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Lessons for America from COVID-19

Larry Kummer, Editor

Summary: A crisis strips away the pretense and reputations to shows a nation’s true self. COVID-19 revealed two stories about America. First, how the nation best-prepared in January became one of the worst affected. Second, how our reaction to this showed America’s senescence. That is, we have become the equivalent of a cranky old guy – dysfunctional but certain that others cause all his problems. Here is the evidence. Perhaps it will help ignite a spirit of reform.

America walking away from global leadership into a new future.

By Anastasiya, AdobeStock_289536235.

Looking at America on the brink

This is how Dr. Anthony Fauci (Director of NIAID and member of the White House Task Force) described the epidemic when interviewed by Newsmax on January 21. At that point, there were 282 confirmed confirmed cases of COVID-19 (278 of which were in China).

“Obviously you need to take it seriously and do the kinds of things that the CDC and the Department of Homeland Security are doing. But this is not a major threat to the people in the United States, and this is not something that the citizens of the United States right now should be worried about.”

As usual in a crisis, factions exploit them for political gain by staging two-minute hates on their foes. These liars omit his first sentence, and ignore that Fauci said that the US public should not worry about this “right now.” He made no predictions about the future because he is a responsible official, not a wizard. He told the US public what they knew at that time.

Later that day, the first case in the US was confirmed and immediately isolated. That day, the CDC activated its Emergency Response System to support its response to 2019-nCoV, and deployed a team to Washington. Read the transcript of the press conference with health officials of the CDC and Washington State. They were confident that everything necessary was being done. This was the consensus of US health care experts at that time (e.g., on January 21 by Vanderbilt professor William Schaffner, on February 8 by USC professor David Agus). Unlike bold amateurs, they were not making statements about an unknowable future.

Were Fauci and others right, based on available information?

Was America well-prepared in January for a pandemic? This post described America’s large (and expensive) preparations for an epidemic, including stockpiles of drugs and equipment. Several simulations tested America’s preparations for an epidemic – producing useful recommendations (e.g., Dark Winter in 2001, Crimson Contagion in 2019). A 2016 report on America’s response to Ebola also gave valuable recommendations. During the past two decades, the US government had been planning for an epidemic.

We have the largest and most sophisticated health care system in the world, by most measures. We have the largest number of ICU beds per capita, and equally vast resources of talent and infrastructure in the health sciences. Also, in 2009 the USAID began the PREDICT program to monitor zoonotic infectious diseases around the world (capable of jumping from animals to humans) to help provide early warning of pandemics.

The 2019 Global Health Security Index calculated that America was by far the nation best prepared for an epidemic. Statista wrote more about this on 28 February 2020. Also see “The Countries Best Prepared To Deal With A Pandemic” by Niall McCarthy at Statista, October 2019.

Plus, we had two months to mobilize our material resources and people. WHO gave early warnings (see page 2 of this), and CDC accordingly quickly responded. On January 6, the CDC issued a travel watch at Level 1 (“Practice usual precautions”) for China. On January 7, the CDC established a 2019-nCoV Incident Management group. On January 8, The CDC began alerting clinicians to watch for patients with respiratory symptoms and a history of travel to Wuhan. On January 15, a leading scientist at the CDC toldlocal and state public health officials “that there would soon be a test.” On January 17, the CDC issued an updated interim Health Alert Notice (HAN) Advisory to inform state and local health departments and health care providers about this outbreak and begin screening of passengers on flights from Wuhan to five major US airports. On January 31, the Trump administration announced that they were blocking the entry of Chinese nationals and requiring mandatory quarantines on US citizens returned in affected parts of China (this was widely mocked as panicky and foolish).

On January 29, Trump formed the White House Coronavirus Task Force. On February 26, Trump announced that VP Pence was “in charge” (descriptions of his title vary) – putting America’s #2 elected official at the helm

See my summary timeline and the larger one at Wikipedia. Fauci’s optimism on January 21, and that of other health care officials and experts in the next two weeks, was reasonable.

What went wrong?

Yet all this early action was followed by epic inaction and mistakes by Federal agencies through late March. These stories are now well known.

“As early indications of China’s coronavirus outbreak emerged in late December, the Trump administration notified Congress it would still follow through with its plan to shutter a US Agency for International Development surveillance program tasked with detecting new, potentially dangerous infectious diseases and helping foreign labs stop emerging pandemic threats around the world.” (From CNN.)

Little effort was made to screen people at our borders. Screening at airports of people from hot spots was grossly inadequate – usually none. Even the high-profile restriction on travelers from China was porous. There are reports that the Diamond Princess’ passengers were quarantined at Travis by people inadequately trained and equipped (details here).

There was no planning for a large epidemic by Federal and State health agencies. There was not even good coordination among the many Federal and State health care agencies, all running business-as-usual in their bureaucratic orbits until mid-March.

There was no mobilization of America’s vast resources of medical personnel, inventories of medical equipment, and manufacturing.

The FDA and CDC totally screwed up the provision of desperately needed tests (see a WaPo article about this sad story). As late as March 16, the CDC and FDA are announcing there is an inadequate supply of reagents used in the tests, a bottleneck that should have been recognized in January. This is inexcusable, since the rest of the world has run hundreds of thousands of tests by now.

It was quickly apparent that only forced quarantines (not absurd “self-quarantines) and cordons sanitaire are the most effective containment methods. China proved their effectiveness. Yet the US government made little of them, allowing hot spots to form and the virus to spread from these across the nation. So they used lock-downs, with their devastating effect on the economy.

Perhaps the worst aspect of the response was by America’s senior leadership. The White House Task Force appears to have done little in its first 4 -6 weeks. Pence appears to have done almost nothing. As late as March 18 – 24, Trump refused to use the Defense Production Act to mobilize resources to produce essential medical equipment in dire shortage (see here and here).

From the start, Trump’s statements have varied from calls to war against COVID-19 to saying its little more than the flu (even as late as March 9). See this “Timeline: Trump’s efforts to downplay the coronavirus threat.” I showed some of this information to a brilliant conservative with long experience in government service. His reply: “fake news.” This is America, where only tribal truths are seen. But slowly the truth emerges, for those willing to see it.

Much of the Right followed his lead. For example, see this about coverage by Fox News. Also this article putting Fox News’ coverage in a larger context: “The network has conditioned its viewers to hate experts and to trust miracle cures for 25 years.”

This lack of leadership from the President and VP had ill effects at all levels of America. Federal agencies were slow to mobilize. Key responses were an uncoordinated mess by State governments.

To demonstrate that this senescence affects the full US political leadership – not just Republicans – Biden and Sanders (Trump’s equally elderly challengers) were dormant, and the Democrats fought the epidemic riding their hobbyhorses of racism and climate change.

Without strong support for experts from US leaders, the public fell prey to rumors and misinformation. Many quickly turned to amateurs for information – so that the most ignorant and boldest claims dominated. See this debunking of a nonsensical theory by a right-wing historian cosplaying an epidemiologist: bogus but went “viral” anyway. For more examples, see The info superhighway makes us stupid about COVID-19). This inevitably leading to panic. Perhaps the biggest example is the hysteria about masks. A cry went out for everybody to wear them – while first-line health care personnel did not have them. WHO and CDC said that the general public should not use masks unless required (e.g., when caring for someone infected) while medical personnel lacked them (e.g. see this statement). Rabble-rousing hysterics screamed that experts at CDC and WHO were lying about masks and putting us in danger!

While American’s complained about China’s response (mostly lies), the US was slow to provide funds for a global response. Worse, we seized vital medical supplies manufactured here going to our allies – while triumphantly concluding that nations were foolish to rely on China for vital medical supplies. They will not soon forget this. See Canada’s reaction here and here. A German minister condemned as “piracy” the US seizure of masks going to Berlin. Rather than a leader of a coordinated response of the West, Americans attempted to outbid France for masks already loaded on a plane for export from China.

This may be another step in the long process of the world seeing a new America, as described by Richard Haas, president of the Council on Foreign Relations, in Foreign Affairs.

“Just as consequential as U.S. policy choices is the power of America’s example. Long before COVID-19 ravaged the earth, there had already been a precipitous decline in the appeal of the American model. Thanks to persistent political gridlock, gun violence, the mismanagement that led to the 2008 global financial crisis, the opioid epidemic, and more, what America represented grew increasingly unattractive to many. The federal government’s slow, incoherent, and all too often ineffective response to the pandemic will reinforce the already widespread view that the United States has lost its way.”

A competent response: Germany

Many nations competently responded. For example, we could have learned much from the successful responses by East Asian nations.

But those are Asians, and Americans won’t learn from them. There is a closer example of a similar nation that did better than us. One with a competent government, one trusted by its people, with a robust and rationally-run health care system (more ICU bed per capita than in the US). See the NYT reporting on “The German Exception.”

“In mid-January, long before most Germans had given the virus much thought, Charité hospital in Berlin had already developed a test and posted the formula online. By the time Germany recorded its first case of Covid-19 in February, laboratories across the country had built up a stock of test kits. …

“By now, Germany is conducting around 350,000 coronavirus tests a week, far more than any other European country. Early and widespread testing has allowed the authorities to slow the spread of the pandemic by isolating known cases while they are infectious. It has also enabled lifesaving treatment to be administered in a more timely way. ‘When I have an early diagnosis and can treat patients early – for example, put them on a ventilator before they deteriorate – the chance of survival is much higher,’ Professor Kräusslich said.

“Medical staff, at particular risk of contracting and spreading the virus, are regularly tested. To streamline the procedure, some hospitals have started doing block tests, using the swabs of 10 employees, and following up with individual tests only if there is a positive result. …

“One key to ensuring broad-based testing is that patients pay nothing for it, said Professor Streeck. This, he said, was one notable difference with the United States in the first several weeks of the outbreak. …One key to ensuring broad-based testing is that patients pay nothing for it, said Professor Streeck. This, he said, was one notable difference with the United States in the first several weeks of the outbreak. ‘A young person with no health insurance and an itchy throat is unlikely to go to the doctor and therefore risks infecting more people,’ he said.

“On a Friday in late February, Professor Streeck received news that for the first time, a patient at his hospital in Bonn had tested positive for the coronavirus: A 22-year-old man who had no symptoms but whose employer – a school – had asked him to take a test after learning that he had taken part in a carnival event where someone else had tested positive. In most countries, including the United States, testing is largely limited to the sickest patients, so the man probably would have been refused a test. Not in Germany. As soon as the test results were in, the school was shut, and all children and staff were ordered to stay at home with their families for two weeks. Some 235 people were tested.

“‘Testing and tracking is the strategy that was successful in South Korea and we have tried to learn from that,’ Professor Streeck said. …

Beyond mass testing and the preparedness of the health care system, many also see Chancellor Angela Merkel’s leadership as one reason the fatality rate has been kept low. Ms. Merkel, a trained scientist, has communicated clearly, calmly and regularly throughout the crisis, as she imposed ever-stricter social distancing measures on the country. The restrictions, which have been crucial to slowing the spread of the pandemic, met with little political opposition and are broadly followed. The chancellor’s approval ratings have soared. ‘Maybe our biggest strength in Germany,’ said Professor Kräusslich, ‘is the rational decision-making at the highest level of government combined with the trust the government enjoys in the population.’“

China: first hit, its success copied by others

On March 10, China closed the last of its 16 temporary hospitals in Wuhan. As I wrote on March 30, China is restarting – slowly, carefully – its economy. On April 7, China ended Wuhan’s 76 day lockdown. US media reported this mournfully (e.g., NYT and CBS) this triumph.

But America has taken stronger measures to see that our self-image as Number One remains unsullied – and that we see China as the evil, unscrupulous Yellow Peril. The more obvious the gap between their effective response and our clownshow, the stronger the need to create an Potemkin Village reality (easy since no matter how often our leaders lie, we believe what we are told). Right-thinking Americans know that all numbers by China are probably wrong. If more were infected than China reported, that means that their success was even larger – so their success must be doubted. Tell an American that there are many foreign observers in China confirming their approximate accuracy and see the incredulous response (after all, what about the Bamboo Curtain between China and the rest of the world).

American’s were told of that the response of China and WHO were terrible with no supporting evidence. Compare this timeline of China’s response to COVID-19 with the CDC’s timeline of the US response to the 2009 H1N1 (swine flu) epidemic – remembering that the US has almost 4x China’s per capita income and spends 2x to 3x more of its GDP on health care than its peer nations. We were told that the epidemic was China’s fault, for which it should be punished. Just as the 2009 Swine Flu epidemic emerged in the US and spread across the globe. There is also evidence that the first appearance of the H1N1 influenza virus in 1918 also originated in the US (details here and here). Whatever the source of the virus, we contributed to its spread (see “How {US} Generals Fueled 1918 Flu Pandemic To Win Their World War”).

As the clownish response by the US government became brutally obvious, the search for others to blame became more intense. Conservatives’ suspicion of international agencies was exploited to blame WHO. With its broad range of responsibilities and microscopic $4.2 billion budget, they blame it for not performing miracles. In the real world, WHO ably performed its primary roles as a global collector reporter of information and coordinator of national responses.

All this probably will make impossible much effective learning from COVID-19 by America.

Conclusions

COVID-19 is a dress rehearsal for more serious crises that lie ahead. It has shown America’s senescence. Top to bottom, leaders to followers, nothing worked well. This makes our pretense of global leadership a sad joke, like somebody attempting to wear too-large shoes. If this decline continues, even our prosperity will be at risk.

As I have long said, I suspect that this decline will eventually result in a funeral pyre for America from whose ashes something new will emerge. Whether for good or ill is beyond my vision.

It’s easy to follow the COVID-19 story

The World Health Organization provides daily information, from highly technical information to news for the general public. These are the best sources of information.

Also, see the wealth of information at the CDC website, especially their situation reports.

Posts about effects of COVID-19

For More Information

Ideas! For some shopping ideas, see my recommended books and films at Amazon. Also, see a powerful and disturbing story about “Birth of a Man of Steel …for the Soviet Union.”

Please like us on Facebook and follow us on Twitter. Also, see these posts about epidemics…

  1. See the ugly cost of the next big flu pandemic. We can do more to prepare.
  2. Stratfor: The superbugs are coming. We have time to prepare.
  3. Posts debunking the hysteria about the 2009 swine flu in America.
  4. Posts debunking the hysteria about the 2015 ebola epidemic in America.
  5. Important: A vaccine against the fears that make us weak.

A medieval city defeats a plague

Available at Amazon.

Florence Under Siege:
Surviving Plague in an Early Modern City.

By John Henderson (2019), professor of Italian renaissance history at U of London.

I strongly recommend reading this fascinating review of it in the London Review of Books, with its great excerpts. From the publisher …

“Plague remains the paradigm against which reactions to many epidemics are often judged. Here, John Henderson examines how a major city fought, suffered, and survived the impact of plague. Going beyond traditional oppositions between rich and poor, this book provides a nuanced and more compassionate interpretation of government policies in practice, by recreating the very human reactions and survival strategies of families and individuals.

“From the evocation of the overcrowded conditions in isolation hospitals to the splendor of religious processions, Henderson analyzes Florentine reactions within a wider European context to assess the effect of state policies on the city, street, and family. Writing in a vivid and approachable way, this book unearths the forgotten stories of doctors and administrators struggling to cope with the sick and dying, and of those who were left bereft and confused by the sudden loss of relatives.”

 

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