Looking back and how we got here
Second guessing is the order of the day and it's time for me to join in. This is a look back to what happened wrong and right, and what could have been done better. To do this, let's use the standards set forth by NY Governor Mario Cuomo during some of his press conferences. When asked why he was looking for 40,000 ventilators earlier this year when NY needed less than 10,000, Gov. Cuomo said, and I paraphrase you act based on what you know at the time, and a related point would be did you act based on what you knew at the time. In another press conference Gov. Cuomo speculated on what he might have done differently if he knew then what he knew now. A fair analysis of the actions of the Trump Administration can be made using those standards.
1. Acting based on what you know.
The Administration has a standard cast of characters who are called on when there are epidemics. This includes the National Institutes of Health, the Centers for Disease Control, the Department of State, the FDA, and so on. Dealing with epidemics and pandemics is not new. We've had three events this century, the SARS outbreak of 2003, the Swine Flu or H1N1 in 2009, the Ebola outbreak in the 2014-2016 period.
When the world first became aware of the Coronavirus, these folks started paying attention. Unfortunately, they were hamstrung by the Communist Chinese Government suppressing or falsifying information and the World Health Organization (WHO) parroting their lies.*1
In the absence of accurate information, they followed the standard playbook drawn up from the past events. They monitored the information coming from China and the WHO. There was a standard progression that was followed. For example, the CDC and the State Department issued advisories to people traveling abroad. As it became apparent this virus was serious, the experts recommended to President Trump that travel to China be restricted and he agreed, and a Coronavirus task force was formed.*2
As the experts learned more they acted and that is the related question. When the Trump Administration gained information, did they act on it? The answer is yes. I can offer two examples.
First, in February and early March the CDC did not recommend wearing masks. In April, that guidance changed and they began recommending all people wear masks. Why the change? Originally, the data indicated only sick people needed to wear masks to avoid spreading the virus. As Dr. Deborah Birx pointed out, the Administration had since learned there are many people carrying the virus without showing symptoms and that, combined with how easily the virus spreads, caused them to update their guidance.
The second example I point to are the comments made by Dr. Anthony Fauci when he spoke at a news briefing and addressed some misconceptions that came from an interview he gave. Dr. Fauci said the first time they spoke to the President about imposing serious guidelines on social distancing and not gathering in small groups - the guidelines that led to shutting down the US - President Trump agreed. And again when they wanted to extend that another 30 days, President Trump agreed.
It's clear that, as information became available, the medical experts in the Administration recommended actions, and President Trump acted. He followed the advice and recommendations made to him regardless of how that impacted the economy or whatever other impressions it created. They told President Trump what they thought was the right thing to do to protect lives and he did it.*3
2. If we could do it all over again, aka lessons learned
First lesson - don't believe anything the Communist Chinese Government says when there is another disease outbreak in that country.
Second, when China started arresting medical professionals for reporting about the disease and refused to let anyone come in to study the disease and started cornering the market on personal protection equipment (PPE), that is a clear indicator that the situation is very bad.
Third, there are a couple of lessons to be learned about testing. To begin with, when there is a whiff of an epidemic, start testing everyone coming into the country from that region of the world. Test the travelers, do the contact tracing to find who they have met and test those people to mitigate the possible spread of the disease.
And modify the standard playbook. The standard playbook for these types of events is for testing to be centralized with the CDC and state health agencies. Unfortunately, the CDC screwed up developing the test and that cost us too much time. When private industry was brought into the picture it was remarkable how the testing process improved - more machines, faster machines, simpler processes. Every week or two brought dramatic announcements.
Fourth, PPE. The media started criticizing President Trump Administration for wasting time before stockpiling PPE. That's more complicated than it sounds. PPE is primarily made in China and we now know that in January (and perhaps earlier) China was hoarding this equipment - they were literally buying all they could find and not allowing manufacturers to ship PPE from China to other countries. How do you start stockpiling PPE when the factories that make the stuff can't get it out of China for you to stockpile. The real lesson to be learned is a) we never should have become so dependent upon China in the first place and now that we've activated so many companies to produce this stuff domestically don't let that stop. And b) when you use the national stockpile you need to replace what you use. Specifically, when the Obama Administration used PPE for the Swine flu and Ebola outbreaks, it was never replaced either by that Administration or the Trump Administration.
Fifth, reporting. It took too long befor the Federal Government began to receive data from every source. We now have a network set up for submitting data to federal agencies and that needs to be retained. Once we have the data, the Government needs to do a better job of parsing out and accurately reporting which deaths are due to coronavirus, or the next major illness, versus the deaths that really have another primary cause.*4 We should not find ourselves in a situation as Gov. Cuomo pointed out where New York City has suddenly seen the disappearance of death due to heart disease or cancer - because everything is attributed to Coronavirus.
Sixth - the briefings. The briefings are at their best when the President covers facts and provides his update and the various professionals do presentations. During that portion of the briefing, tremendous information is provided. The briefings go sideways when President Trump rambles off-script. In hindsight, it would have been better for President Trump to be part emcee and part cheerleader for the country and perhaps have no questions or only a few questions.
Seventh - Comments by the President. I refer to comments made prior to the briefings, like saying China was doing a good job or we have this under control, or the virus would disappear in the summer. President Trump makes up names like "Sleepy Joe" and "Crooked Hillary"but he doesn't make stuff like that up. He embellishes it but usually is saying it based on something he heard from what he considers a reputable source. I bet all of those comments were based on what eople were telling him. He'd be smart to preface remarks like that by saying "My people tell me..." Then when the media questions him later, he can say "well that is what my people were telling me at that time." I won't try to suggest he not say those things at all because we know that won't happen.
Finally, Trump time. Up until the President announced the guidance that shut down the country, President Trump was following the lead of his team. When they announced that guidance, the impression I have is President Trump really got involved. I say that because right after the announcement of social distancing and the rest of the guidelines, that's when things happened and they happened on what Peter Navarro called "Trump time" - meaning very damn fast. Using the Defense Production Act to kick business in the ass to get them moving. FDA approval of a vaccine trial in record time, and other approvals happening much faster than ever before. Getting the USS Comfort out of drydock and on their way to NY in days not weeks. Private industry stepping up to improve testing. The IRS and Small Business Administration getting money into the hands of individuals and businesses in amazingly fast time.
Watching the President's daily briefings there was a revelation every day of some dramatic development to speed us forward in the fight against the virus, saving lives, or helping people financially. That needs to become part of the playbook for the future - the idea of putting aside the red tape, the bureaucracy, the need to own and centralize, in favor of speed and innovation and doing whatever it takes to bring about success. Compare the time it took to issue checks for people and businesses in the last few weeks versus the quagmire that was the Mortgage Relief program intended to help people avoid losing their homes in 2009 and 2010. It's night and day and this is the way it should be from now on.
The summary of all this is that yes, in hindsight, some things could have been done better by the Trump Administration. But this pandemic was unlike any of the other medical events we experienced in the past 20 years (SARS, H1N1, and Ebola). As someone once said, we can fix the blame or we can fix the problem. There is an opportunity here to learn from this event so we prevent the spread of a virus or disease like this in the future if people will put politics aside and fix the problem not the blame.
I'm an optimist but even I have to admit I'm not going to hold my breath waiting for that.
*1 This posting is going to be long enough without covering in detail the hideous acts and culpability of the Communist Chinese Government. Also, when I refer to China in this article, I refer to the Communist Chinese Government.
*2 For further information, if you want in-depth reviews of what happened, I believe media outlets like NY Times and Washington Post tried to capture, moment by moment, what the Trump Administration did. Others have reviewed specific actions at length. This posting is going to be long enough so I'm going to refer you to the other sources rather than try to cover that level of detail
*3 I am not getting into the debate of whether we really needed to shut down the country or not.
*4 I recall a reporter asking at the President's briefing, in an accusatory fashion, whether the Government was under reporting
1. Acting based on what you know.
The Administration has a standard cast of characters who are called on when there are epidemics. This includes the National Institutes of Health, the Centers for Disease Control, the Department of State, the FDA, and so on. Dealing with epidemics and pandemics is not new. We've had three events this century, the SARS outbreak of 2003, the Swine Flu or H1N1 in 2009, the Ebola outbreak in the 2014-2016 period.
When the world first became aware of the Coronavirus, these folks started paying attention. Unfortunately, they were hamstrung by the Communist Chinese Government suppressing or falsifying information and the World Health Organization (WHO) parroting their lies.*1
In the absence of accurate information, they followed the standard playbook drawn up from the past events. They monitored the information coming from China and the WHO. There was a standard progression that was followed. For example, the CDC and the State Department issued advisories to people traveling abroad. As it became apparent this virus was serious, the experts recommended to President Trump that travel to China be restricted and he agreed, and a Coronavirus task force was formed.*2
As the experts learned more they acted and that is the related question. When the Trump Administration gained information, did they act on it? The answer is yes. I can offer two examples.
First, in February and early March the CDC did not recommend wearing masks. In April, that guidance changed and they began recommending all people wear masks. Why the change? Originally, the data indicated only sick people needed to wear masks to avoid spreading the virus. As Dr. Deborah Birx pointed out, the Administration had since learned there are many people carrying the virus without showing symptoms and that, combined with how easily the virus spreads, caused them to update their guidance.
The second example I point to are the comments made by Dr. Anthony Fauci when he spoke at a news briefing and addressed some misconceptions that came from an interview he gave. Dr. Fauci said the first time they spoke to the President about imposing serious guidelines on social distancing and not gathering in small groups - the guidelines that led to shutting down the US - President Trump agreed. And again when they wanted to extend that another 30 days, President Trump agreed.
It's clear that, as information became available, the medical experts in the Administration recommended actions, and President Trump acted. He followed the advice and recommendations made to him regardless of how that impacted the economy or whatever other impressions it created. They told President Trump what they thought was the right thing to do to protect lives and he did it.*3
2. If we could do it all over again, aka lessons learned
First lesson - don't believe anything the Communist Chinese Government says when there is another disease outbreak in that country.
Second, when China started arresting medical professionals for reporting about the disease and refused to let anyone come in to study the disease and started cornering the market on personal protection equipment (PPE), that is a clear indicator that the situation is very bad.
Third, there are a couple of lessons to be learned about testing. To begin with, when there is a whiff of an epidemic, start testing everyone coming into the country from that region of the world. Test the travelers, do the contact tracing to find who they have met and test those people to mitigate the possible spread of the disease.
And modify the standard playbook. The standard playbook for these types of events is for testing to be centralized with the CDC and state health agencies. Unfortunately, the CDC screwed up developing the test and that cost us too much time. When private industry was brought into the picture it was remarkable how the testing process improved - more machines, faster machines, simpler processes. Every week or two brought dramatic announcements.
Fourth, PPE. The media started criticizing President Trump Administration for wasting time before stockpiling PPE. That's more complicated than it sounds. PPE is primarily made in China and we now know that in January (and perhaps earlier) China was hoarding this equipment - they were literally buying all they could find and not allowing manufacturers to ship PPE from China to other countries. How do you start stockpiling PPE when the factories that make the stuff can't get it out of China for you to stockpile. The real lesson to be learned is a) we never should have become so dependent upon China in the first place and now that we've activated so many companies to produce this stuff domestically don't let that stop. And b) when you use the national stockpile you need to replace what you use. Specifically, when the Obama Administration used PPE for the Swine flu and Ebola outbreaks, it was never replaced either by that Administration or the Trump Administration.
Fifth, reporting. It took too long befor the Federal Government began to receive data from every source. We now have a network set up for submitting data to federal agencies and that needs to be retained. Once we have the data, the Government needs to do a better job of parsing out and accurately reporting which deaths are due to coronavirus, or the next major illness, versus the deaths that really have another primary cause.*4 We should not find ourselves in a situation as Gov. Cuomo pointed out where New York City has suddenly seen the disappearance of death due to heart disease or cancer - because everything is attributed to Coronavirus.
Sixth - the briefings. The briefings are at their best when the President covers facts and provides his update and the various professionals do presentations. During that portion of the briefing, tremendous information is provided. The briefings go sideways when President Trump rambles off-script. In hindsight, it would have been better for President Trump to be part emcee and part cheerleader for the country and perhaps have no questions or only a few questions.
Seventh - Comments by the President. I refer to comments made prior to the briefings, like saying China was doing a good job or we have this under control, or the virus would disappear in the summer. President Trump makes up names like "Sleepy Joe" and "Crooked Hillary"but he doesn't make stuff like that up. He embellishes it but usually is saying it based on something he heard from what he considers a reputable source. I bet all of those comments were based on what eople were telling him. He'd be smart to preface remarks like that by saying "My people tell me..." Then when the media questions him later, he can say "well that is what my people were telling me at that time." I won't try to suggest he not say those things at all because we know that won't happen.
Finally, Trump time. Up until the President announced the guidance that shut down the country, President Trump was following the lead of his team. When they announced that guidance, the impression I have is President Trump really got involved. I say that because right after the announcement of social distancing and the rest of the guidelines, that's when things happened and they happened on what Peter Navarro called "Trump time" - meaning very damn fast. Using the Defense Production Act to kick business in the ass to get them moving. FDA approval of a vaccine trial in record time, and other approvals happening much faster than ever before. Getting the USS Comfort out of drydock and on their way to NY in days not weeks. Private industry stepping up to improve testing. The IRS and Small Business Administration getting money into the hands of individuals and businesses in amazingly fast time.
Watching the President's daily briefings there was a revelation every day of some dramatic development to speed us forward in the fight against the virus, saving lives, or helping people financially. That needs to become part of the playbook for the future - the idea of putting aside the red tape, the bureaucracy, the need to own and centralize, in favor of speed and innovation and doing whatever it takes to bring about success. Compare the time it took to issue checks for people and businesses in the last few weeks versus the quagmire that was the Mortgage Relief program intended to help people avoid losing their homes in 2009 and 2010. It's night and day and this is the way it should be from now on.
The summary of all this is that yes, in hindsight, some things could have been done better by the Trump Administration. But this pandemic was unlike any of the other medical events we experienced in the past 20 years (SARS, H1N1, and Ebola). As someone once said, we can fix the blame or we can fix the problem. There is an opportunity here to learn from this event so we prevent the spread of a virus or disease like this in the future if people will put politics aside and fix the problem not the blame.
I'm an optimist but even I have to admit I'm not going to hold my breath waiting for that.
*1 This posting is going to be long enough without covering in detail the hideous acts and culpability of the Communist Chinese Government. Also, when I refer to China in this article, I refer to the Communist Chinese Government.
*2 For further information, if you want in-depth reviews of what happened, I believe media outlets like NY Times and Washington Post tried to capture, moment by moment, what the Trump Administration did. Others have reviewed specific actions at length. This posting is going to be long enough so I'm going to refer you to the other sources rather than try to cover that level of detail
*3 I am not getting into the debate of whether we really needed to shut down the country or not.
*4 I recall a reporter asking at the President's briefing, in an accusatory fashion, whether the Government was under reporting
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