The Four Men Responsible For America’s COVID-19 Disaster

Trump, Azar and Redfield.

With a majority of states now "reopening" their economies, millions of Americans remain unemployed or furloughed and it is unclear when the economy will full recover - some analysts point to late 2021. In this state, the question becomes why was the United States so ill prepared and why was the national response bungled so badly?  A very long piece in Rolling Stone looks at the disastrous federal response and names four individuals as ultimately to blame, starting with Donald Trump who has always treated the pandemic as a PR and political issue rather than a public health emergency.  While Trump set the tone, the disaster was compounded by his appointees who were picked based on ideology and/or ties to far right Christians rather than for the true expertise and competence. In making these flawed appointments, Trump was following both GOP ideology and pandering to leading Christofascists.  The results have proven deadly for tens of thousands of Americans.  Here are highlights from the article which is an indictment of Trump and ultimately the GOP "small government" agenda and obsession with funding cuts to finance tax cuts for the very wealthy (read the entire piece):  

Dr. Robert Redfield, the director of the Centers for Disease Control, flanked Donald Trump at the podium in the White House briefing room. It was February 29th, the day of the first reported U.S. death from the coronavirus, and [Trump] the president fielded an urgent question: “How should Americans prepare for this virus?” a reporter asked. “Should they go on with their daily lives? Change their routine? What should they do?”

A tall man, with a tan, freckled head, and a snow-white chinstrap beard, Redfield stepped to the podium. “The risk at this time is low,” Redfield told the country. “The American public needs to go on with their normal lives.”

This reassurance came at precisely, and tragically, the wrong time. With a different answer, much of the human devastation that was about to unfold in the United States would have been avoidable. Academic research from Imperial College in London, modeling the U.S. response, estimates that up to 90 percent of COVID-19 deaths could have been prevented had the U.S. moved to shut down by March 2nd. Instead, administration leaders dragged their feet for another two weeks, as the virus continued a silent, exponential assault. By early May, more than 75,000 Americans were dead.

Even as he spoke, Redfield knew the country should be taking a different course. The Coronavirus Task Force had resolved to present the president with a plan for mitigation efforts, like school and business closures, on February 24th, but reportedly reversed course after Trump exploded about the economic fallout. Instead, the CDC director continued touting “aggressive containment” to Congress on February 27th.

Experts tell Rolling Stone that ship had sailed when the virus made the leap from infected travelers into the general public. “If you’ve got a community spreading respiratory virus, it’s not going to be containable,” says Dr. Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security. “You have to shift to mitigation right away.”

Patty Murray is the ranking member of the Senate’s top health committee, and represents Washington state, the nation’s first coronavirus hot spot. She blames the administration for a delay that “overwhelmed the health care system and resulted in tens of thousands of deaths.” And she singles out Redfield, in particular, for “dereliction of duty.”

“We had ample notice to get our country ready,” says Ron Klain, who served as President Obama’s Ebola czar, and lists the rolling out of testing, securing protective equipment, and building up hospital capacity as necessary preventative steps. “We spent all of January and February doing none of those things, and as a result, when this disease really exploded  in March, we weren’t prepared.”

The government leaders who failed to safeguard the nation are CDC Director Redfield; FDA Commissioner Stephen Hahn; Health and Human Services Secretary Alex Azar; and of course, President Trump. Together, these men had the power to change the direction of this pandemic, to lessen its impact on the economy, and constrain the death toll from COVID-19. Each failed, in a series of errors and mismanagement that grew into a singular catastrophe — or as Jared Kushner described it on Fox & Friends, “a great success story.”

Precious weeks slipped by — amid infighting, ass covering, and wasted effort — and the virus slipped through the nation’s crippled surveillance apparatus, taking root in hot spots across the country, and in particular, New York City.

The mismanagement cost lives. With adequate testing from the beginning, says Dr. Howard Forman, a Yale professor of public-health policy, “we would have been able to stop the spread of this virus in its tracks the way that many other nations have.” Instead, says Sen. Murray, the administration’s response was “wait until it’s too late, and then try and contain one of the most aggressive viruses that we’ve ever seen.”

Blind to the virus’s penetration and unable to target mitigation where it was needed, the administration and state governors had to resort to the blunt instrument of shuttering the economy, says Dr. Ashish Jha, director of the Harvard Global Health Institute. And the lack of testing kept us in limbo. “Our economy is shut down because we still do not have adequate testing,” Jha says. “We have been woefully behind from the beginning of this pandemic.”

If the president’s deputies made trillion-dollar mistakes, accountability for the pandemic response lies with Trump, who waived off months of harrowing intelligence briefings, choosing to treat the coronavirus as a crisis in public relations, rather than a public-health emergency. Having staked his re-election on a strong economy, Trump downplayed the virus.

The front-line agency built to respond to a pandemic, the CDC, was placed in unreliable hands. Dr. Robert Redfield is a right-wing darling with a checkered scientific past. His 2018 nomination was a triumph for the Christian right, a coup in particular for evangelical activists Shepherd and Anita Smith, who have been instrumental in driving a global AIDS strategy centered on abstinence.

Redfield championed discriminatory policies that he defended as “good medicine” — including quarantining of HIV-positive soldiers in a segregated barracks. These soldiers were routinely given dishonorable discharges after superiors rooted out evidence of homosexuality, and left to suffer the course of their devastating disease without health insurance.

When his CDC appointment was announced in March 2018, Sen. Murray warned of Redfield’s “pattern of ethically and morally questionable behavior,” as well as his “lack of public-health expertise,” and urged Trump to “reconsider.” But the CDC post does not require Senate approval. Redfield sought to reassure CDC staff that his views had modernized, and that he now embraced condoms to slow HIV infection.

The CDC reports to the Department of Health and Human Services, led by Alex Azar, a former executive for the pharmaceutical giant Eli Lilly who gained infamy, in his five-year tenure, by doubling the price of insulin.

Azar is a creature of the GOP establishment: He cut his teeth as a Supreme Court clerk to Antonin Scalia, worked with Brett Kavanaugh on the Clinton-Whitewater investigation under special counsel Ken Starr, and served as a deputy HHS administrator in the George W. Bush era, before becoming Eli Lilly’s top lobbyist.

Azar sought to shrink the CDC, an agency that has been on the chopping block throughout the Trump administration. In HHS’s most recent budget proposal — unveiled this past February, 10 days after the World Health Organization declared a global emergency over the coronavirus — Azar sought an $85 million cut to the CDC’s Emerging and Zoonotic Infectious Diseases program and a $25 million cut to Public Health Preparedness and Response. Azar defended the budget at the time as making “difficult, prudent choices.”

The Trump administration had also hollowed out the CDC’s China presence, slashing staff from 47 to barely a dozen. These cuts were part of a broad-reaching drawdown of America’s disease preparedness, including Trump’s decision to disband the National Security Counsel’s pandemic-response team.

Stephen Hahn had been on the job at the FDA for barely a month. A bald, 60-year-old of modest height, Hahn has an impeccable résumé — he served as chief medical executive at the University of Texas MD Anderson Cancer Center — but he had no experience running a government agency.

The need to engage the private sector for coronavirus testing was not only foreseeable, it was foreseen — by Trump’s first FDA commissioner, Scott Gottlieb. In a January 28th Wall Street Journal article, “Act Now to Prevent an American Epidemic,” Gottlieb warned that the “CDC will struggle to keep up with the volume of screening.” He said the government must begin “working with private industry to develop easy-to-use, rapid diagnostic tests.”

If Hahn read his predecessor’s call to action, he did not act on it. . . . . Yet the failure to activate the private sector was the key difference between the U.S. response to the coronavirus and that of South Korea, which first detected the virus in its country at the same time the U.S. did. “Instead of going through regulatory hijinks,” says Milton, the University of Maryland virologist, South Korea “turned their biomedical industry loose, and they started producing lots of tests right away.”

The testing breakdown had left the nation blind to the true scope of the outbreak. By March 1st, the CDC’s official tally of coronavirus cases had spiked from the 15 cases touted by Trump to 75. But researchers at Northeastern University have now developed models showing there were likely 28,000 infections at the time, in just five major cities, including New York and Seattle.

Having plunged the nation headlong and unprepared into the deadliest disease outbreak in a century, President Trump is now proving to be one of the greatest obstacles to an effective national response.

Sebelius ultimately blames Trump for failing to end the infighting and fix the testing failure. “The White House has a unique way to get agencies’ attention, by making it clear that they want a solution, and everybody at the table with that solution within 24 hours,” she says. “If the president wants this to happen, it will happen.” But on his visit to the CDC in Atlanta, Trump had made an extraordinary admission: That he did not want to let passengers from a cruise ship, then suffering an outbreak off the California coast, to come on shore because the tally of patients would rise. “I like the numbers being where they are,” Trump said.

Trump plainly saw effective testing as a threat to his political messaging that the administration was containing the virus. By standing at CDC headquarters to declare that the tests were “perfect” and that he didn’t want COVID-19 numbers going up, the president was doing the exact opposite of demanding a fix. For the president’s deputies, Sebelius says, “there couldn’t be a clearer signal.”

In the event that Trump is still president when a vaccine becomes available, Sebelius argues that the loose confederations that have formed in the Northeast, Midwest, and Pacific states to coordinate their reopenings may need to band together in a shadow government to sidestep Trump. “Maybe governors will put together their own system,” she says, “and ignore what’s happening in the White House.”

Again, read the entire piece.