It is unfair to lay all of the blame on Trump for some of the problems that have arisen in the last month, but with a more aggressive and proactive approach in January and February, we would probably be in far better shape.
After all, US policymakers and health officials have had previous scares whether it be Ebola or H1N1 where new diseases arose that could have become huge threats. That is not just a failure of Trump but of Clinton, Bush and Obama.
We have been fortunate so far that previous viruses were not nearly as contagious as coronavirus—but our luck has run out and we are caught without an effective plan, safety net, or response.
Problem 1: Downplaying the risk and not listening to the scientific community early on
On January 22, when the first American case was announced the day before, President Trump was asked, “Are there worries about a pandemic at this point?”
His response: “No. Not at all. And we have it totally under control. It’s one person coming in from China, and we have it under control. It’s going to be just fine.”
But even at the time he was wrong—the virus had spread to four other countries, China was taking drastic measures and closed off the city of Wuhan.
Had he taken the threat seriously enough to plan, we would have had nearly six additional weeks to address many of the next things on the list. Instead he repeatedly told the country that this 
was no worse than the flu—and even spread conspiracy theories and suggested it was a hoax.
On January 31, he said that “we pretty much shut it down coming in from China.”
On February 10, he said, “Looks like by April, you know, in theory, when it gets a little warmer, it miraculously goes away.”
On February 19, he said, “I think the numbers are going to get progressively better as we go along.”
On March 6, he said, “There is no testing kit shortage, nor has there ever been.” That was a false statement. There had been a problem with the testing for over a month. That speech was filled with inaccurate and misleading statements by the president.
Problem 2: Testing shortfalls
The testing shortfall is really the first key problem. Yesterday, the NY Times ran an article, “Aggressive screening might have helped contain the coronavirus in the United States. But technical flaws, regulatory hurdles and lapses in leadership let it spread undetected for weeks.”
This was a critical failure because, as the virus spread between late January and early March, had they been able to test people they might have been able to contain the virus before it spread like it has.
Writes the Times, “[L]arge-scale testing of people who might have been infected did not happen — because of technical flaws, regulatory hurdles, business-as-usual bureaucracies and lack of leadership at multiple levels…”
The result was “a lost month, when the world’s richest country — armed with some of the most highly trained scientists and infectious disease specialists — squandered its best chance of containing the virus’s spread. Instead, Americans were left largely blind to the scale of a looming public health catastrophe.”
Problem 3: Failure to implement stay-at-home orders
This week, he stunned many by calling for an Easter return to normal. The reality is that the president can say whatever he wants, but the states that have imposed their own orders are going to follow the advice of the health experts and, as we saw yesterday, even a state like Kansas, which currently has just 200 cases, is implementing the order.
Does early and aggressive stay-at-home orders work? We can see from California compared to, say, New York that it does. California currently has 5500 identified cases (again, we are hamstrung by the lack of testing). New York with half the population has 53,300.
California in absolute terms has the third most, but when you consider population California has done remarkably well.
About 20 states have 1000 or more cases. It may have started in coastal and urban states, but we are seeing more and more midwestern and rural states impacted.
The number of deaths doubled from 1000 to 2000 in just two days.
Instead of opening things up, we need to shut things down to prevent the spread. This week Trump already said he won’t do that and it is going to be left up to the states to decide—at least for now. More critical time to slow the curve is being squandered.
Problem 4: Ventilators
This is a ticking bomb. At least for much of the country.
Nothing really illustrates the problem with ventilators more than the order to GM to produce more ventilators. The problem of course is that when he finally issued the order, first, GM had already agreed to do it (he then criticized GM for wasting time) and second, the order really comes a month too late to make a difference.
Here again is an issue that if he had acted on January 22 instead of downplaying the threat, he might have been able to avert the problem.
Again, he got caught flatfooted.
President Trump said: “Where you have a problem with ventilators, we’re working very hard trying to find — nobody in their wildest dreams would have ever thought that we’d need tens of thousands of ventilators. This is something that’s very unique to this, to what happened.”
But as CNN reported yesterday, there are “10 government reports from 2003 to 2015, federal officials predicted the United States would experience a critical lack of ventilators and other lifesaving medical supplies if it faced a viral outbreak like the one currently sweeping the country.”
In other words not just President Trump but the administration itself should have known this would be a problem. And again, this is not just on President Trump—President Bush and President Obama have some blame here. But on January 22, President Trump had the tools to know that ventilators would be a problem and failed to act.
California is moving in the right direction. The governor announced yesterday, “At the onset of the pandemic, California had approximately 7,500 ventilators across its hospital systems.”
The state set a goal of adding an additional, 10,000 ventilators.
So far, the state has added 4,252 ventilators, approximately 1,000 of which needed to be refurbished.
The governor announced, “Through a partnership with the state, Bloom Energy is working to refurbish ventilators in real time. Yesterday, Bloom Energy refurbished 80 ventilators and it expects to refurbish an additional 120 ventilators today.”
The bottom line message here was important. Governor Newsom on Saturday expressed confidence that California will produce sufficient ventilators to meet projected needs, but, at the same time, he cautioned that the state’s need could expand significantly if the public doesn’t maintain social distancing and the crisis worsens.
Problem 5: Failure to create temporary hospital space in advance of the flood
New York in a lot of ways is our own Italy. The reality is that both have a critical problem—lack of resources and hospital space.
The key problems are going to be the rationing of lifesaving equipment and interventions.
“These decisions run counter to everything that we stand for and are incredibly painful,” wrote Meredith Case, an internal medicine resident at Columbia/New York-Presbyterian Hospital, in a March 25 Twitter thread. “Our ICU is completely full with intubated Covid patients. … We are rapidly moving to expand capacity. We are nearly out of PPE. I anticipate we will begin rationing today.”
Experts now warn that New York City hospitals are basically at capacity and the peak may still be three weeks away.
As a side point to how ill-prepared the administration is: earlier this week, Trump said his goal was to open things by Easter. Yesterday, he started the day by proclaiming that there would be a quarantine of New York. He did this, reportedly without consultation of his advisors, and then by the end of the day, he flipped and they announced a travel advisory.
Problem 6: Stimulus could have been used for triage and other response
The economy is a key concern. The US passed a $2 trillion stimulus plan. But that largely means that some Americans will get a one-time check. While both parties passed this, I would argue this approach is next to useless.
A $1200 check is not going to do much for the economy. Hey, it’s a nice to have thing, if you get it—and a lot of people won’t.
But they could have done something more profound—taken people who were laid off and hired them to help distribute food and triage the sick coming into the understaffed and overworked health care system.
The people impacted by this don’t need a one-time handout for a six-month crisis, they need an income stream and the stimulus package could have been used to provide one.
How bad will this thing get? It is hard to know. There are really three numbers I am watching right now. The New York cases and when the pandemic starts to peak there. The California cases and whether we can continue to keep the rate of spread low. And three, what happens in the smaller and more rural states.
I think if we can get enough testing capacity, ventilators with a general stay-at-home directive, we can still reduce the curve here. But the numbers nationally are bad and getting worse.
—David M. Greenwald reporting
[Moderator: Edited. Comment in your own words on the specific issues raised. Do not post links to articles or videos. ]
Not sure you point. They did a travel ban – it accomplished nothing. The failure of the Trump administration is in the record I presented.
How can you say it accomplished nothing. How bad might the pandemic be here in America if Trump hadn’t instituted the China travel ban? I thought it was all about flattening the curve and giving our health resources more time to respond. But the point is even when Trump acted early he was met with the usual cries of racism and fear mongering from the left.
How can I say it? Because we are flying blind right now. If we had developed testing and been able to target and quarantine we might not even have to have shut down the economy to the extent we have – because we would be able to track and isolate the cases, like they did in South Korea. Once it got in here, we were screwed and it was only a matter of time. And we were completely unprepared at that point.
Keep in mind Keith – once we can actually test people and identify where the concentrations lie, we might be able to relax the social distancing factor.
When you suddenly prohibit links to articles (but use them yourself, in your own article), you’re effectively shutting down debate. Congratulations.
[Moderator: discuss the topic. Use your own words primarily. Do not debate moderation practices. I know you can do this.]
“If we had developed testing and been able to target and quarantine we might not even have to have shut down the economy to the extent we have”
Its worse than that. If we had accepted World Health Organization test kits we wouldn’t be so far behind the curve. Relatives in Panama didn’t” feel well, went to doctor and were tested immediately? Yes its easier to get tested in Panama than in the USA. Why? Panama accented test kits from WHO USA didn’t.
Here’s my deleted post without links (which I guess are no longer allowed on the Vanguard)
When Trump came out early with the China travel ban the Democrat front runner for President was quoted as saying:
And then I posted a link to a video in early Feb of the NY Health Commissioner Barbot stating this:
as she also downplayed the chances of catching Coronavirus and telling people to take the subway and live their lives. The video would’ve said it better but evidently links to videos are no longer allowed.
The greatest fault of the Trump insurrection has been the devaluation of science and scientists. In the first two years of the Trump administration, more than 1,600 federal scientists left government, according to Office of Personnel Management employment data. In 2017 early in his illegitimate presidency he and his lackeys had a briefing on a document entitled: “Playbook for Early response to High-Consequence Emerging Infectious Disease Threats and Biological Incidents.” It included helpful hint (protocols) such as: “Begin early procurement of PPE materials for healthcare workers as soon as the threat is identified.” and “Concentrate on early diagnostic capacity”—i.e. have tests on-hand so that you can monitor the spread of the disease.
Then in February, 2018, [edited: the administration] cut 80% of the CDC effort to stem the global spread of infectious diseases in places including as China, Pakistan, Haiti, Rwanda and Congo.
In January of 2019 the director of National Intelligence issued a “Threat Assessment” that found among other things “The increase in frequency and diversity of reported disease outbreaks—such as dengue and Zika—probably will continue through 2018, including the potential for a severe global health emergency that could lead to major economic and societal disruptions, strain governmental and international resources, and increase calls on the United States for support. A novel strain of a virulent microbe that is easily transmissible between humans continues to be a major threat, with pathogens such as H5N1 and H7N9 influenza and Middle East Respiratory Syndrome Coronavirus having pandemic potential if they were to acquire efficient human-to-human transmissibility.” and “We assess that the United States and the world will remain vulnerable to the next flu pandemic or large scale outbreak of a contagious disease that could lead to massive rates of death and disability, severely affect the world economy, strain international resources, and increase calls on the United States for support.”
Trump ignored it all. Now that the chickens have come home to roost, [edited: they] are trying to use the event to line their pockets.
I agree with John’s assessment of the roots of the problem. David has done a good job of enumerating the current missteps and their outcomes. But the basis for the problem is a philosophy of casual disregard for science and expertise that led Trump to disregard and destroy the attempts of the Obama administration to, based on best evidence available, lay out a structure and protocol for an early and proactive response to a pandemic. This combined with the underlying and seemingly uniquely American view that health is an individual, not a societal matter, are the underpinnings of our current situation.
The real challenge will be stopping the backwards finger-pointing, dealing with the crisis, and remembering ‘lessons learned’, so it doesn’t re-occur with the next ‘novel’ (or, nouvelle) virus that migrates from blood-borne to respiratory… migrates/transforms from a natural state, to a pandemic contagion.
We should take notes as we learn from this, and continue to act on those lessons, continually, moving forward.
There seems to be some complacency, in the past, in government, and the healthcare/public health community, as well. Hundreds of thousands of folk who, to one degree or another, have been ‘complicit’ or “enablers”.
Ex.: individual states could have acted sooner, the healthcare community could have acted sooner, rather than waiting for instructions from the Feds… they didn’t… it was what it is…
What we need to soon focus on, is what will be (que sera, sera, but we can make choices to affect the future, as to preparedness, and future responses to crisis).
” The real challenge will be stopping the backwards finger-pointing, dealing with the crisis, and remembering ‘lessons learned’,…”
I have no trouble working on the daily challenges while blaming those responsible for creating this cluster****. I multitask more than that most of the time. His hubris and misanthropy deserve enduring scorn.
Understood, John… I choose, for myself, to focus on lessons learned/to be learned, the present, and the future, informed by lessons learned, and acted upon… others may choose differently, and that is OK with me…
When the Coronavirus pandemic was just getting started in this country what were the Democrats doing?
Oh that’s right, at that time they were too busy impeaching the President.
Keith
What magic power do you think the party not in control of the WH has to enact policies that are controlled by the executive branch? If we are going to do better in the future as Bill has said, we are going to have to take an honest look at what processes needed to change. For a federal problem, that necessarily starts with the executive branch be it under GOP or Dem control. This is the reality of the structure of our government, not a game of good guys and bad guys.
Bill,
“Ex.: individual states could have acted sooner, the healthcare community could have acted sooner, rather than waiting for instructions from the Feds… they didn’t… it was what it is…”
Yes, and it could have been even better if the virus had never arrived here at all. That does not mean that it was not a national problem that needed to be addressed nationally not on an ad-lib basis by states and municipalities whose actions are necessarily very limited.
I do not believe it is too soon to address the errors that were made in 2017 & 18 when the decisions were made not to improve upon the existing pandemic guidelines if necessary, but rather to cut funding and experienced specialists. That was a decision that could only be made at the federal level and is the logical starting point for any improvements based on past experience.
K. Your opinions are yours, and you’re free to have them. You added no facts. Which is also OK.
Read today’s Bee and see where CA unilaterally cut funding to, and closed PH labs/activities… so, as written, that is an untrue assertion. Choices.
Kaiser and other HC providers could have provided additional funding/specialists… they didn’t… choices…
I would hardly call Gavin Newsom’s state mandate very limited:
Keith
I am quite sure you know, factually, that Newsom has no control over any other state. Since he does not have the ability to close the border, yes, he is quite limited compared to the president.
The Vanguard and its commenters have no control over who gets elected president, or how he/she performs. In fact, the entire state of California might not have a “say”.
What a waste of time this article is, especially when considering the issues facing Davis itself.
Control, no… influence, likely… considering we’re 8-10% of US population, and in terms of the economy, definitely one of the top 10 “countries” in the world. Control vs. ‘influence’… sometimes, hard to tell the difference… if there is one…
Like the ARC, for example 😉
Trump did not defund the CDC, in fact during his Presidency funding for the CDC has increased.
I would supply a link to prove this but we’re no longer allowed to post links or videos.
Two observations… ‘links’ generally reveal the source, and I can weigh the “implicit bias” (CPAC vs. CDC, vs. DNC, a neo-Nazi group, etc.).
I think the “no longer allowed” thingy is overstated… if true, that is a problem, IMO.
I would hope those who read links, “consider the source”… for links, the source, and their mission/etc. should be clearly identified… I believe in thinking, and considering ‘sources’…
But, as has been ‘shown’ or asserted before, I am an “oddball”… so feel free to ignore…
I too think the banning of links is a problem.
When I came the Vanguard for the first time at 5:30, I couldn’t help but say to myself, “What the f**k is the ban on links about? So I sent David a text with that exact question.
When I got his reply, I was sorry I had sent him the text, because it said, “I have no idea. I have other issues right now. My brother-in-law just died.” So with condolences to Cecilia and David for their loss, I think we have to put on hold any discussion of what Bill called a “thingy.”
Hey Matt, seriously, pardon to slap your hand publicly, but maybe they do not want something that personal made public. A bit ‘off limits’ in my book.
Alan M: I had that thought, as well.
Generally, I try to avoid sharing information (especially personal information or conversations) on here, unless I’ve specifically cleared it with that person.
We’ll discuss it more later. Please use links sparingly, in the context of a discussion, using your own words primarily, and be careful of the sources you link. A single sentence plus a link is really not a discussion.
Don, during my academic career I have seen many, many papers destroyed by professors and/or peer reviewers for failure to adequately cite information sources. You seem to be (unilaterally) imposing a different standard here. Why is the tried and true standard not appropriate here?
Ok, my abrupt decision this morning was a mistake. My apologies to Keith.
Links are fine. But everybody, please, as I said earlier:
— use them sparingly.
— use them in the context of a discussion, to emphasize your points. As I said, a single sentence with a link isn’t a discussion.
— use your own words first and preferably. A link should be like a footnote, not primary content.
This is important:
— be careful of the links you choose. Use bona fide news sources, not opinion columns or highly partisan sites. We might remove links from very controversial or unbalanced sources.
We have a long history here that we don’t like memes, gifs, jpgs, cartoons, etc. Sites that allow those tend to devolve pretty rapidly.
Thank you all for your input.
Thank you for being willing to listen Don.
What could go wrong there?
I think we all know where that might/would end up going.
For instance, David often cites the NY Times which I find to be very unbalanced and opinionated even in their supposed fact reporting articles.
That said, thank you for your apology.
All I ask for is a level playing field where the same rules apply to all regardless of their political views.
That is so hard to do when you are sure you are in the right. Bias just doesn’t look like bias to one who is biased.
Just saw that, sorry to hear the news.
That is a good framework. To which I’d add, “avoid use of sites/cites that require subscription or a requirement to ‘accept cookies'” (or, at least disclose those requirements). Would also warn about the words “bona fide” — eye of beholder thing… some might say a cite from a nazi website is ‘bona fide’… others might say quotes from the Torah, Talmud, Qur’an, Thomas Paine, etc. are not. There is also often a difference between ‘facts’, ‘wisdom’, ‘truth’, and “news”. “Sources” are important for each to judge ‘wheat from chaff’…
All of this recent ‘stuff’ would, in my opinion, be worthy of a separate article and discussion…
I’ll also add, when pressed, frustrated, etc., a lot here have said (posted) things, that, in hindsight, we either would not have said (posted), or worded differently — I know that is true of me…
On the ARC, we have an analysis that has been shelved now because a lot of people suggested it wasn’t the best time to run it. You won’t like it, but it will come out probably closer to when public commenting period ends. And the commenter is not a retired traffic engineer, he is the retired city engineer.
Keep something else in mind – last week was a huge challenge. I basically had me and Cres. Dani was on vacation. The interns are off. So I had to largely man the entire ship by myself during a time of crisis when there was a lot coming out and I think we put out a lot of good stuff, but that means analysis of projects or street repairs is not on my highest list of priorities.
Wondering who told you it “wasn’t the best time”, and the reason for that.
I doubt that I’d “dislike it”, if it stuck to the facts (and wasn’t the usual development advocacy piece).
Again, the EIR itself is 500 pages long. Then, there’s the accompanying traffic study.
Lots of material there, which you could illuminate over the course of several articles.
Normally, it is your “priority” – at least when you attempt to tie it in to development proposals.
You yourself suggested that we should put off consideration of ARC. A number of readers that I consult with thought it would be better to wait for things to settle down. And some of the commenters when we put a few things out suggested the same thing.
Normally I have a full staff covering the rest of what we need to cover on a given day. Nothing was normal last week. You don’t seem to have an appreciation for that. We’ll see how it goes this week. There are things that normally would have been covered that weren’t and things that we normally wouldn’t cover, that we did.
The EIR comment period is going forward regardless, and will end on 4/27.
You’ve already noted that you’re simply waiting until the comment period ends, before you resume your advocacy.