. Boston and Chicago are two weeks away from the peak, she cautioned, but the numbers in Detroit and other hard-hit cities are heading down.

A sharp pivot soon followed, with consequences that continue to plague the country today as the virus surges anew.

Even as a chorus of state officials and health experts warned that the pandemic was far from under control, Mr. Trump went, in a matter of days, from proclaiming that he alone had the authority to decide when the economy would reopen to pushing that responsibility onto the states. The government issued detailed reopening guidelines, but almost immediately, Mr. Trump began criticizing Democratic governors who did not “liberate” their states.

Mr. Trump’s bet that the crisis would fade away proved wrong. But an examination of the shift in April and its aftermath shows that the approach he embraced was not just a misjudgment. Instead, it was a deliberate strategy that he would stick doggedly to as evidence mounted that, in the absence of strong leadership from the White House, the virus would continue to infect and kill large numbers of Americans.

He and his top aides would openly disdain the scientific research into the disease and the advice of experts on how to contain it, seek to muzzle more authoritative voices like Dr. Anthony S. Fauci and continue to distort reality even as it became clear that his hopes for a rapid rebound in the economy and his electoral prospects were not materializing.

Mr. Trump had missed or dismissed mounting signals of the impending crisis in the early months of the year. Now, interviews with more than two dozen officials inside the administration and in the states, and a review of emails and do ents, reveal previously unreported details about how the White House put the nation on its current course during a fateful period this spring.

* Key elements of the administration’s strategy were formulated out of sight in Mr. Meadows’s daily meetings, by aides who for the most part had no experience with public health emergencies and were taking their cues from the president. Officials in the West Wing saw the better-known White House coronavirus task force as dysfunctional, came to view Dr. Fauci as a purveyor of dire warnings but no solutions and blamed officials from the Centers for Disease Control and Prevention for mishandling the early stages of the virus.

* Dr. Birx was more central than publicly known to the judgment inside the West Wing that the virus was on a downward path. Colleagues described her as dedicated to public health and working herself to exhaustion to get the data right, but her model-based assessment nonetheless failed to account for a vital variable: how Mr. Trump’s rush to urge a return to normal would help undercut the social distancing and other measures that were holding down the numbers.

* The president quickly came to feel trapped by his own reopening guidelines. States needed declining cases to reopen, or at least a declining rate of positive tests. But more testing meant overall cases were destined to go up, undercutting the president’s push to crank up the economy. The result was to intensify Mr. Trump’s remarkable public campaign against testing, a vivid example of how he often waged war with science and his own administration’s experts and stated policies.

* Mr. Trump’s bizarre public statements, his refusal to wear a mask and his pressure on states to get their economies going again left governors and other state officials scrambling to deal with a leadership vacuum. At one stage, Gov. Gavin Newsom of California was told that if he wanted the federal government to help obtain the swabs needed to test for the virus, he would have to ask Mr. Trump himself — and thank him.

* Not until early June did White House officials even begin to recognize that their assumptions about the course of the pandemic had proved wrong. Even now there are internal divisions over how far to go in having officials publicly acknowledge the reality of the situation.

Judd Deere, a White House spokesman, said the president had imposed travel restrictions on China early in the pandemic, signed economic relief measures that have provided Americans with critical assistance and dealt with other issues including supplies of personal protective equipment, testing capacity and vaccine development.

“President Trump and his bold actions from the very beginning of this pandemic stand in stark contrast to the do-nothing Democrats and radical left who just complain, criticize and condemn anything this president does to preserve this nation,” he said.

At a briefing on April 10, Mr. Trump predicted that the number of deaths in the United States from the pandemic would be “substantially” fewer than 100,000. As of Saturday, the death toll stood at 139,186, the pace of new deaths was rising again and the country, logging a seven-day average of 65,790 new cases a day, had more confirmed cases per capita than any other major industrial nation.

Trump’s Choice

The president had a decision to make.

It was the end of March and his initial, 15-day effort to slow the spread of the virus by essentially shutting down the country was expiring in days. Sitting in front of the Resolute Desk in the Oval Office were Drs. Fauci and Birx, along with other top officials. Days earlier, Mr. Trump had said he envisioned the country being “opened up and raring to go” by Easter, but now he was on the verge of announcing that he would keep the country shut down for another 30 days.

“Do you really think we need to do this?” the president asked Dr. Fauci. “Yeah, we really do need to do it,” Dr. Fauci replied, explaining again the federal government’s role in making sure the virus did not explode across the country.

Mr. Trump’s willingness to go along — driven in part by grim television images of bodies piling up at Elmhurst Hospital Center in New York City — was a concession that federal responsibility was crucial to defeating a virus that did not respect state boundaries. In a later Rose Garden appearance, he appeared resigned to continuing the battle.

“Nothing would be worse than declaring victory before the victory is won,” Mr. Trump said.

But even as the president was acknowledging the need for tough decisions, he and his aides would soon be looking to do the opposite — build a public case that the federal government had completed its job and unshackle the president from ownership of the response.

The hub of the activity was the working group assembled by Mr. Meadows, who had just taken over as chief of staff.

Joe Grogan, the domestic policy adviser, had come around to Mr. Trump’s view that the reaction to the virus was overblown, a position shared at that point by Marc Short, Vice President Mike Pence’s chief of staff and a frequent participant in the meetings. Russell T. Vought, the president’s acting budget director, was there to address the pandemic’s mounting costs.

Chris Liddell, a deputy chief of staff, and Jared Kushner, the president’s senior adviser and son-in-law, acted as the group’s procurement and supply-chain experts.

Hope Hicks, the protector of Mr. Trump’s brand, was a regular participant. Kevin A. Hassett, a top economic adviser, came at times to help assess the numbers and also participated in a 9 a.m. meeting three times a week with Mr. Meadows and Treasury Secretary Steven Mnuchin on the economic aspects of the pandemic.

Then there was Dr. Birx, the response coordinator of the coronavirus task force. Unlike Dr. Fauci, who only stopped by the White House to attend meetings, she was given an office near the Situation Room and freely roamed the West Wing, fully embracing her role as a member of the president’s team.

By mid-April, Mr. Trump had grown publicly impatient with the stay-at-home recommendations he had reluctantly endorsed. Weekly unemployment claims made clear the economy was cratering and polling was showing his campaign bleeding support. Republican governors were agitating to lift the lockdown and the conservative political machinery was mobilizing to oppose what it saw as constraints on individual freedom.

At the meetings in Mr. Meadows’s office, the issue was clear: How much longer do we keep this up?

To answer that, they focused on two more questions: Had the virus peaked? And had the government given the states the tools they needed to manage the remaining problems?

On the first question, Dr. Birx and Mr. Hassett were optimistic: Mitigation was working, they insisted, even as many outside experts were warning that the nation would remain at great risk if it let up on social distancing and moved prematurely to reopen.

Mr. Meadows thought of himself as a data-driven decision maker, and in addition to models and infection numbers from the states and the C.D.C., they looked at traffic on the New Jersey Turnpike (the volume of cars coming in and out of New York City was down by 95.2 percent); payroll and credit card data, and the number of people who were reporting to have self-quarantined.

If the point was to sustain a monthlong lockdown, the numbers told them, the administration succeeded. If it was to squelch the virus to containable levels, later events would show the officials were oblivious to how widely it was already spreading.

The members of his group believed they had succeeded on the second question, too, although shortages of protective gear continued in some places (and would flare again months later).

A one-time anticipated shortage of more than 100,000 ventilators had been overcome; now there was enough of a surplus that the United States could lend them to other countries. A ban on elective surgeries meant there was plenty of bed space — and no more need for the Navy’s hospital ships.

The group thought governors should no longer have trouble getting what they needed for hospitals, doctors and first responders. And they grew increasingly frustrated by what they saw as politically motivated complaining about a lack of federal help and the inability of some states to make effective use of the supplies they were receiving.

Enraged by criticism from New York’s Democratic politicians about not being able to find a shipment of ventilators from the federal government, Mr. Grogan, the domestic policy chief, angrily told Mr. Kushner that they should put more ventilators on eighteen-wheelers, drive them into New York City and invite news helicopters to record it all — just to embarrass Gov. Andrew Cuomo and Mayor Bill de Blasio.

On April 14, the country passed what the group saw as a milestone, administering its three millionth test. Inside the West Wing, Mr. Kushner was insistent on that point: Given their assumption that infections would not surge again until the fall, there was enough testing ability out there.

Those outside experts who disagreed were largely brushed off. In mid-April, Dr. Ashish K. Jha, director of the Harvard Global Health Ins ute, urged a top administration official to embrace his call for conducting 500,000 coronavirus tests a day — far more than was happening at the time.

The official, Adm. Brett P. Giroir, the administration’s testing czar, who had been delivering upbeat descriptions of the nation’s growing testing capacity, eventually conceded to Dr. Jha that his plan seemed to be needed. But he made clear the federal government was not prepared to get there quickly.

“At some point down the road,” is what Dr. Jha said Admiral Giroir told him.

“My take is that Jared Kushner believes that this is not something that the White House should get too involved in,” Dr. Jha recalled. “And then the president believes that it is better left up to the states.”

Their critics notwithstanding, White House officials came to feel that they had in fact accomplished their job: giving governors the tools they needed to deal with remaining outbreaks as infections ebbed.

The wind down of the federal government’s response would play out over the next several weeks. The daily briefings with Mr. Trump ended on April 24. The Meadows team started barring Dr. Fauci from making most television appearances, lest he go off message and suggest continued high risk from the virus.

By the beginning of May, word leaked that the daily meetings of the task force itself would be ended, though Mr. Trump, who had not been told, backpedaled after the coverage caused an uproar.

On testing, Mr. Trump shifted from stressing that the nation was already doing more than any other country to deriding its importance. By June the president was regularly making nonsensical statements like, “If we stop testing right now, we’d have very few cases, if any.”

But during the middle weeks of April the president’s decision to largely walk away from an active leadership role — and give many states permission to believe the worst of the crisis was behind them — came abruptly into public view.

On April 10, Mr. Trump declared that, in his role as something akin to a “wartime president,” it would be his decision about whether to reopen the country. “That’s my metrics,” he told reporters, pointing to his own head. “I would say without question it’s the biggest decision I’ve ever had to make.”

Three days later, he reiterated his responsibility. “When somebody is the president of the United States, the authority is total and that’s the way it’s got to be,” he said.

The next day, Dr. Birx and Dr. Fauci presented Mr. Trump with a plan for issuing guidelines to start reopening the country at the end of the month. Developed largely by Dr. Birx and held closely by her until being presented to the president — most task force members did not see them beforehand — the guidelines laid out broad, voluntary standards for states considering how fast to come out of the lockdown.

In political terms, the do ent’s message was that responsibility for dealing with the pandemic was shifting from Mr. Trump to the states.

On April 16, when Mr. Trump publicly announced the guidelines, he made the message to the governors explicit.

“You’re going to call your own shots,” he said.

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Birx’s Influence

Inside the White House, Dr. Birx was the chief evangelist for the idea that the threat from the virus was fading.

Unlike Dr. Fauci, Dr. Birx is a strong believer in models that forecast the course of an outbreak. Dr. Fauci has cautioned that “models are only models” and that real-world outcomes depend on how people respond to calls for changes in behavior — to stay home, for example, or wear masks in public — sacrifices that required a sense of shared national responsibility.

In his decades of responding to outbreaks, Dr. Fauci, a voracious reader of political histories, learned to rely on reports from the ground. Late at night in his home office this spring, Dr. Fauci, who declined to comment for this article, dialed health officials in New Orleans, New York and Chicago, where he heard desperation unrecognizable in the more sanguine White House meetings.

Dr. Fauci had his own critics, who said he relied on anecdotes and experience rather than data, and who felt he was not sufficiently attuned to the devastating economic and social consequences of a national lockdown.

As the pandemic worsened, Dr. Fauci’s darker view of the cir stances was countered by the reassurances ostensibly offered by Dr. Birx’s data.

A renowned AIDS researcher who holds the le of “ambassador” as the State Department’s special representative for global health diplomacy, she had assembled a team of analysts who worked late nights in the White House complex, feeding her a constant stream of updated data, packaged in PowerPoint slides emailed to senior officials each day.

There were warnings that the models she studied might not be accurate, especially in predicting the course of the virus against a backdrop of evolving political, economic and social factors. Among the models Dr. Birx relied on most was one produced by researchers at the University of Washington. But when Mr. Hassett reviewed its performance by looking back on its predictions from three weeks earlier, it turned out to be hit or miss.

The authors of the University of Washington model spoke to Dr. Birx or members of her team almost daily, they said, and often cautioned that their work was only supposed to offer a snapshot based on key assumptions, like people continuing to abide by social distancing until June 1.

“We made clear that to get the epidemic under control and bring it down to effectively zero transmission required the social distancing mandates to be in place,” said Christopher J. L. Murray, the director of the modeling program. “April 22 — somewhere around that period. That’s when the tone shifted. They started to ask questions about what will be the trajectory and where with the lifting of mandates?”

Some state officials were also alarmed by the administration’s use of the University of Washington model.

Colorado health officials wrote to the administration on April 10, pleading that the White House not use the model to allocate supplies to the state, saying its predictions were rosier than the grim reality they were encountering. (When those concerns were relayed to her, Dr. Birx replied that decisions on allocating equipment were based on factors beyond the one model.)

Dr. Birx declined to be interviewed. A task force official said that she had only used the University of Washington model in a limited way and that the White House used “real data, not modeled data, to understand the pandemic in the United States.”

The official said the White House “immediately reacted to the early signs of community spread” by working with governors in the affected states.

But despite the outside warnings and evidence by early May that new infections, while down, remained higher than anticipated, the White House never fundamentally re-examined the course it had set in mid-April.

Dr. Fauci, a friend of Dr. Birx’s for 30 years, would describe her as more political than him, a “different species.” More pessimistic by nature, Dr. Fauci privately warned that the virus was going to be difficult to control, often commenting that he was the “skunk at the garden party.”

By contrast, Dr. Birx regularly delivered what the new team was hoping for.

“All metros are stabilizing,” she would tell them, describing the virus as having hit its “peak” around mid-April. The New York area accounted for half of the total cases in the country, she said. The slope was heading in the right direction. “We’re behind the worst of it.” She endorsed the idea that the death counts and hospitalization numbers could be inflated.

For Dr. Birx, Italy’s experience was a particularly telling — and positive — comparison. She routinely told colleagues that the United States was on the same trajectory as Italy, which had huge es before infections and deaths flattened to close to zero.

“She said we were basically going to track Italy,” one senior adviser later recalled.

Dr. Birx would roam the halls of the White House, talking to Mr. Kushner, Ms. Hicks and others, sometimes passing out diagrams to bolster her case. “We’ve hit our peak,” she would say, and that message would find its way back to Mr. Trump.

Dr. Birx began using versions of the phrase “putting out the embers,” wording that was later picked up by the press secretary, Kayleigh McEnany, and by Mr. Trump himself.

By the middle of May, the task force believed that another resurgence was not likely until the fall, senior administration officials said.

The New York region appeared well on its way to driving new infections down to levels it could handle — it was the one area of the country that did resemble the Italian model. But the models and analysis embraced by the West Wing failed to account for the weakening adherence to the lockdowns across the country that began even before Mr. Trump started urging governors to “liberate” their residents from the methodical guidelines his own government had established.

Later, it was clear that states that rushed to reopen before meeting the criteria in the guidelines — like Arizona, Texas and Alabama — would have among the worst surges in new cases.

Dr. Birx’s belief that the United States would mirror Italy turned out to be disastrously wrong. The Italians had been almost entirely compliant with stay-at-home orders and social distancing, squelching new infections to negligible levels before the country slowly reopened. Americans, by contrast, began backing away by late April from what social distancing efforts they had been making, egged on by Mr. Trump.

The difference was critical. As communities across the United States raced to reopen, the daily number of daily cases barely dropped below 20,000 in early May. The virus was still circulating across the country.

Italy’s recovery curve, it turned out, looked nothing like the American one.

The Consequences

The real-world consequences of Mr. Trump’s abdication of responsibility rippled across the country.

During a briefing on April 20, Mr. Trump mocked Gov. Larry Hogan of Maryland, a fellow Republican, for the state’s inability to find enough testing. Dr. Birx displayed maps with dozens of dots indicating labs that could help.

“He really didn’t know about the federal laboratories,” Mr. Trump told reporters with mock astonishment. “He didn’t know about it.”

But when Frances B. Phillips, the state’s deputy health secretary, reached out to one of those dots — a National Ins utes of Health facility in Maryland — she was told that they were suffering from the same shortages as state labs and were not in a position to help.

“It was clear that we were on our own and we need to develop our own strategy, which is very unlike the kind of federal response in the past public health emergencies,” Ms. Phillips recalled.

In California, Mr. Newsom had already experienced firsthand the complexities of getting help from Washington.

After offering to help acquire 350,000 testing swabs during an early morning conversation with one of Mr. Newsom’s advisers, Mr. Kushner made it clear that the federal help would hinge on the governor doing him a favor.

“The governor of California, Gavin Newsom, had to call Donald Trump, and ask him for the swabs” recalled the adviser, Bob Kocher, an Obama-era White House health care official.

Mr. Newsom made the call as requested and then praised Mr. Trump that same day during a news conference where he announced the commitment, giving Mr. Trump credit for the “substantial increase in supply” headed to California.

Mayor Francis X. Suarez of Miami, a Republican, said that the White House approach had only one focus: reopening businesses, instead of anticipating how cities and states should respond if cases surged again.

“It was all predicated on reduction, open, reduction, open more, reduction, open,” he said. “There was never what happens if there is an increase after you reopen?”

Other nations had moved aggressively to employ an array of techniques that Mr. Trump never mobilized on a federal level, including national testing strategies and contact tracing to track down and isolate people who had interacted with newly diagnosed patients.

“These things were done in Germany, in Italy, in Greece, Vietnam, in Singapore, in New Zealand and in China,” said Andy Slavitt, a former federal health care official who had been advising the White House.

“They were not secret,” he said. “Not mysterious. And these were not all wealthy countries. They just took accountability for getting it done. But we did not do that here. There was zero chance here that we would ever have been in a situation where we would be dealing with ‘embers.’ ”

A New Surge

By early June, it was clear that the White House had gotten it wrong.

In task force meetings, officials discussed a e in cases across the South and whether any bumps in caseloads were caused by crowded protests over the killing of George Floyd. They briefly considered if it was a fleeting side effect of Memorial Day gatherings.

They soon realized there was more at play.

Digging into new data from Dr. Birx, they concluded the virus was in fact spreading with invisible ferocity during the weeks in May when states were opening up with Mr. Trump’s encouragement and many were all but declaring victory.

With the benefit of hindsight, the head of the Centers for Disease Control and Prevention, Dr. Robert R. Redfield, acknowledged this week in a conversation with the Journal of the American Medical Association that administration officials — himself included — severely underestimated infections in April and May. He estimated they were missing as many as 10 cases each day for every one they were confirming.

The number of new cases has now surged far higher than the previous peak of more than 36,000 a day in mid-April. On Thursday, there were more than 75,000 confirmed new cases, a record.

Mr. Trump’s disdain for testing continues to affect the country. By the middle of June, lines stretched for blocks in Phoenix and in Austin, Texas. And getting results could take a week to 10 days, officials in Texas said — effectively inviting the virus to spread uncontrollably.

Dr. Mandy K. Cohen, the top health official in North Carolina, contacted the Trump administration after a surge in June, asking the government to quickly open 100 new testing sites in her state, in addition to the 13 it was then operating.

“We will keep those 13 open for another month — you are welcome,” Dr. Cohen said, mocking the response she received.

It was a devastating situation, said Mayor Steve Adler of Austin, who watched as the Covid-19 cases at intensive care units at area hospitals jumped from three in mid-May to 185 by early July. Mr. Adler had a simple plea for the White House.

“When we were trying to get people to wear masks, they would point to the president and say, well, not something that we need to do,” he said.

Mr. Suarez expressed similar frustrations with Mr. Trump’s dismissive approach to mask wearing. “People follow leaders,” he said, before rephrasing his remarks. “People follow the people who are supposed to be leaders.”

[ElNono]

Thanks for sharing, great writeup

[boutons_deux]

Birx is panning out to be stupidly wrong, basically her "science" fixed up to agree with Trash,

which means her science is mortally wrong bull

[Splits]

Article decimates Birx with all her happy talk. She should resign.

[Winehole23]

COVID-19 was Trump's chance at political greatness, not only did he blow it badly, his leadership has been objectively catastrophic for the USA. .Mass death and depression were avoidable, Trump's incompetence clinched both.

[weebo]

Waiting for Trump to throw Brix under the bus any minute now...

[JamStone]

Really enlightening read. Yeah Birx gets destroyed in the piece.

One of the biggest takes that has already been a consistent criticism throughout this whole ordeal is not just the lack of leadership, but the confusing, inconsistent message by the White House. There was never a consistent, unifying message or action. Teetering back-and-forth from federal authority to state responsibility whenever it suited him in order to shift blame. Early on, if decisive and consistent actions were made on the importance of how individuals needed to act, it likely would have given states the ability to distribute that message to the people and handle people who refuse to follow guidelines much better. But the mixed messages started almost immediately when the virus was taking hold of the country, from calling it a democratic hoax to suggesting it will magically disappear in April to demanding states to re-open to telling people it might be a good idea to inject disinfectant. It starts from the top. And the top handled it disastrously. That’s why it’s a disaster now.

Remember the ans?

“At ude reflect leadership... captain.”

[boutons_deux]

Trash, criminal reckless manslaughter of 100K+ Americans, 50x more than OBL, STILL has 40% approval

Trash should be impeached for inaction and actions causing 100K+ Americans to die.

There could be Repug Senators, trying to save their own skins, that would vote for convicting.

The Dems do nothing. Pelosi thinks voting Trash out is enough punishment.

[Spurs Homer]

Called it on that Birx

yet her defenders praised her and said we were better off with her as she was some authority


anyone with eyes and ears could see she was no less of sycophant than pence, redfield, giroir and the rest of those weak treasonous pussies

treasonous because they all put their cult/dear leader loyalty - over american lives

[Splits]

The crisis that shocked the world: America’s response to the coronavirus

Dysfunctional politics, a lack of funding for public health and a rush to reopen the economy ignited the resurgence of the virus
July 19, 2020 at 10:00 p.m. GMT+2
Isabelle Papadimitriou, 64, a respiratory therapist in Dallas, had been treating a surge of patients as the Texas economy reopened. She developed covid-19 symptoms June 27 and tested positive two days later. The disease was swift and brutal. She died the morning of the Fourth of July.

The holiday had always been her daughter’s favorite. Fiana Tulip loved the family cookouts, the fireworks, the feeling of America united. Now, she wonders whether she’ll ever be able to celebrate it again. In mourning, she’s furious.


Tulip, 40, had seen her country fail to control the novel coronavirus. She had seen Texas ease restrictions even as case counts and hospitalizations soared. She had seen fellow citizens refuse to wear masks or engage in social distancing.


Isabelle Papadimitriou devoted herself to treating patients as a respiratory therapist in Dallas. She was stricken with covid-19 as it surged in her state, and died on the Fourth of July. (Family photo)
Isabelle Papadimitriou devoted herself to treating patients as a respiratory therapist in Dallas. She was stricken with covid-19 as it surged in her state, and died on the Fourth of July. (Family photo)
“I feel like her death was a hundred percent preventable. I’m angry at the Trump administration. I’m angry with the state of our politics. I’m angry at the people who even now refuse to wear masks,” she said.


Six months after the coronavirus appeared in America, the nation has failed spectacularly to contain it. The country’s ineffective response has shocked observers around the planet.


Many countries have rigorously driven infection rates nearly to zero. In the United States, coronavirus transmission is out of control. The national response is fragmented, shot through with political rancor and culture-war divisiveness. Testing shortcomings that revealed themselves in March have become acute in July, with week-long waits for results leaving the country blind to real-time virus spread and rendering contact tracing nearly irrelevant.


The United States may be heading toward a new spasm of wrenching economic shutdowns or to another massive e in preventable deaths from covid-19 — or both.


How the world’s richest country got into this dismal situation is a complicated tale that exposes the flaws and fissures in a nation long proud of its ability to meet cataclysmic challenges.


The fumbling of the virus was not a fluke: The American coronavirus fiasco has exposed the country’s incoherent leadership, self-defeating political polarization, a lack of investment in public health, and persistent socioeconomic and racial inequities that have left millions of people vulnerable to disease and death.


In this big, sprawling, demographically and culturally diverse nation, the decentralized political structures gave birth to patchwork policies that don’t make sense when applied to a virus that ignores state boundaries and city limits.


While other countries endured some of the same setbacks, few have suffered from all of them simultaneously and catastrophically. If there was a mistake to be made in this pandemic, America has made it.


The single biggest miscalculation was rushing to reopen the economy while the virus was still spreading at high rates through much of the country, experts say. The only way to reopen safely, epidemiologists said as far back as early April, was to “crush the curve” — to drive down the rate of viral transmission to the point that new infections were few and far between.


Many countries did just that. The United States did not follow the expert advice. Now, the curve is crushing America.


“We didn’t have the stick-to-itiveness, the determination, to carry through what we started in March, April and May, and now the virus is taking advantage of that,” National Ins utes of Health Director Francis Collins said.


“If we’d had really strong guidance from local, state and national leaders, maybe we could have sustained the determination to get the curve all the way down to zero,” he said. “Now, we’re on the upswing, and I don’t quite see the top of the upswing yet.”


America, the outlier
Other countries have managed to avoid the kind of dramatic viral resurgence that is happening in America. Spain, Italy, Germany and France — all devastated by the virus months ago — drove coronavirus cases and deaths to relatively low levels. The United Kingdom has been an outlier in Europe, with one of the highest per capita death tolls in the world, but after suppressing transmission, it has not seen a major rebound.


In Venice, hopes for another rebirth after the coronavirus outbreak
Businesses and residents of Venice were hoping to bounce back after historic flooding, but then came the coronavirus outbreak. What does the future hold now? (Alexa Juliana Ard, Michelangelo Ruzzene/The Washington Post)
And in Asia, the picture is radically different. In Taiwan, baseball fans sit in the stands and watch their teams play. Japan has had fewer than 1,000 deaths from covid-19, the illness caused by the coronavirus. South Korea has had fewer than 300. Vietnam has recorded no deaths from the virus.


The death rate from covid-19 in the United States looks like that of countries with vastly lower wealth, health-care resources and technological infrastructure.


America’s mishandling of the pandemic has defied most experts’ predictions. In October, not long before the novel coronavirus began sickening people in China, a comprehensive review ranked the pandemic preparedness of 195 countries. The project — called the Global Health Security Index and spearheaded by the Johns Hopkins Center for Health Security and the Nuclear Threat Initiative — assigned scores to countries as a way to warn them of the rising threat of infectious-disease outbreaks.


With a score of 83.5 out of 100, the United States ranked No. 1.


How did the nation get caught so flat-footed? By not really trying, said Beth Cameron, who helped lead the project for the Nuclear Threat Initiative.


The federal government punted the coronavirus response to the states, counties and cities, said Cameron, who was senior director for global health security and biodefense on the White House National Security Council and helped write a pandemic response plan under President Barack Obama. The team Cameron led was disbanded after Donald Trump took office.


“I just never expected that we would have such a lack of federal leadership, and it’s been deliberate,” she said. “In a national emergency that is a pandemic, spreading between states, federal leadership is essential. And if there was any doubt about that, we ran that experiment from March and April until now. It failed. So we have to run a different experiment.”


A nation of individuals
Somehow, this highly mobile virus keeps sneaking up on communities, seeding itself extensively before people detect the breadth and intensity of the attack. That happened catastrophically in New York City early in the pandemic. The new outbreaks have been largely in the South and West.


This month, Roy Ramos, a reporter for WPLG-TV in Miami, noticed he had a cough. He and his wife, the station’s evening news anchor, Nicole Perez, went to get tested for the coronavirus. Positive — both of them. Soon, another anchor and the station’s chief meteorologist had tested positive, too.


As of July 14, 10 station employees had tested positive, including some who hadn’t even been in the office or in contact with their co-workers. The virus was everywhere in South Florida, which is now reeling from the pathogen’s assault.


“This is not a political message, but a personal one,” Perez’s co-anchor, Calvin Hughes, told viewers. “Please, please wear a mask.”


Local officials in Florida are calling on the Republican governor to better convey the urgency of the health crisis as covid-19 cases surge. (Reuters)
In the minds of many Americans, the coronavirus crisis that was so alarming in March and April lost its fearsomeness in May and June, when people tried to resume something approximating a normal life. The shutdowns had been miserable, but they’d been effective.


The success of the shutdowns meant that many Americans didn’t know anyone personally sickened by the virus. In places with low transmission, the crisis seemed far away.


“We just let our guard down,” Ohio Gov. Mike DeWine (R) said in an interview Friday. “Some people when they heard, ‘Hey, Ohio’s open,’ what they mentally processed is, ‘It’s safe. We can go out and do whatever we want to. It’s back to normal.’ ”


In the past two months, the virus has been smoldering in his state, the governor said, and “now we start to see some flames.” He fears Ohio could soon have the kind of runaway transmission afflicting Florida.


“Florida a month ago is where Ohio is today. If we don’t want to be Florida, we’ve got to change what we’re doing. Everybody’s got to mask up,” the governor said.


He and others cite human nature as a problem with containing the virus. Human brains simply aren’t wired to emphasize the importance of doing things, like wearing masks, that protect others but offer no immediate payoff, said Paul Slovic, a University of Oregon psychologist.


“You don’t get rewarded for putting on a mask,” Slovic said. “You don’t see who you’ve protected from harm, but you do feel an immediate discomfort.”


Protecting one life — or even one small puppy — generates a major emotional response that can prompt action, Slovic has found. But as the number of individuals involved increases — say, to the 137,000-plus deaths caused by the coronavirus — people grow inured to the loss, less prone to take action.


That makes public messaging especially essential, experts say. But the messaging in the United States has been all over the place. Even the scientists have struggled: They were wobbly on the effectiveness of masks before eventually embracing them.


Kristin Urquiza, 39, said she tried warning her father, Mark — a lifelong Republican — against going out and risking infection. In their home state of Arizona, as leaders including Gov. Doug Ducey (R) sprinted to reopen in May and June, Urquiza could tell she was losing the argument.


“When the president, the governor and people on cable news are all saying one thing, how do you compete with that?” she said. “He would push back. ‘I hear what you’re saying, but why would the governor say it’s safe to go out if it’s not true?’ ”


Her father died of the virus June 30. In the obituary she wrote, she lashed out at government leaders.


“He was a huge supporter of Trump and Arizona governor Ducey. He believed what they said. And they betrayed him,” she said in an interview.


Even before the pandemic hit, local public health agencies had been decimated by years of staffing and budget cuts.


They had lost almost a quarter of their overall workforce since 2008 — a cut of almost 60,000 workers, according to national associations of health officials. The agencies’ main source of federal funding — the Centers for Disease Control and Prevention’s emergency preparedness budget — had been cut 30 percent since 2003.


Public health is an enterprise with an intrinsic problem: People can’t see sicknesses avoided or deaths averted.


“You don’t see the results. It’s a dog that doesn’t bark,” said David Himmelstein, professor of public health and health policy at the CUNY School of Public Health.


“The question is, does the water come out of your tap clean? Are the sewer systems being inspected? Are restaurants and food being inspected? Those things, you don’t notice until they fail,” he said.


The country’s electronic disease surveillance systems are “archaic and bersome,” said Cathy Slemp, who was recently dismissed as West Virginia’s public health commissioner after the governor blamed her for failing to reclassify certain coronavirus cases as recovered.


“We’re driving a Pinto and want to have a Ferrari,” she said.


The public health challenges are keenly felt in Malheur County, a vast swath of mostly federal rangeland in rural eastern Oregon. About a quarter of its 30,000 residents live in poverty. Teen pregnancy rates are double the statewide rate. There’s one school nurse for 10,000 square miles. Drug use is high.


The first coronavirus case hit March 30, and for more than a month, the county averaged just one to two cases a week. There was resistance to a statewide shutdown in the conservative area, but most people were willing to observe temporary restrictions, said Sarah Poe, director of the county health department.


But after a month or so, residents began to complain of government overreach. Many felt they had to resume working to survive, she said.


“People’s response has been to just take care of themselves, take care of your own business, your own family,” Poe said. “That’s not how this virus works.”


Now, the coronavirus is a full-blown crisis in Malheur County. Cases began soaring three weeks ago, to 15 or 16 a day. As of Friday, the county had 477 cases. The ulative positive rate since the first case is nearly 16 percent — quadruple the state’s rate.


On Wednesday, facing an accelerating caseload, Malheur County commissioners passed a resolution that goes further than the state’s mask order. It recommends gatherings of no more than 10 people indoors and 25 outdoors, and mask-wearing in groups indoors and out.


But resistance in the county remains high. Poe said she regularly gets hate mail and phone calls accusing her of peddling a hoax.


“We’re up against just a ton of misinformation,” she said. “What are we fighting here? We are fighting a virus and our goal is to save lives. Let’s not be distracted into fighting other people.”


A turning point
America, experts say, is approaching a tipping point at which its public health systems could become so overwhelmed they begin to collapse. Already, coronavirus test results take so long to come back they are almost useless for anything except as a historical record.


The delays have a cascading effect. Contact tracing is rendered ineffectual. Containing the virus by isolation becomes impossible. And as hospitals fill, the virus’s fatality rate could inch upward because of overtaxed ICU nurses and doctors struggling to care for so many.


But the most dangerous cascading effect could be despair — a loss of hope, along with the resolve to fight the virus, warned Michael T. Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy.


“When that happens, you lose the ability to act rationally. You lose the commitment to fight. You lose all chance of beating back the virus,” he said.


Doctors warn against reopening too soon | Voices from the Pandemic
As some states began to reopen in late April, New York doctors who saw a decline in coronavirus patients said lifting social distancing could reverse progress. (Joyce Koh/The Washington Post)
Adam Fleming Petty, a writer in Grand Rapids, Mich., said he feels that demoralization acutely — as well as “so much rage” at Trump and other political leaders whose measures did not quell the virus enough to allow many schools to open.


“One thing I told myself was, ‘Okay, as long as school starts back up in the fall, I can do this. I can make it through the summer if I have that goal waiting for me.’ Now, that goal isn’t there anymore,” said Petty, 38, who has been the primary supervisor of two daughters, ages 5 and 7, while his wife works from home. For four months, the family has socialized with only a handful of relatives just a few times.


“This is far from the first time that governmental administrative incompetence has been displayed. But I can’t remember the last time that the consequences of that were so personal,” Petty said.


Governors and local officials across the Sun Belt have announced incremental measures in recent days to halt the viral resurgence. California ins uted a statewide mask requirement. Arkansas and Colorado did so Thursday. Arizona allowed local jurisdictions to implement mask mandates as they see fit.


Florida’s governor has resisted weeks of calls to implement such a mandate. Georgia Gov. Brian Kemp (R) announced Wednesday that all local mask mandates in his state are void.


Louisiana and Texas recently shut down bars all over again. Alabama Gov. Kay Ivey (R) announced a statewide mask mandate in recent days as an alternative to closing. West Virginia limited gatherings to 25 people or fewer.


In New York, Gov. Andrew M. Cuomo (D) threatened to close restaurants if social distancing is not taken seriously.


“Closing the bars is going to be the equivalent of fixing three of the five screen doors in your submarine,” said Osterholm, who says that places with high levels of transmission need to return to the kind of shutdowns common in March and April.


In a telephone interview, Cuomo said New York officials were caught off guard early in the year because everyone assumed the virus was coming into the West Coast from China. But it had already spread in Europe, and from there to New York.


“We didn’t find out until after the fact. You don’t have the revelation by the academics until mid-March that this was one of the great health blunders of all time,” Cuomo said. “You actually got hit by a bus that came from the other direction.”


He expressed dismay about the national failure to suppress the virus.


“If you could have written a prescription four months ago, a manual — ‘This is what you must do to deal with a virus’ — and if people could just follow the manual, we would be over this, like other countries are over it,” Cuomo said. “I think it exposed a fundamental weakness in this country. We have a divided country.”


New York beat back the virus by closely following the scientific data and being cautious about reopening the economy, Cuomo said. Many places suffering high rates of infections didn’t do that, he said.


“It was science denial meets government incompetence,” he said.


‘The exception and anomaly’
This crisis has been sucked inexorably into the vortex of political polarization.


Trump repeatedly downplayed the viral threat. “You have 15 people, and the 15 within a couple of days is going to be down to close to zero,” he said in late February. On Twitter, he cheered on citizen protests of shutdowns that had been ordered by Democratic governors. He did not wear a mask in public until July 11.


White House spokeswoman Sarah Matthews in a statement defended the administration’s response to the crisis, saying Trump “has led an historic, whole-of-America coronavirus response — resulting in 100,000 ventilators procured, sourcing critical PPE for our frontline heroes, and a robust testing regime resulting in more than double the number of tests than any other country in the world. … This strong leadership will continue as we safely reopen the economy, expedite vaccine and therapeutics developments, and continue to see an encouraging decline in the U.S. mortality rate.”


A White House official on background defended the president’s support for reopening the economy while the virus was still spreading, citing Trump’s belief that the cure cannot be worse than the disease: “There are consequences to staying closed, including but not limited to missed doctors’ appointments, drug or alcohol misuse, and suicide as a result of the pandemic.”


Future historians will not treat kindly Trump’s efforts to divide and confuse, said James Grossman, executive director of the American Historical Association.


“You look at the Great Depression and how Roosevelt made a concerted effort to unite the country — the fireside chats, the New Deal. That is the instinctive reaction of almost every president in crisis. Even if you don’t succeed, you try to convince people that they’re all in this together,” Grossman said. “This presidency is the exception and anomaly.”


Many Americans now believe the pandemic has been exaggerated, or even fabricated, by scientists and the mainstream news media. The rejection of scientific expertise has flowered into a conspiracy theory holding that the experts are lying as part of a political agenda.


“The most outrageous lies are the ones about Covid 19. Everyone is lying. The CDC, Media, Democrats, our Doctors, not all but most, that we are told to trust,” former “Wheel of Fortune” game show host Chuck Woolery tweeted July 12.


Trump retweeted that. Days later, Woolery revealed his son was sick with the virus, and he has since taken down his Twitter account.


To be an American
As she prepares for a three-day drive across the country — from New York to Texas — to bury her mother, Tulip said she has been thinking a lot about what it means to be American.


She was raised like many Texans, unabashedly proud of her roots and her patriotism. “I grew up a Dallas Cowboys fan. All about the stars and stripes. You know that song ‘Proud to Be an American’? We would literally sing that as kids in elementary school and mean every word.”


Now, she said, she feels betrayed by her country and home state. For the past two weeks, she and her husband have been calling funeral homes in Brownsville, unable to get through because the town has been overwhelmed by the virus.


“I desperately want to believe we as a country can change, that we can recover from where we are now,” she said. “I want to believe that America can get back to who we were, a proud country, one where people can thrive and not suffer.”

[Splits]

Another really good article I pasted above, if you can get through the paywall here's the source: https://www.washingtonpost.com/healt...us-us-failure/

[Winehole23]

[clambake]

“That’s a nasty question”

If he takes questions.