Monday, May 04, 2020

The Dysfunction And Desperation Within The Trump Administration Are Somehow Worse Than Everyone Thought

In the past seven weeks, there have been published several in-depth accounts of how Donald Trump and his administration ignored and minimized the numerous warnings regarding the coronavirus, and then, when forced by circumstances to respond, did the absolute minimum while the death toll steadily increased, abdicated its responsibility to the states, telling them they were on their own, as if they were fifty separate countries, not a part of the United States.

The federal government hijacked (i.e., stole) and redirected deliveries of medical supplies arranged by the states on their own to states Trump believes are key to winning in November. Now, impatient to get things "back to normal", Trump is pushing for businesses to re-open even though the daily numbers of new cases and deaths has not abated. Trump is convinced that if the economy rebounds, he will be re-elected and he's refusing to let a deadly pandemic get in his way, no matter how many Americans die due to his negligence.

Before Trump Inauguration A Warning-The Worst Influenza Pandemic Since 1918
Politico, March 16, 2020
On January 13, 2017, seven days before Donald Trump's inauguration, 30 officials in his administration were given a lengthy briefing from out-going Barack Obama officials about a terrifying, new reality: a dangerous virus that could rapidly become a global pandemic. The Trump administration was also given a comprehensive report on the lessons learned by the Obama administration when battling Ebola in 2016.
Before Virus Outbreak, a Cascade of Warnings Went Unheeded
New York Times, March 19, 2020
From January to August 2019, the Trump administration conducted an eight-month exercise (code-named "Crimson Contagion") in more than a dozen cities, simulating a pandemic of a respiratory virus that begins in China and quickly spreads around the world. The results were sobering: the federal government was underfunded, underprepared, and uncoordinated to deal with a virus for which no treatment existed. There were repeated cases of "confusion", with federal agencies fighting over who was in charge, state officials and hospitals struggling to ascertain what equipment was stockpiled or available, and cities and states making their own decisions about school closings.
U.S. Intelligence Reports From January And February Warned About A Likely Pandemic
Washington Post, March 20, 2020
"U.S. intelligence agencies were issuing ominous, classified warnings in January and February about the global danger posed by the coronavirus while President Trump and lawmakers played down the threat and failed to take action that might have slowed the spread of the pathogen, according to U.S. officials familiar with spy agency reporting. ... Taken together, the reports and warnings painted an early picture of a virus that showed the characteristics of a globe-encircling pandemic ... But despite that constant flow of reporting, Trump continued publicly and privately to play down the threat the virus posed to Americans."
The Missing Six Weeks - How Trump Failed The Biggest Test Of His Life
The Guardian, March 28, 2020
On January 20, 2020, a 35-year-old man from Washington state became the first person in the US to be diagnosed with the virus. It was not until February 29 that the Trump administration allowed laboratories and hospitals to conduct their own coronavirus tests. "Those missing four to six weeks are likely to go down in the definitive history as a cautionary tale of the potentially devastating consequences of failed political leadership. ... 'The US response will be studied for generations as a textbook example of a disastrous, failed effort,' Ron Klain, who spearheaded the fight against Ebola in 2014, told a Georgetown university panel recently. 'What's happened in Washington has been a fiasco of incredible proportions.'"
The U.S. Was Beset By Denial And Dysfunction As The Coronavirus Raged
Washington Post, April 4, 2020
"By the time Donald Trump proclaimed himself a wartime president — and the coronavirus the enemy — the United States was already on course to see more of its people die than in the wars of Korea, Vietnam, Afghanistan and Iraq combined. ... It did not have to happen this way. Though not perfectly prepared, the United States had more expertise, resources, plans and epidemiological experience than dozens of countries that ultimately fared far better in fending off the virus. The failure has echoes of the period leading up to 9/11: Warnings were sounded, including at the highest levels of government, but the president was deaf to them until the enemy had already struck. ... [I]t took 70 days from that initial notification for Trump to treat the coronavirus not as a distant threat or harmless flu strain well under control, but as a lethal force that ... was poised to kill tens of thousands of citizens. That more-than-two-month stretch now stands as critical time that was squandered."
Trade Adviser Warned White House in January of Risks of a Pandemic
New York Times, April 6, 2020
"A top White House adviser starkly warned Trump administration officials in late January that the coronavirus crisis could cost the United States trillions of dollars and put millions of Americans at risk of illness or death. The warning, written in a memo by Peter Navarro, President Trump's trade adviser, is the highest-level alert known to have circulated inside the West Wing ... 'The lack of immune protection or an existing cure or vaccine would leave Americans defenseless in the case of a full-blown coronavirus outbreak on U.S. soil,' Mr. Navarro's memo said. 'This lack of protection elevates the risk of the coronavirus evolving into a full-blown pandemic, imperiling the lives of millions of Americans.' Dated Jan. 29, it came during a period when Mr. Trump was playing down the risks to the United States, and he would later go on to say that no one could have predicted such a devastating outcome."
He Could Have Seen What Was Coming: Behind Trump's Failure On The Virus
New York Times, April 11, 2020
"'Any way you cut it, this is going to be bad,' a senior medical adviser at the Department of Veterans Affairs, Dr. Carter Mecher, wrote on the night of Jan. 28, in an email to a group of public health experts scattered around the government and universities. 'The projected size of the outbreak already seems hard to believe.' ... Throughout January, as Mr. Trump repeatedly played down the seriousness of the virus and focused on other issues, an array of figures inside his government ... identified the threat, sounded alarms and made clear the need for aggressive action. The president, though, was slow to absorb the scale of the risk and to act accordingly, focusing instead on controlling the message, protecting gains in the economy and batting away warnings from senior officials."
Americans At World Health Organization Transmitted Real-Time Information About Coronavirus To Trump Administration
Washington Post, April 19, 2020
"More than a dozen U.S. researchers, physicians and public health experts, many of them from the Centers for Disease Control and Prevention [17 staff members, 16 from the CDC], were working full time at the Geneva headquarters of the World Health Organization as the novel coronavirus emerged late last year and transmitted real-time information about its discovery and spread in China to the Trump administration ... Senior Trump-appointed health officials also consulted regularly at the highest levels with the WHO as the crisis unfolded, the officials said. The presence of so many U.S. officials undercuts President Trump's assertion that the WHO's failure to communicate the extent of the threat, born of a desire to protect China, is largely responsible for the rapid spread of the virus in the United States."
President's Intelligence Briefing Book Repeatedly Cited Virus Threat
Washington Post, April 27, 2020
U.S. intelligence agencies issued warnings about the novel coronavirus in more than a dozen classified briefings prepared for President Trump in January and February, months during which he continued to play down the threat, according to current and former U.S. officials. The repeated warnings were conveyed in issues of the President's Daily Brief ... But the alarms appear to have failed to register with the president, who routinely skips reading the PDB and has at times shown little patience for even the oral summary he takes two or three times per week ..."
Today, the Washington Post published "34 Days Of Pandemic: Inside Trump's Desperate Attempts To Reopen America". It covers the time from March 29, when Trump acquiesced and extended the strict social-distancing guidelines he originally hoped to abolish, to last Friday, May 1, when some states began to "re-open". It reveals a stunningly dysfunctional and desperate administration ignoring everything except the virus's effect on Trump's re-election chances in November.

Kathleen Sebelius, former governor of Kansas and health secretary in the Barack Obama administration:
We wasted two months denying it. We're now wasting another two months by just dithering around. The administration seems to have washed their hands of it and said [to governors], we're out of it. You're on your own. Figure it out.
One adviser to the trump administration agreed:
That's really the story of all this. The states are just doing everything on their own.
The Post's most-recent account is based on interviews with 82 administration officials, outside advisers, and experts with detailed knowledge of the White House's handling of the pandemic.
The epidemiological models under review in the White House Situation Room in late March were bracing. In a best-case scenario, they showed the novel coronavirus was likely to kill between 100,000 and 240,000 Americans. President Trump was apprehensive about so much carnage on his watch, yet also impatient to reopen the economy — and he wanted data to justify doing so.

So the White House considered its own analysis. A small team led by Kevin Hassett — a former chairman of Trump's Council of Economic Advisers with no background in infectious diseases — quietly built an econometric model to guide response operations.

Many White House aides interpreted the analysis as predicting that the daily death count would peak in mid-April before dropping off substantially, and that there would be far fewer fatalities than initially foreseen, according to six people briefed on it. ... [I]t was embraced inside the West Wing by the president's son-in-law, Jared Kushner, and other powerful aides ... It affirmed their own skepticism about the severity of the virus and bolstered their case to shift the focus to the economy, which they firmly believed would determine whether Trump wins a second term. ... [Trump began] cheering an economic revival rather than managing a catastrophic health crisis. ...

By the end of April — with more Americans dying in the month than in all of the Vietnam War — it became clear that the Hassett model was too good to be true. "A catastrophic miss," as a former senior administration official briefed on the data described it. The president's course would not be changed, however. Trump and Kushner began to declare a great victory against the virus, while urging America to start reopening businesses and schools. ...

So determined was Trump to extinguish the deadly virus that he repeatedly embraced fantasy cure-alls and tuned out both the reality that the first wave has yet to significantly recede and the possibility of a potentially worse second wave in the fall.

The president sought to obscure major problems by trying to recast them as triumphs. He repeatedly boasted, for instance, that the United States has conducted more tests than any other country, even though the total of 6.75 million is a fraction of the 2 million to 3 million tests per day that many experts say is needed to safely reopen.

And though Trump was fixated on reopening the economy, he and his administration fell far short of making that a reality. The factors that health and business leaders say are critical to a speedy and effective reopening — widespread testing, contact tracing and coordinated efforts between Washington and the states — remain lacking. ...

Some of Trump's closest advisers rebutted on the record the suggestion that the pandemic response has been anything but successful. ...

Trump's interactions with the states during the time were jarringly inconsistent. One day, he called himself a wartime president with total authority; the next day, he said he was merely President Backup, there to help states as he deems necessary. Trump crowned himself "the king of ventilators" and boasted of his work shoring up supply chains, yet shamed governors for asking for too many supplies for besieged hospitals and health-care workers in their states. At one point, he seemed to suggest that hospitals were selling protective gear provided by the federal government on the black market. ...

Trump tried to manage the perception of his performance by holding daily, hours-long press briefings that confused and repelled large swaths of the country. As the death toll mounted, the briefings became less about providing critical health information and more a forum for Trump to air grievances, shift blame, stoke feuds, spread misinformation and inspire false hope. ...

Aside from reading perfunctory remarks scripted by aides, the president voiced little compassion for the tens of thousands who have lost lives or the tens of millions who have lost their jobs. ...

Two physicians on the White House task force, Deborah Birx and Anthony S. Fauci, presented dire projections based on publicly-available models showing that without continued social distancing and other mitigation efforts as many as 1.6 million to 2.2 million Americans could die. With a continued lockdown, there would be an estimated 100,000 to 240,000 fatalities. ...

Trump, meanwhile, used his presidential megaphone to promote what he thought was a silver bullet: hydroxychloroquine. Night after night in late March and early April, he kept hearing about the controversial anti-malarial drug on his favorite Fox News Channel programs ...

On April 3, Fox host Laura Ingraham paid Trump a visit in the Oval Office to talk up hydroxychloroquine. She brought with her two regular on-air guests in what she dubs her "medicine cabinet" ... Some senior Republicans who heard about the meeting cringed about a television host's special access to offer medical advice to the president, but it fit a pattern of Trump soliciting input from media stars rather than government experts. ...

Trump at times went to extreme lengths to promote hydroxychloroquine. Keith Frankel, a vitamins executive who occasionally socializes with Trump at his Mar-a-Lago Club in Palm Beach, Fla., said the president asked him to call California Gov. Gavin Newsom (D) on his cellphone and try to make a deal for the nation's largest state to buy millions of tablets of hydroxychloroquine from an Indian manufacturer. Frankel said he got Newsom's phone number from Trump.

Frankel was not working through official U.S. government channels, according to a senior government official. California did not agree to take the drugs being offered, Frankel said ...

Trump embraced hydroxychloroquine, as well as azithromycin, as "one of the biggest game-changers in the history of medicine." In the weeks that followed, however, the dangers became more clear. A Veterans Affairs study released April 21 found that covid-19 patients who were treated with hydroxychloroquine were more likely to die than those who were not. Three days later, the FDA warned that doctors should not use the drug to treat covid-19 patients outside a hospital or clinical trial because of reports of "serious heart rhythm problems."

Although Trump stopped touting the drug publicly, privately he maintained his support for hydroxychloroquine and got upset with government officials presenting studies or bringing him evidence of its risks or failings, encouraging them to have a more positive outlook, aides said. ...

Marc Short, chief of staff to Vice President Pence, exerted significant influence over the coronavirus task force [in April] ... Short also is one of the White House's most vocal skeptics of how bad the pandemic would be. He repeatedly questioned the data being shared with Trump, and in internal discussions said he did not believe the death toll would ever get to 60,000 and that the administration was overreacting ... Day after day, Short pressed other officials to reopen the entire country, encouraging more risks to get the economy humming again. ...

The task force members with medical degrees — Birx, Fauci and Hahn, as well as CDC Director Robert Redfield, Surgeon General Jerome M. Adams and Brett Giroir, who leads the U.S. Public Health Service Commissioned Corps — splintered off in mid- to late-March and began meeting on their own almost daily, three senior administration officials said. Some in the "doctors group" were distressed by what one official dubbed the "voodoo" discussed within the broader task force. ...

Trump has peppered his new chief of staff, Mark Meadows, and other senior aides with phone calls "in almost every single hour of the day," sometimes well after midnight ... The president was often in a sour mood, complaining about media coverage and carping that he does not get enough credit. ...

One of the more political issues during this period was the fight for supplies, such as ventilators, testing machines and swabs, and masks and other protective gear. Amid disruptions to the global supply chain, governors pleaded with the White House for help ... Trump derided governors when he thought they were asking for too much or not praising him enough. ...

Drive-throughs were the centerpiece of the administration's national testing plan, pieced together by Kushner and his team and hastily rolled out by Trump on March 13 in the Rose Garden. ... Trump's promise of a drive-through testing site at your neighborhood CVS or Walmart never materialized. ... [So] the president placed responsibility for testing on the states. ...

Trump has tried to claim testing as an unambiguous success. ... A federal official who recently met with Birx said "she knows they are far behind on testing, no matter what the president says." In a White House meeting with other officials in early April, Birx said that many of the testing labs were still only operating at 10 percent of capacity. Birx said she needed to learn where all the machines and labs were, and that the government did not know. ...

Illinois Gov. J.B. Pritzker (D) said Trump was either confused about what is required to administer tests or deliberately glossing over the urgent problems. "The truth of the matter is that the president doesn't seem to understand the difference between testing capacity and getting testing results," Pritzker said. "We don't have the supplies to run those tests." ...

Without assistance from Washington, Wisconsin began working with Illinois, Michigan and other states in a regional alliance to obtain supplies and develop a strategy. States in other regions of the country also are partnering with one another, forming a patchwork of alliances. ...
In Maryland, Gov. Larry Hogan (R) quietly entered into negotiations with South Korea, with the help of his wife, Yumi, a Korean American. Exasperated with the lack of tests in his state, Hogan spent about 22 days arranging to procure 500,000 tests, negotiating with eight different Maryland agencies, the Korean embassy and officials at the State Department. ... [A] Korean Air jet touched down at Baltimore-Washington International Marshall Airport on April 18 to deliver the supplies. Hogan said he was worried federal officials would try to commandeer the tests, so he had Maryland Army National Guard members and Maryland State Police officers escort and protect the cargo. ...

The move infuriated Trump, who has long chafed at Hogan's criticisms and, according to advisers, saw Maryland's deal with South Korea as a bid to embarrass the president. ...

The weekend of April 11, Trump took a break from his daily news conferences in observance of Easter. He spent considerable time on the phone with friends and advisers and began to shift toward concluding that the country could not afford to remain locked down much longer. He was irate [and] screaming and swearing at one ally about how things were so unfair. ...

Trump had been agonizing over the economy, watching the number of Americans filing unemployment insurance claims climb each week. He fretted about the unemployment rate rising to 15 percent or even higher, a milestone that advisers warned him would seriously jeopardize his reelection. ... [Hassett and Kudlow] warned the president of double-digit unemployment and tens of millions of Americans losing their jobs. ...

On April 14, Ingraham returned to the Oval Office ... The Fox host reiterated her belief that the country needed to reopen and argued for limits on contact tracing ... As Trump watched television during this period, he sensed popular support. Outside state capitols, a smattering of activists flouted social distancing guidelines to protest governors who had issued stay-at-home orders. Many of them waved Trump campaign flags or sported other Trump-branded paraphernalia. ...

CDC and FEMA officials sent a 36-page document on April 10 outlining in detail the recommended stages of reopening, including detailed instructions for schools, child-care facilities, summer camps, parks, faith-based organizations and restaurants. But on April 16, when Trump and Birx released their guidelines for a slow and staggered return to normal in places with minimal cases of the coronavirus, many of the details fine-tuned by the CDC were stripped out. ...

Trump formally embraced the quarantine protesters on April 17 with a trio of all-caps tweets: "LIBERATE MICHIGAN!" "LIBERATE MINNESOTA!" and "LIBERATE VIRGINIA." Inside the White House, there was disappointment about Trump's tweets ... Privately, several of them acknowledged that the "LIBERATE" tweets brought Trump back into the realm of conspiracy and anger, which he considers safe harbor when he feels boxed in. ...

For parts of the United States to reopen, health departments need to be ready to extinguish any new outbreaks immediately. ... Trump, however, [has] rarely mentioned contact tracing. His focus was on more personal challenges. One senior White House official said that the president was among the most animated when discussing what his press appearances would be like: A call-in to the radio? A morning photo opp? An evening news conference? Hicks had to move along the conversation in coronavirus meetings by telling the boss they would decide later. ...

[On April 22] Trump's focus was squarely on his declining political fortunes. His reelection team ... staged something of an intervention. They presented fresh polls that painted a picture so grim they hoped the president would be persuaded to curtail his daily press briefings, as the data suggested the performances had damaged him. ...

The decision to share the data with Trump backfired. The president went into one of his rages. He said he did not believe the numbers, arguing that people "love" his performances at the briefings and think he is "fighting for them" ...

On April 23, the day after his campaign team's polling intervention, Trump continued with his usual behavior. During a lengthy and at times hostile question-and-answer session with reporters, Trump mused aloud about ... injecting bleach or another household disinfectant into the body to cure the coronavirus. ...

Injecting or ingesting disinfectants is dangerous and can be deadly. Trump would later claim he was being sarcastic, but there was no trace of sarcasm in the president's comments.

That day, 1,857 Americans died of the coronavirus. The next week, the number of cases reported in the United States surpassed 1 million.

And by month's end, as Trump cheered businesses reopening in Georgia, Texas and several other states "because we have to get our country back," the total dead climbed past 63,000, with no sign of slowing down.
Heather Digby Parton, writing in Salon, notes a model released by the Wharton School
which projects that reopening the states now will result in 233,000 additional deaths from the virus by the end of June. Since many states will not completely reopen and others will stay locked down for some time, the actual number probably won't be that bad. But make no mistake — it's going to go up, possibly way up, as states open up willy-nilly and many individuals decide they aren't going to bother with social distancing guidelines anymore. It's already happening.

Dr. Deborah Birx made it clear on Fox News this weekend that her projections were always between 100,000 and 240,000 American lives. It's hard to see how the worst-case scenarios aren't much more plausible now, and she seems to know it.

Since the Trump administration didn't have the ability to manage the crisis effectively, the decision has obviously been made to accept massive casualties. President Trump clearly sees the growing death toll as nothing more than a political liability he can overcome with a strong economic recovery.
The Trump administration is privately projecting a daily death toll of about 3,000 by June 1. That is double the current average. The number of new cases is forecast to increase from about 25,000 per day to 200,000 per day.

No comments: