Monday, April 13, 2020

Public Health Authorities Have Failed America at Every Level

By Shikha Dalmia - April 13, 2020 at 02:00PM

President Donald Trump recently slammed the World Health Organization (WHO) for how it has handled the coronavirus pandemic, pointing out that the agency had "literally called every shot wrong." He's right about that. But then, so did officials at every level of government, starting with Trump himself.

If there is any reason for the WHO to exist, it is to alert the world to burgeoning health threats. The WHO's director-general, Tedros Adhanom, did the opposite. He ignored early signals that this virus was spreading, assuring everyone that China, which had lobbied aggressively for him to head the WHO, had everything under control. He rejected Taiwan's pleas in mid-January to declare a "public health emergency of international concerns" after it witnessed an alarming rise of disease clusters among visitors from the mainland.

Nor did Tedros hit the alarm button after the WHO conducted its own fact-finding mission to China at the end of January. Instead he declared that the Chinese had "rolled out perhaps the most ambitious, agile and aggressive disease containment effort in history," thus "creating a stronger first line of defense" for the global community. He reached this remarkably inaccurate conclusion by swallowing Beijing's official tally for COVID-19 case and mortality rates. British analysts estimate that those may have undercounted the actual numbers by a factor of anywhere from 15 to 40.

Obscenely, Tedros even complimented China's leadership for the "transparency it had demonstrated"—after the government had arrested researchers for telling their international peers about the growing threat. Tedros finally declared corona a global pandemic on March 11.

Tedros wasn't alone in falling for Chinese propaganda. Donald Trump did too.

The president lavishly complimented China's coronavirus response five times from late January to late February. On January 24—around the time his economic adviser Peter Navarro was warning in internal White House memos that coronavirus could take more than half a million American lives and cost close to $6 trillion—Trump tweeted that "the United States greatly appreciates their [Chinese leadership's] efforts and transparency" and assured Americans that "it will all work out well." Trump limited travel from China six days later, but that didn't stop him from complimenting President Xi Jinping on February 7 as "strong, sharp and powerfully focused on leading the counterattack on the Coronavirus."

Trump didn't just overestimate Xi's competence. He overestimated the competence of his own health agencies, the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC).

Trump is not coy about dissing executive agencies that he dislikes. (Just ask all the inspector generals he keeps threatening, such as Christi Grimm, who investigated the shortage of protective gear.) Yet even though the CDC foisted a defective test on the country—botching America's early response to the epidemic—Trump declared in early March that the "tests are all perfect" and "anybody that wants a test can get a test." (That is not true even now.)

Remember, the virus genome was publicly available by mid-January and the first tests were available shortly thereafter. In fact, one of the few things the WHO did right was to send hundreds of thousands of tests to dozens of labs around the world within a few weeks. If the United States had done what South Korea, Taiwan, and Germany did and allowed private and state labs to get these tests ready for mass production, we would have been able to conduct country-wide screening almost immediately. Instead the CDC decided to reinvent the wheel and develop its own test. It ordered private labs to desist and told them to wait for its test—and when the agency finally rolled the test out, it didn't work. By the end of February, only 4,000 tests had been conducted and the country had no idea how fast the virus was spreading.

Meanwhile, the feds were bungling reporting procedures, causing even more waste and delay. In early March, when private testing had yet to come up to speed and public labs were the only game in town, the FDA issued a directive requiring the CDC to retest every positive coronavirus result by these labs before certifying it. This meant that for several crucial weeks, America's coronavirus tally was lagging and everyone was underestimating how bad things were. Worse, it meant that lab resources and chemical agents, which have been in acutely short supply, couldn't be used for new tests. The FDA was apparently afraid that false positives would make the spread look worse than it was.

It wasn't just global and national authorities who screwed up. Many state and local authorities performed poorly too. Just look at New York, the worst hit state in the country.

Gov. Andrew Cuomo is trying to turn himself into the hero of the republic with his straight talk at press briefings about just how dire things are in New York. But in early March, like Trump, Cuomo and New York Mayor Bill de Blasio publicly and repeatedly underestimated the seriousness of the outbreak and overestimated their ability to cope with it. De Blasio even urged city residents to go about their daily business without changing their behavior. Meanwhile, in a rare joint press conference the two held, Cuomo bragged: "Excuse our arrogance as New Yorkers—I speak for the mayor also on this one—we think we have the best health care system on the planet right here in New York."

The two were blasé not just in their words but in their actions. They both promised that health investigators would track every person who had come in contact with the first two confirmed victims—a woman who had returned from Doha and a New Rochelle lawyer—but they failed to fully follow through, The New York Times reports. Both lagged as well in seeing the need for social distancing. San Francisco and Ohio closed their schools on March 12 when the former had only 18 confirmed cases and latter a mere five. De Blasio waited another few days, until his city's case count touched 329.

Just as Tedros and Trump will admit no misgivings about their initial handling of the situation, neither will the New York duo. Cuomo insists that he took action that everyone at the time regarded as "premature." And de Blasio pooh-poohs critics with the usual bromides about "hindsight" being perfect.

There's plenty of blame to go around, but will anyone take any responsibility?


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