Need for Accountability for US Failures to Respond Effectively to the Covid19 Pandemic
Lewis's New Book Helps Us to Come to Terms with the Long Sad History of the US's inadequate response to the Pandemic
Michael Lewis’s excellent new book The Premoniton looks as though it will be one historians will turn to understand the particular madness of our age. Ostensibly it is a story about how (as the blurb has it) “a band of medical visionaries” find themselves pitted against “the wall of ignorance that was the official response of the Trump administration.” It is of course more than that. Lewis helps us understand the way “walls of ignorance” got formed and was patrolled by people who rationalized that holding onto their paychecks was a higher moral calling than truth telling that could have saved hundreds of thousands of American lives.
We all know from Woodward’s latest book that Trump was briefed in January of 2020 about the virus that it would lead to millions of fatalities as it was more contagious and deadly than the flu . “You just breathe the air and that’s how it’s passed,” Trump told Woodward, according to The Post. “And so that’s a very tricky one. That’s a very delicate one. It’s also more deadly than even your strenuous flu.” Instead of making fighting this pandemic an urgent priority --he did the opposite--and called it a hoax and played down the danger to the point that even today many of his supporters continue to not get vaccinated, observe social distance rules or choose to wear masks. When Trump was not openly silencing his public health officials he was firing them and appointing lackeys in their place. A taskforce that was set up by the Obama administration to oversee pandemic response was disbanded and states were left on their own to figure out their response. So much of that disgraceful history of governmental malfeasance is known that Lewis decides not to dwell on it but to tell the story of several heroes-those at the lower echelons of the bureaucracy who rang the alarm bells and begun to mount if not a federal government response--at least a semi-national one. The heroes of this story had to confront time and time again the Trump desire not to “panic” lest his base believed that he was less than the complete authoritarian since he could not control a pesky thing like a virus run amok.
Lewis expertly tells a heroic tale (reminiscent in some ways of his other groundbreaking best seller The Big Short ) featuring fearless souls who refused to buy the conventional narrative. People like Dr Charity Dean, newly appointed chief health officer for Santa Barbara county and Dr Carter Meecher, head of a VA ICU unit both of whom found their way to connect with other like minded insiders who were capble both of puting the many puzzle pieces followig the outbreak of the pandemic in Wuhan China in 2019 and figure out how to penetrate a bureaucracy that had been captured by nothing short of a madman. But as you read through the often suspenseful narrative what you realize that not only is the country’s response being led by an unstable and deeply flawed amoral human being but that the key institution that was charged with disease fighting that should have been above politics, the Centers for Disease Control (CDC) was neutured. Under the leadership of Dr Robert Redfield according to one former CDC director the country had acquisced to political interference. As a result CDC as manifested by their website ignored the science and lied about the diseases’ severity in conformity to the White House wishes.
There is no defense or excuse for the cowardly CDC response but there is something of an explanation--weak though it might be. It is a little remembered story but in 1976 the country was faced with what was termed the Swine Flu epidemic. Beginning with a few soldiers in Fort Dix, New Jersey, scientists found that some of the fatalities connected the strain of the flu to 1918 pandemic that caused the deaths of 50 million world wide deaths. The then head of the CDC, David Sencer made the decision in October 1976 to vaccinate the US population and as Lewis states--”everything that could go wrong went wrong ” Even though 43 million people were vaccinated over two and a half months. Three elderly people died as result of the vaccine to massive publicity--to a total of 54 people in ten states. By Decemeber the program was abandoned and the program judged a failure. No one will know how many hundreds and thousands of lives were saved by the program. As Dr Harvey V Fineberg i president of the Institute of Medicine, Washington DC, United States of America (USA) stated on the WHO website,
“Once set on its course, CDC did not establish a basis for review and reconsideration of the situation. As facts evolved, such as the absence of further cases, CDC’s pursuit of the original strategy to immunize everyone became more and more controversial and costly in terms of long-term credibility. From technical, political and policy points of view, it is very difficult to deal with low probability–high consequence events – events that are relatively unlikely, but that would have catastrophic consequences should they occur. When you have such an event in prospect, the naysayer who argues that you are over-reacting is more likely to be right than wrong. It is just like the person who says, “Don’t buy insurance for your house this year; it’s not going to burn down.” The pandemic never occurred. We will never know why. From then on under successive presidents the CDC was pulled in under tighter rein into the White House orbit.
But there was someone who had bothered to learn from history --to some extent. George W Bush had read John Berry’s history of the 1918 influenza , The Great Influenza: The Story of the Deadlist Epidemic in History in the summer of 2005 and was impressed with the work enough to appoint a White House fellow who happened to have medical training, Rajeev Venkaya to develop a plan to fight a future pandemic and head up the Biodefense Directorate. He produced a twelve page document which called for an over seven billion dollar appropriation from Congress for a vague strategy that involved which as Rajeev said gave them “a license to go and figure things out.” It brought in people like Carter Meecher who began to reexamine some of the data from the 1918 outbreak and found that one of the more positive responses was closing the schools and other social distancing measures which had to be done early in the outbreak if they were to be effective. But cities that employed such measures like Philadelphia and St Louis were under incredible pressure from the business community that resulted when they caved to such pressure--large second waves of disease. Armed with these facts Carter Meecher and his team went to the CDC on repeated occasions to insist on taking the Covid epidemic more seriously and begin to take preventive measures. Even a high schooler featured in the book as one of those forgotten heroes who had studied the 1918 outbreak for a science fair competition recognized that if social distancing measures were employed flu strains could be “entirely .thwarted.” However when the news started trickling in from China the Trump administration after having disbanded the pandemic taskforce, and declared it was every state for themselves despite the shortage of supplies for protective equipment and as it turned out ventilators. Trump ignored masking, favored unscientific solutions and no interest in testing and the chaos that ensued as the hospitals filled up to over capacity and fatalities in confined spaces such as nursing homes and densely populated urban areas mounted. As Lewis states it was not all Trump’s fault--it was the enablers in the scientific community who should be held responsible. Medical professors and other opinion leaders who should have known better played to a populist streak in American society that had made Trump’s reign of ignorance possible. Aided and abetted by a neutered CDC the pandemic was given an unecessary and dangerous edge. According to one authoritative report at “ least 130,000 deaths and perhaps as many as 210,000 could have been avoided with earlier policy interventions and more robust federal coordination and leadership.” The report using a comparative analysis had “the US followed Canadian policies and protocols, there might have only been 85,192 U.S. deaths – making more than 132,500 American deaths “avoidable.” If the U.S. response had mirrored that of Germany, the U.S. may have only had 38,457 deaths – leaving 179,260 avoidable deaths. And in the unique case of South Korea -- which had one of the quickest and most robust intervention strategies – the U.S. might have seen just 2,799 deaths, leaving nearly 215,000 deaths avoidable.”
Lewis leaves it to others to point fingers--but the record is clear there needs at some point when this pandemic fades to hold the people who perpetuated this disaster fully accountable.