COVID-19 Chaos in America: Before, During and Beyond Trump

03/06/2020
COVID 19 in the United States. Simon Reich CERI

By the end of May 2020, over 100,000 Americans had died of COVID-19, and the U.S. constituted thirty percent of all cases globally, with the numbers still rising. The American economy was in shambles. Agricultural producers were pouring milk down the drain, slaughtering livestock and grinding crops back into the soil because of the loss of commercial demand and strains on delivery systems. Conversely, supermarket stores often lacked a rotating array of fresh and processed products. All but the most essential stores had been closed in many states since early March. Americans lined up, often in their thousands, to collect free provisions at food banks. From a record low of 3.5 percent, unemployment had ballooned, beyond 40 million people to approximately 25 percent, with many applicants for assistance as yet uncounted due to delays in processing their claim. COVID-19 cases were increasing in 17 American states as their governors were simultaneously reducing restrictions and “opening up” their economy. Arkansas portended America’s future, as it recorded a second wave of infections. Nationwide protests over the death of George Floyd promised to hasten that wave.

Truly tested by a historic crisis, both President Trump and his senior political staff were found woefully inadequate. His administration having depleted the national reserve stockpile of Personal Protective Equipment (PPE), Trump refused to show elements of leadership by respecting simple protocols like wearing a face mask. He mocked Joe Biden, his erstwhile election rival next November, for doing so. Furthermore, senior administration officials’ lack of experience in harnessing the mechanisms of governance became transparent. The organization of public health provisions, like testing, was abandoned by the Federal government and left to officials at the state and local level.

Trump’s focus by then had moved on to two elements of a narrative. The first was his consistent claims of “success:” how his administration’s “early” decisions (like precluding flights from Europe and China) had saved so many lives. Indeed, senior advisor Jared Kushner’s suggestion that the administration’s response was a “success story” at the end of April, with a million confirmed COVID-19 cases and 60,000 dead, will surely become one of the more infamous episodes when the complete story of America’s COVID-19 crisis is eventually written. This trajectory was coupled with another apparent “success:” how effective the president was being in coercing and cajoling state governors to reopen the American economy.

The second element of this narrative was the provision of blame—a discursive tool that has been a continuing feature since then-candidate Trump first campaigned in 2015. The Chinese were to blame for the crisis. So was the World Health Organization (WHO). Domestic partisanship ruled. Liberal governors were first blamed for their incapacity to secure sufficient PPE for their individual states on the open market. Next for their inability to administer mass COVID testing (although that was, according to the president, simultaneously unwarranted). And then for their sabotaging of any prospective economic recovery before November’s presidential election because of their slow lifting of restrictions on business activity. Even Anthony Fauci, the longstanding director of the National Institute of Allergy and Infectious Diseases at the National Institute of Health who had become the most trusted figure in the eyes of the American public—was criticized by Trump when Fauci appeared to contradict him.

Everybody was deemed responsible for successive failures, except the president and his political appointees. Trump otherwise spent his time, against the best medical advice, advocating people preemptively take hydroxychloroquine––manufactured under the brand name of Plaquenil by Sanofi, the French firm in which the President has “a small financial interest.”[1]

Protests against Trump Miami 2020. Copyright: Shutterstock

Miami Downtown, FL, USA - MAY 31, 2020: Man with posters against US President Donald Trump. Copyright: Shutterstock

 

The Trump Administration’s Flawed Policy Responses

It is easy, and understandable, to blame the crisis solely on the ineptitude, negligence and political self-interest of the Trump administration. Proponents of that view have plenty of ammunition, even as he continues to convince a stable 42 percent of the electorate that he is doing a good job.[2]

To be clear, there is an American governmental infrastructure that is supposed to address public health emergencies, recently succinctly described by Al Mauroni, director of the U.S. Air Force Center for Strategic Deterrence Studies, as follows:

Congress designated the Department of Health and Human Services through the Public Health Service Act to lead the federal response to public health emergencies. Under that department’s jurisdiction, the National Institutes of Health oversees the National Institute of Allergy and Infectious Diseases, which has a strategic plan for COVID-19 research. The assistant secretary for preparedness and response, also of the Department of Health and Human Services, oversees the Biomedical Advanced Research and Development Authority (BARDA). Since 2004, this agency has been responsible for developing and procuring medical countermeasures for public health threats, to include emerging infectious diseases, and putting them into the Strategic National Stockpile. [3]

But that organizational infrastructure, founded on the principle of public health rather than national security, has been deemed largely unimportant and side-lined by the administration since Trump’s election in 2016. And as Tara O’Toole, former Under Secretary of Homeland Security for Science and Technology in the Obama administration recently noted in a Belfer Center webcast , the American public health and intelligence communities simply don’t talk to each other about issues like pandemics.

That chasm between public health and national security was exacerbated by the administration’s decision in May of 2018 to shutter those departments in the National Security Council (NSC) charged with addressing pandemic responses.[4] Ambassador John Bolton, then NSC Advisor, claimed that this was simply a case of “bureaucratic stream-lining.” [5] Others called it “a necessary re-organization.” [6] But that was only the most visible action. The administration had previously failed to implement the 65-page pandemic response plan developed by the Obama administration. [7] Furthermore, funds for PREDICT , USAID’s infectious disease monitoring system, had been cut by 75 percent. [8] Fauci did in fact become the president’s foil at a succession of nightly news conferences. But the Center for Disease Control, historically regarded as a global leader in combatting infectious diseases during previous pandemics, was largely ignored by an administration looking for private sector solutions in the form of ameliorative drugs or the development of a vaccine. [9]

Empty streets in NYC during COVID 19 lockdown. Copyright: Shutterstock

Empty streets in New York City during COVID-19 lockdown. Copyright: Shutterstock

Trump Abroad

Trump fared no better in dealing with foreign leaders. He first asserted the failings of an assortment of states including China, the members-states of the EU, the EU itself, and latterly Brazil. Travel bans were introduced. These were justified as an expedient measure, although their effectiveness remains in doubt given the occasional time delays in their applying the measures, the categories of exemptions allowed, and lack of testing of those Americans returning from those countries. The net effect was to alienate foreign leaders and turn a collective-action problem requiring a multilateral response into a nationalistic reaction predicated on a unilateral strategy. The US would vainly try and hide behind its borders, pursue a solitary course in the fight for available PPE globally, and then await the development of ameliorative medicines or a vaccine. It would even buy the proprietary right to any drugs created by French firm Sanofi. [10]

Most conspicuously, however, Trump—as mentioned earlier—has repeatedly attacked the WHO for its purported subservience to China in reputedly misleading foreign policymakers about the scope of the problem in Wuhan. This was an organization that the United States had sponsored at its creation, a key part of its immediate post-war process of global institution-building. Furthermore, the U.S. has been its largest financial contributor throughout is history. [11] Thus the administration’s decision to freeze funding to the organization before withdrawing American membership had, and will have, both financial and symbolic repercussions. The immediate consequence was to generating a leadership vacuum in the domain of global public health—that commentators have asserted will adeptly be filled by China, creating a self-fulfilling prophecy for Trump.

Trump Alone–or a Series of Chasms?

I could chronicle the failings of the Trump administration at far greater length, both domestically and abroad. When historians write about this period—free of the political narrative that attracts his devoted portion of the electorate and Republican party officials who fear his political wrath—I suspect that they will not be generous in their assessment of his management of the crisis.

It would be a mistake, however, to allay blame solely on the Trump administration for what former-President Obama labelled “an absolute chaotic disaster.”[12] For to an extent, like many developments in the United States in the last four years, Trump is both the cause and the symptom.

One source of the problem lies in the gulf between conceptions of security that begins in American academia. Scholars working in the field of national security have long disparaged the significance of human security. They consider it marginal to their priorities of conventional and nuclear war, and more recently terrorism, irregular warfare and cyber conflict. Issues associated with human security, like trafficking, have routinely been listed in the most important national strategic documents. But they have not been prioritized within the national security infrastructure. Public health is largely ignored.

This academic chasm is further evident in scholarly debates on American grand strategy. The debate between variants of realism and liberalism remains fierce. But it is overly focused on kinetic threats posed by other states (and occasionally large groups like ISIS), where a response can be militarized. This debate has latterly included the question of bio-security, because of concerns about the use of biological agents by terrorists. But little beyond that. [13]

This debate has therefore largely, consciously, ignored two other kinds of threats. The first is anthropogenic threats, which consist of menacing phenomena that are the unintended product of human behavior, such as climate change. The second are naturogenic threats. These have no human origin or intent. Rather, they originate in nature but nonetheless can have a lethality comparable or greater than other forms of threats. COVID-19 is the exemplar of a naturogenic threat. It has now killed more Americans than the Korean and Vietnam wars combined.

This chasm has been further mirrored in a public policy chasm. Health care professionals drew momentous lessons from the Spanish Flu at the end of World War I, which is estimated to have killed up to 50 million people globally, including 675,000 Americans. [14] Clearly, dating from HIV in the 1980s, successive presidential administrations have become increasingly aware of naturogenic threats, notably H1N1, SARS, MERS and Ebola. Indeed, H1N1 accounted for 12,469 deaths in the U.S. alone. [15] Although the Reagan administration was slow in responding to HIV, successive administrations became far more proactive. George H.W. Bush recognized HIV/AIDS as a global epidemic.[16] President Bill Clinton established “national policy and implementing actions to address the threat of emerging infectious diseases by improving surveillance, prevention, and response measures.” [17] He even expanded the mission of the Department of Defense (DoD) “to include support of global surveillance, training, research and response to emerging infectious disease threats.”[18] George W. Bush singled out the threat to international security posed by AIDs, and established the President's Emergency Plan for AIDS Relief (PEPFAR) to fund treatment and prevention in African countries.[19] President Obama committed the United States to a global leadership role in preventing, preparing for, and combatting infectious diseases. [20] He asserted that “America is the world leader in fighting pandemics, including HIV/AIDS, and in improving global health security.”[21] Obama even deployed 3,000 military personnel to quell an Ebola outbreak in Africa in 2015.

But the rhetoric, and subsequent initiatives, often had weak policy results, largely lost on national security officials. Pandemic preparedness was often nominal. Stockpiles of PPE were often built and then depleted (the Trump administration was notably egregious in allowing the latter). Nobody thought of sustaining or resurrecting America’s domestic capacity to manufacture ventilators. And, most problematically, the link between health security and national security remained tenuous at the highest echelons of government. This meant that the funding and provisions for health security often withered while the national security budget bloated.

Safety rules during COVID lockdown. Copyright Shutterstock

Safety rules during COVID-19 lockdown. Copyright: Shutterstock


Where From Here?

Unlike most Europeans, Americans have a profound belief in the power of technology to overcome nature. This is in fact based on a firm historic foundation. Settlers travelled across America and conquered the deserts of the west, the frozen tundra of upper Midwest and the swamps of the south. Even today, cities are built in Arizona where nature clearly didn’t intend them to be. California’s terrain has become a fertile ground for American farming. This cultural proclivity is evident in both the administration’s and the public’s attitude. There was no discussion of ‘herd immunity’ in the U.S. Yet no embrace of confinement among large portions of the population across the country. The domestic expectation, fed by the president, however unjustified, is that ameliorative medicines or a vaccine will quickly appear, while warm summer weather will meanwhile subdue the infection rate. Meanwhile, those who want to stay at home can do so.

Indeed, the death toll will inevitably continue to rise until a pharmaceutical response arrives. But the greater damage may be to America’s credibility abroad. Whatever residual elements of goodwill that existed amongst the US’ allies have been largely depleted by the administration’s legally questionable seizure of PPE supplies, refusal to financially contribute to collective efforts to develop a vaccine, often unjustified assertions of blame, and arbitrary travel bans. While proclamations of China’s new global leadership may be premature, it has consolidated their standing in some domains, and with some states.

The election of Joe Biden—a familiar and more trusted voice—as US President in November may do something to restore American credibility amongst its allies. That legitimacy is needed to deal with a whole series of collective problems—ranging from beyond pandemics to climate change, an impending economic catastrophe and further possible Russian aggression in the Arctic, Baltics and Ukraine. But credibility takes a long time to build and is easily lost. It will only likely be European needs, rather than its traditionally more comfortable preference, that pushes its governments, hesitantly, back towards Biden. And should Trump be reelected, however unlikely according to the latest American opinion polls, then this pandemic may simply be a warning of the greater challenges to come.

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[1] Peter Baker, Katie Rogers, David Enrich and Maggie Haberman, “Trump’s Aggressive Advocacy of Malaria Drug for Treating Coronavirus Divides Medical Community,” New York Times, 6 April 2020, https://www.nytimes.com/2020/04/06/us/politics/coronavirus-trump-malaria...

[2] For comprehensive statistics on public opinion on President Trump’s performance regarding COVID-19 see Aaron Bycoffe, Christopher Groskopf and Dhrumil Mehta, “How Americans View The Coronavirus Crisis And Trump’s Response,” Fivethirtyeight.com, (accessed 28 May 2020), https://projects.fivethirtyeight.com/coronavirus-polls/?ex_cid=rrpromo

[3] Al Mauroni, “Militarizing Global Health Isn’t the Right Answer,” War on the Rocks, 27 May 2020, https://warontherocks.com/2020/05/militarizing-global-health-isnt-the-ri...

[4] Beth Cameron, “I ran the White House pandemic office. Trump closed it,” Washington Post, 13 March 2020, https://www.washingtonpost.com/outlook/nsc-pandemic-office-trump-closed/... .

[5] Tal Axelrod, “Bolton defends decision to shutter NSC pandemic office,” The Hill, 14 March 2020, https://thehill.com/homenews/administration/487581-bolton-defends-decisi...

[6] Lena H. Sun, “Top White House official in charge of pandemic response exits abruptly,” Washington Post, 10 May 2018, https://www.washingtonpost.com/news/to-your-health/wp/2018/05/10/top-whi...

[7] Dan Diamond and Nahal and Toosie, “Trump team failed to follow NSC’s pandemic playbook,” Politico, 25 March 2020, https://www.politico.com/news/2020/03/25/trump-coronavirus-national-secu... .

[8] Donald G. McNeil Jr., “Scientists Were Hunting for the Next Ebola. Now the U.S. Has Cut Off Their Funding,” New York Times, 25 October 2019, https://www.nytimes.com/2019/10/25/health/predict-usaid-viruses.html

[9] Frank Bruni, “She Predicted the Coronavirus. What Does She Foresee Next?” New York Times, 2 May 2020, https://www.nytimes.com/2020/05/02/opinion/sunday/coronavirus-prediction...

[10] Jillian Deutsch, “French drug firm boss: US will get first dibs on its coronavirus vaccine,” CNN, 13 May 2020, https://www.politico.eu/article/sanofi-boss-us-will-get-first-dibs-on-it...

[11] See World Health Organization, “The United States of America: Partner in Global Health,” (undated), https://www.who.int/about/planning-finance-and-accountability/financing-...

[12] Quoted in Jeff Zeleny, “Obama says White House response to coronavirus has been 'absolute chaotic disaster',” CNN, 9 May 9 2020, https://www.cnn.com/2020/05/09/politics/obama-trump-coronavirus-response...

[13] Frank Smith III, American Biodefense: How Dangerous Ideas about Biological Weapons Shape National Security (Ithaca, NY: Cornell University Press 2014).

[14] Laurie Garrett, “The Next Pandemic?” Foreign Affairs 84, no. 4 (July- August. 2005), p. 3; “World War 1 Casualties,” Robert Shuman Center (undated), http://www.centre-robert-schuman.org/userfiles/files/REPERES%20–%20module%201-1-1%20-%20explanatory%20notes%20–%20World%20War%20I%20casualties%20–%20EN.pdf

[15] Mark Terry, “Compare: 2009 H1N1 Pandemic Versus the 2020 Coronavirus Pandemic,” Biospace, 19 March 2020, https://www.biospace.com/article/2009-h1n1-pandemic-versus-the-2020-coro...

[16] Approaches to AIDS evolved over time see Gwyn Prins, “Aids and Global Security,” International Affairs 80, no. 5 (October 2004), pp. 931–952.

[17] White House, Presidential Decision Directive NSTC-7 “Infections Diseases” (1996), unnumbered: https://fas.org/irp/offdocs/pdd/pdd-nstc-7.pdf

[18] Ibid., unnumbered.

[19] Harold Varmus, "Making PEPFAR," Science & Diplomacy vol. 2, no. 4 (1 December 2015), http://www.sciencediplomacy.org/article/2013/making-pepfar .

[20] Julie Fischer and Rebecca Katz, “U.S. priorities for global health security,” in J. Stephen Morrison (ed.), Global Health Policy in the Second Obama Term (Washington, DC: CSIS, February 2013), pp. 85-95.

[21] Ibid., p. 14.

 

Cover image: NEW YORK, NY - MARCH 26: A man in a full protective suit delivers supplies to Elmhurst Hospital due to COVID-19 outbreak on March 26, 2020; Queens neighborhood of New York City. Copyright: Shutterstock




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