Mismanagement of COVID-19 by US Federal Government

 The Trump administration’s mismanagement of the COVID-19 Pandemic will cost American lives. The mismanagement started not when the disease first came to the attention of the western world at the end of 2019, but much earlier in the administration. In the summer of 2018, Trump eliminated the National Security Council’s Global Health Security Unit and the Department of Homeland Security’s Epidemic Response Team. Neither team was replaced. This left the Administration without adequate insight into the threat to American life, and without several key organs of response.

The administration’s mismanagement was not confined to craven elimination of key NSC and HHS staff perspective extends to other key agencies as well. The administration chose Tom Price to be the Secretary of HHS, a partisan politician who would soon be forced to resign ignominiously after his improper use of chartered jets came to light. But who could really claim surprise? After all, Price was criticized during his confirmation hearings for insider trading in healthcare stocks while serving in the congress on the Ways and Means subcommittee on health. That subcommittee was responsible for writing legislation regulating the companies in which Mr. Price was trading. The administration then chose Alex Azar to run HHS. Azar was a lobbyist for drug giant Eli Lilly & Co for past decade. This is a post normally staffed by a scientist, a physician, or a public health expert, or even better, somebody whose credentials encompass all of the above bona fides. Instead, the Trump administration chose Azar, a lobbyist, to replace the disgraced former secretary. Azar by no means the only lobbyist at HHS, where at least 27 other lobbyists of lesser stature run departments.

Within HHS the administration made questionable choices to staff other key leadership roles. After the first CDC Director appointed by President Trump was forced to resign over ethical breaches pertaining to investments in the tobacco industry, President Trump appointed Robert Redfield, a virologist and physician with no experience leading a public health agency. Peers in the scientific community were concerned that some of Redfield’s religious and discriminatory policy positions were inconsistent with best practices in public health. More over, Redfield faced criticism for misrepresenting data on an experimental HIV vaccine in the 1990’s.

So it is within this context of leadership choices by the administration that specific actions, or in some cases lack of action, must be viewed. For example, HHS sent more than a dozen workers to process the first Americans evacuated from Wuhan, without proper training, personal protection equipment, or proper procedures in place to insure containment of the disease. The HHS employees were then dispersed back into their communities after being exposed to the virus. Shortly thereafter, the first known case of community transmission was confirmed within miles of where the HHS employees had processed the evacuees from Wuhan.

The CDC botched the rollout of tests, and because of poor management, failed to correct the problem for weeks. As a result, to this date, only a few thousand Americans have been tested for COVID-19, where in other places around the world, nations like South Korea and Italy test that many or more on a daily basis. Not only would professional management have enabled the CDC to correct the issue with the test kits, but other institutions should have been allowed to produce test kits beginning in January. They are now allowed to do so. Stanford has developed a test, as have various state labs and other institutions, and hopefully this will help the United States overcome the glaring deficit in preparation.

The list of public health mistakes made by this administration is manifold. When the above-mentioned evacuees from China came home, despite recommendations to segregate confirmed infections, the uninfected and the infected were put on the same plane by the US Department of State. This is what happens when lobbyists and political partisans are put in charge of public health. They lack the credibility and gravitas to impress upon another cabinet agency like State to implement the best public health decisions. What’s the administration’s response to these initial missteps?

The President has responded by lying to the American public. On Friday of last week, the President visited the CDC and told the media that “Anybody that wants a test can get a test.  That’s what the bottom line is. But — but I think — I think, importantly: Anybody right now and yesterday — anybody that needs a test gets a test.  We — they’re there.  They have the tests.  And the tests are beautiful.  Anybody that needs a test gets a test.” This of course was not true. The nation still short hundreds of thousands of tests and has no ability to understand the extent of the problem yet. Sadly though, the President’s penchant for lying to the American people is no surprise. He also told the media last week that there were 15 cases of COVID-19 and that with those people recovering there would soon be zero. Obviously not true. In addition to disinformation from the President, the administration has further tasked the Vice President to coordinate messaging.             

The President appointed Vice President Pence to coordinate White House policy and communication on COVID-19. To some this was an odd choice because of Mr. Pence’s troubling public health record in his previous capacity as governor of Indiana. When Scott County, Indiana, suffered one of the most severe outbreaks of HIV in many years, Pence failed to follow the recommendations of the CDC. Later a study conducted by the Yale School of Public Health concluded Pence’s decision caused the epidemic to infect as many as 20 times more people than would have been infected had then Governor Pence immediately followed the CDC’s recommendations. It turns out Pence’s history of ignoring the best advice of public health professionals was a harbinger of things to come. Mike Stobbe of The Associated Press reported on March 7 that the CDC advised the White House that elderly Americans should not fly on commercial airlines. The White House chose to overrule the CDC and did not issue that guidance.

How many elderly Americans, who are known to be at such risk, will get sick because the administration has chosen disinformation as a management technique? How many Americans will get infected because the administration made personnel choices based on partisanship and cronyism, and those political hacks allowed the disease to break containment and lead to early community spread? How many Americans will get sick and how many will die because that community spread has been unchecked by adequate testing and quarantines?

~~ Pete Dailey

Sources:

https://apnews.com/921ad7f1f08d7634bf681ba785faf269?utm_medium=AP&utm_source=Twitter&utm_campaign=SocialFlow&fbclid=IwAR0y4OP50E5d3-JbGeHjiowBclJzT7g0neYPEqiFiGfnipFXtapqA74AcLo

https://www.npr.org/2020/02/27/809930094/pences-new-coronavirus-role-raises-questions-about-his-public-health-record

https://www.vox.com/2018/3/22/17150322/robert-redfield-cdc-director-trump

https://cspinet.org/news/cspi-urges-administration-not-appoint-dr-robert-redfield-history-scientific-misconduct-cdc

https://foreignpolicy.com/2020/01/31/coronavirus-china-trump-united-states-public-health-emergency-response/

https://www.pbs.org/newshour/nation/hhs-pick-tom-price-made-brazen-stock-trades-committee-scrutiny

 https://www.technologyreview.com/s/615323/why-the-cdc-botched-its-coronavirus-testing/

 https://www.nytimes.com/2020/03/07/us/politics/trump-coronavirus-messaging.html