How the Trump Administration Lost Control of the Coronavirus Crisis?

Sunday, March 8, 2020 - 14:02

Known as COVID-19, coronavirus was first detected in China and which has now been detected in almost 90 locations internationally, including in the United States.

Outbreaks of novel virus infections among people are always of public health concern. In this regard, the Washington Post brought together key facts for an in-depth look at this question: "How the Trump administration lost control of the coronavirus crisis?"

Public health experts and officials faced a deluge of challenges, almost from the beginning. First there were the problems with the initial coronavirus test kits, which contained an unspecified problem with a compound that prompted inconclusive results; it took experts nearly three weeks of troubleshooting to find a workaround.

Initial U.S. guidelines for testing also were overly narrow, only screening individuals who presented with respiratory symptoms and had either recently traveled to China or come in close contact with an infected person.

Infighting quickly materialized among agencies that have long had poor relationships — feuding was especially intense between the CDC and the Office of the Assistant Secretary for Preparedness and Response — and when the situation went awry, recriminations were swift. Public health officials and experts also struggled to find an uneasy equilibrium between doing their jobs honestly and transparently while trying to manage a mercurial president, who griped about what he viewed as overheated rhetoric by officials and the media.

At the White House, Trump and many of his aides were initially skeptical of just how serious the coronavirus threat was, while the president often seemed uninterested as long as the virus was abroad. At first, when he began to engage, he downplayed the threat — “The Coronavirus is very much under control in the USA,” he tweeted in late February — and became a font of misinformation and confusion, further muddling his administration’s response.

On Friday, visiting the CDC in Atlanta, the president spewed more falsehoods when he claimed, incorrectly: “Anybody that needs a test, gets a test. They’re there. They have the tests. And the tests are beautiful.”

Public health and infectious-disease experts have lamented that the faulty CDC test and limited testing criteria delayed officials’ abilities to detect the virus’s spread throughout the United States. They also said the government expended too much time and too many resources on trying to contain a virus — at 70 times smaller than a single blood cell — that scientists and doctors quickly realized spread easily and stealthily.

The virus was hopscotching around the world in the middle of cold and flu season and presenting with similar symptoms — including a cough and fever — that made it difficult to distinguish from other common ailments without a diagnostic test.

Several experts said the United States should have spent more time making sure hospitals and state and local health departments had the money, training, personal protective equipment and resources they needed to respond to outbreaks. But the White House’s messaging in January and well into late February that the virus was contained and under control probably led health-care facilities to be insufficiently prepared, these experts added.

During a late January meeting at the White House, Health and Human Services Secretary Alex Azar was having trouble focusing Trump’s full attention on his coronavirus briefing. Azar had arrived to brief the president on the latest virus news, but Trump instead interjected, badgering the health chief about the administration’s messy decision to implement a limited ban on flavored e-cigarettes.

Shortly after that meeting between Azar and Trump, the White House declared a “public health emergency,” announcing quarantines and major travel restrictions — including barring most non-U.S. citizens who recently visited China from entering the United States — intended to limit contagion.

Around this time, in the early days of February, the CDC got its diagnostic test up and running. But the testing criteria was extremely narrow: Only those with recent travel to China or those who had come into contact with a confirmed infection would be tested.

Then came the testing errors, as some labs began reporting inconclusive results from the CDC kits. The problem with tests quickly snowballed, becoming a self-perpetuating cycle. Because the tests were faulty and the testing criteria so limited, the government was missing a lot of the cases because it couldn’t scale up. Some in the administration didn’t initially take the crisis more seriously, in part, because it appeared that the case count was low.

Internally, some officials — including Joe Grogan, director of the Domestic Policy Council, and Ken Cuccinelli, acting deputy secretary of homeland security — were raising questions about the testing process, asking if officials were sure they were catching all the cases. Grogan was also frustrated with HHS for the department’s initial inability to coordinate a national testing strategy.

Until the end of February, only about a dozen labs outside of the CDC had the ability to do their own testing for the virus. Health officials were sounding increasingly dire public warnings. At a regularly scheduled media briefing for reporters on Feb. 25, Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, focused her remarks on community mitigation — such as closing schools or avoiding mass gatherings — rather than the detective work of tracking down and trying to contain existing cases.

Last weekend, on Feb. 29, the Food and Drug Administration finally announced its more lenient testing guidelines — allowing academic and hospital labs to create and perform their own diagnostic coronavirus tests.

But the news could have come far sooner, officials said. Behind the scenes, some FDA officials — having realized the CDC tests were faulty — began pushing for a loosening of testing standards earlier in February, according to three high-level officials. Two other senior officials, however, denied this and said the FDA was solely focused on the CDC test.

Several officials also asserted that key players were missing in the early days of the response — most notably from the FDA, which can work with private manufacturers on diagnostics, therapeutics and vaccine development. FDA Commissioner Stephen Hahn participated in some media briefings and FDA officials took part in HHS briefings, but Hahn was not added to the task force until the end of February, after Vice President Pence took over the response.

Some in the administration, including Trump himself, viewed the initial steps to contain the virus as the solution — rather than merely as a starting point from which to use to buy themselves more time.

“We have contained this,” Trump economic adviser Larry Kudlow told CNBC the last week of February. “I won’t say airtight, but it’s close to airtight.”

The repeated false claims by the president that the virus was being contained exacerbated the problem. They made it difficult for public health officials to lay out the need to prepare for what happens next, even after most experts had begun to fear the virus was already here and spreading. There was also a ripple effect, with health officials and others not taking the threat as seriously as they should have because Trump kept on making faulty assurances, such as his claim at a Feb. 26 news conference that within the United States, the number of cases was “going to be down to close to zero.”

The $8.3 billion in supplemental funds for emergency coronavirus aid, which Trump signed into law Friday, should have been requested a month earlier, many officials and experts said. Had the request come sooner, government agencies could have gotten an earlier start to research and develop vaccines; they could have ensured that state and local health departments had the money and resources they needed to support lab testing and infection control, transportation and lodging for people needing quarantine; and hospitals could have stockpiled supplies such as masks and gowns.

The White House began Friday with an apparent lie: The president, the White House said in a statement, had canceled a planned trip to the CDC in Atlanta because he did “not want to interfere” with the mission of the agency, which had been working nonstop to combat the virus.

But the president soon contradicted his own press office, telling reporters that his trip had been canceled because of a suspected case of coronavirus on the CDC campus, which turned out to be negative.

“So I may be going,” said Trump, who did indeed continue on with his visit as planned.

Yet there was Trump, touring the CDC in a red “Keep America Great” campaign hat and offering an alternative reality just 24 hours later during a chaotic appearance: “Anybody who wants a test will get a test, that’s the bottom line,” said Trump, who went on to describe the coronavirus testing kits as being nearly as “perfect” as his phone call with the Ukrainian president last summer, which ultimately led to his impeachment.

Then Trump ended the day by injecting yet another note of chaos into an already frenetic period, tweeting out news of a major staff shake-up.

I am pleased to announce that Congressman Mark Meadows will become White House Chief of Staff,” he wrote, pivoting away from coronavirus, at least briefly.

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