Five Trump Failures That Unleashed a Pandemic

Suppose you learned that the school bus driver had been warned – just before the big crash that killed a dozen kids – that the brakes were failing. “Sir, that brake line could blow out at any minute,” the mechanic told him that morning. “Can’t wait. You need to get that fixed right away.”

“You’re being alarmist, Tony. I’m sure they’re good for another few days. Besides, it’s Friday, I’ve got big weekend plans, and I don’t have time to take the bus in.”

One hour later, as the school bus just rolled through the stop sign at the state highway, the semi smashed into the side of the bus.

That’s America in the time of pandemic. Except that after the crash, Donald Trump goes on driving the bus – he’s still the owner and no one can fire him – and he still doesn’t believe in maintenance. And so Americans are still needlessly dying of Covid-19.

As America approached four million coronavirus cases early in July (now we are past five and a half million), President Trump briefly pretended to take the pandemic seriously. He finally wore a mask in public.

His gesture was too little, too late. Deaths are increasing and will go on increasing because Trump has no plan for containing the pandemic and because Trump continues to encourage his follower to defy the precautions needed to contain the contagion.

Trump may have tweeted that wearing a mask was now “patriotic.” But meanwhile he counselled that coronavirus is “totally harmless” in ninety-nine percent of cases, predicted that the virus will “sort of just disappear,” and – in a reality-bending assertion – claimed “large portions of our country” are now “corona-free.”

Masks cause problems, too,” Trump said soon after his heralded first mask use, in explaining why he opposed a national mask mandate. And on July 27 Trump shared a video (a “must watch,” he said) which simply advises: “You don’t need masks.”

Trump’s followers see little need for precautions. Sixty-eight percent believe the importance of the outbreak has been exaggerated. A majority don’t realize coronavirus is far more deadly than seasonal flu. Three-quarters say they are comfortable returning to their regular routine. Fully a third of Republicans do not routinely wear a mask when out in public, and appear impervious to evidence of the risks.

Texas Rep. Louie Gohmert illustrates the power of Republican denial. When Gohmert – who has refused to wear a mask on the House floor – himself tested positive for coronavirus, he blamed his occasional mask use.

The inevitable outcome of Trump’s long campaign of covid denial: death on an ever-increasing scale. How could it be otherwise? How could anyone think that thwarting the response to an epidemic that is prescribed by doctors, scientists and public health leaders would not cause lives to be lost?

And now the pandemic has re-surged and is out of control. In the first two weeks of August there were 742,000 new Covid-19 cases and over one thousand deaths per day. The true death toll has now been calculated as over 200,000 souls.

Donald Trump did not launch the pandemic. But when it reached America, his denial, neglect of duty, lies and self-absorption worsened a contagion that was contained elsewhere, and should have been contained here. Because of Trump’s malfeasance, many tens of thousands of Americans – probably a large majority of the victims – have succumbed who would otherwise have lived. And millions have suffered disease who needn’t have been infected. At the current rate, by Christmas we will have suffered more than 300,000 dead, lives lost during President Trump’s stewardship and in no small part because of it.

As the numbers of newly infected Americans reach record highs again and terrifying swells in mortality wash over us, it is time for a reckoning. An enormous proportion of the coronavirus devastation and death underway must be attributed to President Trump’s failures. The story of the plague to date has been the story of Donald Trump’s inaction, his frail response and his actively destructive conduct.

The story begins in the early days of this year, when prompt, forceful leadership could have brought the pandemic under control in America. Trump refused to take the coronavirus seriously for two critical months. Then he opposed decisive action and undermined the interventions that the Center for Disease Control, epidemiologists and public health officers all knew were needed. And now he insists on pretending that we’re returning to normal, no matter what the real-world cost in lives and economic disaster.

To understand why Trump’s actions have been so destructive, it is necessary to understand just what it means for a lethal virus to spread exponentially.

If you started with 100 deaths per day and doubled the number every three days – the rate at which the coronavirus contagion was actually expanding in January 2020 – the numbers swiftly explode: 100, 200, 400, 800, 1600, 3200 after five three-day cycles (two weeks).

Double 100 deaths for ten three-day cycles – one month – and the last day’s total shoots up to 102,400 deaths. Interrupt the doubling half-way through the month cycle, at two weeks into the sequence, you stop at 3,200 deaths, instead of 102,400. “Obviously,” Dr. Anthony Fauci of the Center for Disease Control observed, “if you had a process that was ongoing and started mitigation earlier, you could have saved lives.” Because the spread is exponential, the consequences of Trump’s feeble, delayed response have been appalling.

It didn’t have to be this way.

South Korea and the United States each identified its first case of Covid-19 on the same day, January 20, 2020. From the outset it was clear there was reason for deep foreboding and need for strong action. An epidemic was raging out of control in China, and within a week the Chinese government locked down 15 central China cities, quarantining 57 million people.

After learning of the first cases, the South Korea government sprang into action. They recognized that their nation faced a monumental threat and responded with an immediate crash program for testing. They mobilized South Korean companies to swiftly create a reliable coronavirus test. They produced testing kits en masse and used them to identify people with Covid-19. Then they traced and isolated the contacts of the infected individuals, and treated them.

It worked. Testing, tracking and quarantine broke the exponential growth of new Covid-19 cases in South Korea.

Our president also responded immediately – with denial and baseless reassurances. When asked about coronavirus two days after the first U.S. case had surfaced, Trump said he was “not at all” worried about an outbreak because “we have it totally under control.

He continued his cheerleading throughout February: “It’s going to be fine.” “We’re in very good shape.” The virus is “very well under control … very few people with it, and they’re all getting better.” “The risk to the American people remains very low. … within a couple of days [cases are] going to be down to close to zero.”

At the end of February he promised that, “like a miracle, it will disappear.”

The outcome? Seven months after the first case, South Korea had only 16,058 coronavirus cases. [Aug 19] This would be the equivalent, if South Korea had a population the size of the U.S., of 103,574 cases. [US=6.45xSK population.] The United States at the same point actually had over 5.4 million Covid-19 cases, more than anywhere else in the world.

The disparity in deaths is stark. As of August 19, 2020 over 230,000 Americans were dead of coronavirus. South Korea: 306. [Johns Hopkins tracker plus over 60,000 excess deaths reported by NY Times ]

Is there a reason that America, with our vast resources, could not have fared as well as South Korea in responding to the pandemic? Yes. Donald Trump.

Here are the five things that President Trump did and failed to do that ushered in the coronavirus Trumpedemic.

1. Degrading Our Preparation For a Pandemic: Donald Trump Disabled Two Early Warning Systems and Ignored the Lessons of His Own Pandemic Preparation Exercises

In the past few decades there have been a number of near pandemics and international disease scares. Increasingly, our government recognized that these represented a grave risk to America itself, and responded by setting up agencies, working with other nations and making plans to address the danger of an epidemic at home.

But in 2018, a year and a half before coronavirus reached America, Trump disbanded the National Security Council’s Directorate for Global Health Security, the group specifically tasked with defending against disease threats from overseas. Rear Adm. Timothy Ziemer, the top White House official responsible for leading the U.S. response in the event of a deadly pandemic, departed. Fired at the same time was Tom Bossert, who was described by the Washington Post as the “White House homeland security adviser . . . who had called for a comprehensive biodefense strategy against pandemics.”

As Dr. Anthony Fauci, the renowned head of the National Institute of Infectious Diseases, observed with tactful understatement, “It would be nice if the office was still there.” The office and the people who were experts on a pandemic could have led a prompt response when the pandemic struck.

In October 2019 Trump also shut down a U.S. Agency for International Development program called “PREDICT,” that had trained thousands of people in 30 countries to detect and respond to deadly new viruses. Perhaps Trump thought predicting and following viruses in other countries was nothing to us.

But if you live in an apartment building, you can’t say you don’t care about a fire in another apartment. As we now know all too well, the nations of the world are just as inter-connected.

Between January and August of last year, the administration also conducted a “war game” type of exercise designed to see how well the United States would respond to a pandemic flu originating in China, and to identify potential problems. Over the first eight months of 2019 more than a dozen federal and 12 state agencies and departments participated in the exercises, dubbed “Crimson Contagion.”

The list of things that went wrong during the exercise will seem sadly familiar to anyone following the news this year:

* Personal protective equipment for medical personnel ran out, and there was a shortage of ventilators.

* No one knew which federal agencies should address the shortages.

* There was no way to quickly manufacture more essential medical equipment, supplies or medicines, including antiviral medications, needles, syringes, N95 respirators and ventilators.

* Coordination among federal and state and local agencies was confused.

* Different federal agencies wrangled over who was in charge – if anyone.

With more than a dozen federal agencies participating in a series of exercises stretching over most of a year, was it too much to expect that the president of the United States would pay attention to the results? Apparently. Donald Trump did nothing to address the problems identified by Crimson Contagion. The same failures afflicted Trump’s actual response to the real pandemic. But this time real people died.

2. Trump Ignored Warnings of the Coronavirus Threat And Rejected Decisive Action For Two Critical Months

The time to move against a contagion is at the outset, before it spreads exponentially, before it gets beyond control. But for more than two months after Donald Trump was first told of the impending contagion, Trump stubbornly asserted it was no big thing, “totally under control” he said time and again. Those who expressed concern over the failure to actually get the contagion under control were, Trump said, promoting a “new hoax” against him.

Beginning in early January, confidential presidential briefings were presented to Trump more than a dozen times apprising him of the emerging danger of the coronavirus. “The system was blinking red,” said an official with access to Trump’s intelligence reports. But, the official said, no one could “get him to do anything about it.” Why? Trump was afraid it would spook the stock market. Instead of acting immediately and decisively, as South Korea did, the president of the United States tweeted his disbelief and denial.

On January 29, Trump’s trade advisor Peter Navarro prepared a memo that warned Trump of the possibility of a “full-blown pandemic, imperiling the lives of millions of Americans” and threatening economic harm in the trillions of dollars. Navarro recommended an “aggressive containment” strategy and spoke to the president himself about the threat.

At the end of January, President Trump did bar some travelers from China from entering the U.S. But the horses had long since left the barn. Some 300,000 travelers from China had entered the U.S. during January, and the coronavirus was already here and spreading across America.

In addition to the presidential briefings and Navarro warning of the danger, the president’s Health and Human Services Secretary, Alex Azar, also personally told Trump of the danger. In mid-January and then again on January 30, Azar told Trump that a pandemic was possible. But Trump responded that Azar was being “alarmist.”

Trump had no meaningful basis for saying it was “alarmist” to fear an eruption of coronavirus. No written report or intelligence briefing minimized the seriousness of a potential outbreak. No epidemiologist or public health official considered the risks trivial. The problem was merely that the president did not want to hear news unpleasant to him. He was enchanted by positive economic indicators and had ears for nothing else.

Reality did not conform to Donald Trump’s wishes. Cases of coronavirus infection multiplied and disseminated in early February. By the third week of the month, a White House task force comprised of health officials agreed among themselves that aggressive efforts were needed to prevent pandemic spread, including social distancing and keeping people home from work. A report prepared on February 14 suggested “significantly limiting public gatherings and cancellation of almost all sporting events, performances, and public and private meetings.” The report advised that school closures and widespread stay-at-home directives should be considered.

But President Trump refused to adopt serious measures to slow or contain the virus. He exploded when he learned that the immunization chief of the Center for Disease Control (CDC), Dr. Nancy Messonnier, publicly stated on February 25 that it was no longer a matter of “if” the pandemic would strike, but “a question of exactly when this will happen and how many people in this country will have severe illness.”

In a too-realistic-for-Trump press briefing, Dr. Messonnier issued the very warnings the health officials had concluded were needed: She “ask[ed] the American public to prepare for the expectation that this might be bad,” noting that we “need to be preparing for significant disruption. . . The disruption to everyday life might be severe.” Schools might have to close, conferences could be canceled, businesses might make employees work from home. “Now is the time for businesses, hospitals, communities, schools, and everyday people to begin preparing.

Our military had also been watching and they considered the threat to be just as serious. That same day in late February that Dr. Messonnier delivered her warnings, the U.S. Army’s National Center for Medical Intelligence raised its pandemic warning level to WATCHCON 1 – “imminent” crisis. The stock market, more attuned to reality than President Trump, crashed. Trump’s reaction? He raged at HHS Secretary Azar that Messonnier had scared people unnecessarily and threatened to fire her.

Why did the president believe that warnings were unnecessary?

Whether a pandemic is inevitable is not a matter of opinion, like whether Trump’s Palm Beach golf course is better than St. Andrews in Scotland. The inevitability of the pandemic was a matter of facts, scientific observation and judgment. Trump had no basis for putting his wishful thinking above the consensus of public health experts.

Dr. Messonnier had issued a wake-up call when she warned that pandemic was inevitable. Trump responded the next day with a go-back-to-sleep lullaby: “No, I don’t think it’s inevitable,” soothed the president. “The risk to the American people remains very low. . . We’ve had tremendous success. . . We’re going very substantially down, not up.”

Decisive action to contain the coronavirus – action that might be “disruptive” – was off the table. Instead, Trump put Vice President Pence (rather than any epidemic control expert or public health official) in charge of the federal government’s coronavirus response. Shuffling “leadership” did not mean the president grasped the challenge or was prepared to act. All it really meant was that public health officials were muzzled. They were directed to make no statements and no public appearances without Pence’s approval.

It would be weeks more before the White House yielded to the need for stronger measures. Meanwhile, the pandemic fanned out across America, unrestrained by the recommended measures, while Trump continued to belittle the danger.

The consequences? The New York Times has reported the conclusions of epidemiology researchers from Columbia University on the result of the period of inactivity:

“If the country had begun locking down cities and limiting social contact on March 1, two weeks earlier than most people started staying home, the vast majority of the nation’s deaths – about 83 percent – would have been avoided.”

The number of deaths that would have been prevented: 54,000 of the 65,300 who had died as of May 3.

Researchers from the Imperial College in London reached essentially the same conclusion: An estimated 90% of the Covid-19 deaths in America, they found, could have been prevented by acting two weeks earlier.

Nearly sixty thousand Americans unnecessarily dead of Covid-19 as of early May – by now, almost certainly more than one hundred thousand, since those who were unnecessarily infected with Covid-19 went on to infect others, with still further infections spreading exponentially. This has been the price of Donald Trump’s failure.

3. Trump Ignored The “Playbook” For Dealing With A Pandemic and Ignored the Anticipated Shortages of Essential Protective Equipment

In mid-March Donald Trump nominally acknowledged that we were in a pandemic. Pretending to be ahead on the problem he had so long asserted was no problem, now Trump claimed he had known all along it was a pandemic. A “totally under control” pandemic. But still he refused to confront the crisis.

A 69-page government plan – called the “Playbook for Early Response to High-Consequence Emerging Infectious Disease Threats” – was at hand when the pandemic reached America. It carefully laid out the steps that should be taken and the developments that needed to be monitored in order to slow and control an infectious disease outbreak.

The Playbook had been developed during the Obama administration, embodying some of the lessons of earlier epidemic outbreaks.

Trump ignored the Playbook and the problems it flagged.

The Playbook instructed those confronting a pandemic to be ready to answer precisely the kinds of questions that Donald Trump’s government only addressed too late:

* “Can the disease be effectively screened in travelers as a means to stop transmission?”

* “What is the robustness of contact tracing?”

* “Is diagnostic capacity keeping up?”

* “Is the public health infrastructure keeping up with the cases?”

Some of the ignored guidance was quite specific:

“Is there sufficient personal protective equipment for healthcare workers who are providing medical care?

“If YES: What are the triggers to signal exhaustion of supplies? Are additional supplies available?

“If NO: Should the Strategic National Stockpile release PPE to States?”

Had the Trump administration attended at least to this advice when the president was first warned of a possible epidemic in January – had Trump moved while there was time to ensure that medical level protective masks, gowns and other equipment did not run out – how many doctors, nurses and emergency medical personnel who died caring for Covid-19 patients would be alive today?

The 69-page Playbook was, as a former Trump administration official put it, “thrown onto a shelf” and ignored. It had been developed during the Obama administration, and all things Obama were anathema to Donald Trump and his government.

“They didn’t run the plays,” an Obama White House Ebola coordinator observed sadly. “It would have made a big difference if they had.”

Even without following the Playbook, though, public health officials recognized and warned that stockpiles of protective gear for medical and emergency workers were inadequate.

In January the head of the Food and Drug Administration asked the Health and Human Services Department about contacting diagnostic and pharmaceutical companies concerning possible shortages of personal protective gear and other equipment. HHS head Azar told him not to do so. As the New York Times reported, Azar felt that such calls “would alarm the industry and make the administration look unprepared.”

For a Trump administration official, looking unprepared was much worse than being unprepared. Looking good outweighed the suffering that would ensue when actual shortages were ignored.

The consequences of ignoring reality and ignoring recommended precautions? More unnecessary deaths.

The shortages remain a problem. Reports the New York Times in July: “As coronavirus cases surge across the country, hospitals, nursing homes and private medical practices are facing a problem many had hoped would be resolved by now: a dire shortage of respirator masks, isolation gowns and disposable gloves that protect front-line medical workers from infection.”

Astonishingly, even by July Donald Trump’s government was incapable of solving the shortages of personal protective equipment.

4. On Donald Trump’s Watch the Government Flubbed the Deployment of Coronavirus Testing, Crippling the Response

You cannot fight what you cannot see,” observed a former adviser to the Health and Human Services Department. To see the coronavirus threat, dependable testing was needed.

The reason: the most effective way to control a viral outbreak for which there is no cure is to promptly identify the people who have been infected, quarantine them, and track down and isolate their contacts. That’s what worked for South Korea. To do this you must create a reliable test for the disease and swiftly manufacture it on a mass scale.

If you cannot bring the contagion under control at the outset by testing, quarantine and contact tracking, you must use social isolation and lockdowns to limit the contagion. Then bring testing and contact tracing to bear. Either way, effective coronavirus testing is essential.

When you do it right,” said an infectious disease professor at Florida International University, “testing and contact tracing can eliminate the virus from the community.”

The United States failed woefully.

On February 5 the Center for Disease Control began distributing a limited number of test kits to state and local public health laboratories. But the kits were defective and unreliable. Two precious weeks passed before the issue was resolved, but even then the CDC’s constrained capacity meant that testing was too limited. Only those who had recently been to China or had been exposed to a known case of Covid-19 were being tested, not all whose symptoms might reflect the virus.

Meanwhile, academic and public health labs were discouraged from developing their own tests. Not until the end of February did the Federal Drug Administration relent and allow other labs to do their own testing. As of February 29, five weeks after the first case had been detected in each of the two countries, South Korea had performed 66,652 coronavirus tests. The United States, with more than six times South Korean’s population, had performed only 472 tests.

We were flying blind. Isolating the infected and tracing their contacts was impossible because we lacked testing capacity. Nor could we concentrate resources on hot spots, because we didn’t know where they were until it was too late.

What did President Trump do about the problem? Indifferent to the troubling reality, he responded in early March with the falsehood that “anybody who wants a test gets a test.” Actually, as Vice President Pence had admitted only one day earlier, “we don’t have enough tests today to meet what we anticipate will be the demand going forward.”

Trump did not actually consider the limited availability of tests to be a problem because he feared more testing might show more coronavirus cases, and that might make him look bad. His concerns mirrored those of his son-in-law and self-styled coronavirus expert Jared Kushner, who reportedly argued to the effect that “testing too many people . . . would spook the markets and so we just shouldn’t do it.”

When you test,” Trump said in May 2020, “you find something is wrong with people. If we didn’t do any testing, we would have very few cases.” Better not to know how many people are actually infected. Better to have numbers that look good.

Reliable tests were essential for bringing coronavirus under control. But given Trump’s priorities, it is no surprise he did not consider it urgent to fix the problem.

It is true that developing and deploying effective virus tests are technical matters not within the skill set of a president. Still, when the CDC faltered, a president concerned about the nation would have taken charge.

President Trump was personally urged to do so by Republican Senator Tom Cotton in early February. But despite the fact that test kit development had stalled, the president was still insisting “it’s going to work out fine.” Because warm weather was coming.

The president who said “like a miracle, it will disappear,” the president who vetoed drastic steps to stop the pandemic, was not taking charge.

Remember when we had presidents criticized for being “micro-managers,” meaning they paid attention to detail? Such a president, concerned that our tests weren’t working and that CDC could never perform enough testing on its own anyway, would have insisted we authorize private companies to come up with tests, as South Korea did, or use the tests Germany had developed in January, or import test kits from the World Health Organization. A president awake to the critical need would have pressed for answers and demanded solutions.

No one would ever accuse Donald Trump of micromanagement. Unlike the previous seven presidents, Trump won’t (or perhaps can’t) even trouble to read the President’s Daily Brief, a confidential intelligence report produced before dawn each day to call the president’s attention to important global developments and security threats.

When Trump was confronted with the failings of the testing program, his response was in character and this time entirely accurate: “I don’t take responsibility at all.”

Real leaders want to take responsibility so they can solve problems. If the U.S. had solved the test kit problem and established an adequate testing system early on, observed Dr. Howard Forman, a Yale professor of public health policy, “we would have been able to stop the spread of this virus in its tracks the way that many other nations have.”

At the time of this writing, in early August 2020, the collapse of Trump’s feckless efforts to reopen the economy have shown that we still need large-scale testing, now more than ever. We need to monitor because the current approach has caused too many people to become infected. Information might help experts decide if we need to slow down the reopening program so fewer people will die.

But Donald Trump remains hostile to testing. In May, he said, “Maybe it is overrated.” During a campaign rally in Tulsa, Oklahoma on June 20 he went further into his denial of reality: “When you do testing to [a large] extent, you’re going to find more people. You’re going to find more cases. So I said to my people, ‘Slow the testing down, please!’” And they are. “The Trump administration is planning to end its funding and support for coronavirus testing sites at the end of the month,” NBC News reported on June 24.

In July, the Trump continued his war against testing, seeking to block billions of dollars in federal coronavirus relief that would go to the states to conduct testing and contact tracing. After all, what matters more to Donald Trump? Taking actual steps to slow the pandemic and save lives – or concealing the extent of the death toll so Trump looks better?

Less testing. “Better” numbers. More dead. It works for Donald Trump.

5. Donald Trump Politicized the Crisis and Sabotaged the Shut Down

On February 26 President Trump said “we have a total of 15 people” with coronavirus “and the 15 within a couple of days is going to be down to close to zero.” But as March unfolded, following two lost months, the number of identified Covid-19 cases and deaths exploded, shattering Trump’s claim there were only a handful of cases that would soon vanish.

Denial confronts reality

The contagion had been proliferating for some weeks – under the radar, since coronavirus could be disseminated by infected individuals before any symptoms appeared. But in March more confirmed cases surfaced, first on the east and west coasts. By the middle of the month, California had 472 confirmed cases. The state of Washington, 642. New York, 1,700. The country as a whole, 8,500 known cases of Covid-19 as of March 18 – and 145 dead. Coronavirus was in all 50 states.

The disease spread exponentially. In a mere two and a half weeks, identified Covid-19 cases would leap from 8,500 on March 18 to 240,000 at the beginning of April. In that two and a half weeks, deaths would jump from 145 to over 7,000. But Trump refused to recognize that his miracle was not going to arrive. On March 7 he bragged, “We closed it down; we stopped it.” On March 10: “We’re doing a great job . . . It will go away.”

Eventually reality forced itself on Donald Trump. Three days after saying “it will go away,” on March 13 President Trump was forced to declare a national emergency. On March 16 he announced a set of recommendations – still not directives – to mitigate the pandemic: Americans should work or school from home if possible; avoid social gatherings of more than 10 people; avoid going to restaurants, bars and food courts; and avoid unnecessary travel.

Too little too late

He did not order a national lockdown. None of the steps was mandatory. He said nothing about individual social distancing. He issued no stay-at-home order.

Decisions on whether to implement the recommendations were left to each state or locality. In other words, President Trump refused to provide unified national leadership. But since the virus was no respecter of state borders, letting every state or locality devise its own response (if any) to a pandemic was no way to bring it under control. The recommendations would inevitably be of limited value. There was no strategy calculated to prevent the virus from attacking the entire nation.

Various states and counties began lock-downs on their own. On March 16, public health officers of the seven San Francisco Bay Area counties issued a joint shelter-in-place order. On March 20 California’s governor made the order state-wide and that same day New York State also issued a stay-at-home order. Further orders followed. March 25: Washington State. March 31: Texas. April 1: Pennsylvania and Georgia. Others delayed but eventually went along with varying degrees of strictness.

Massive business, school, recreational and organizational closures followed, and unemployment skyrocketed. Congress enacted and Trump signed legislation to mitigate the economic impacts. But Trump soon resumed his resistance to effective public health measures and instituted no national campaign against the virus. To this day, although Trump has made demands regarding reopening businesses, schools and the economy, he has not once articulated any strategy whatsoever for bringing the pandemic under control.

Abdication of leadership

Trump failed to provide national leadership even as infections proliferated in April and May and the death toll and burden on hospitals soared. During a single week in early April, 13,000 people died in the United States. Serious shortages of personal protective equipment (“PPE”) for medical and emergency personnel materialized, the very danger that the unheeded Obama-era Playbook had warned against.

Others had also warned of shortages. The president’s trade advisor Peter Navarro had personally informed Trump back in February that $400 million in PPE, including at least one billion protective masks and 200,000 protective Tyvek suits, would be needed because this would be “the first line of defense for our health care workers.”

The early warnings of PPE shortages had been ignored. So doctors, nurses and first responders were left in lethal danger. But Trump found a way to blame them rather than accepting responsibility. As New York descended into the dark valley of Covid-19 death, and hospital mortuaries and funeral homes were backing up with bodies, the president suggested that doctors and nurses who were risking their lives might be stealing masks and sending them “out the back door.” No evidence supported the slander.

Trump was slow to use the Defense Manufacturing Act to force manufacturers to make PPE and ventilators, also in short supply, on the ground that this would be like “nationalizing our businesses.” Actual government action in the crisis was shunned.

National leadership was necessary to set priorities, decide which regions had the most urgent needs and allocate scarce resources accordingly. But just as Trump had bragged, “I don’t take responsibility at all” for the testing debacle nor for the shortages, he also disclaimed responsibility for obtaining and rationally distributing required medical materiel.

Instead, the states were left to fend for themselves and compete with each other, as Trump explicitly abdicated leadership: “Respirators, ventilators, all of the equipment – try getting it yourselves,” the president told a group of governors during a conference call. “We’re not a shipping clerk.”

When the consequences emerged, with hospitals across the county suffering serious shortages, and the Inspector General of the Department of Health and Human Services reporting “significant challenges centered on testing and caring for [Covid-19] patients . . . and keeping staff safe,” Trump finally responded. He fired the Inspector General.

Even as the shelter-at-home regime and tough but necessary measures were being put into place by others, Trump started beating the drums to end them. As early as March 23 – only ten days after finally encouraging Americans to take the pandemic seriously – he warned against the supposed danger of letting “the cure be worse than the problem.” On March 24, he called for reopening the country by Easter, less than three weeks away. The CDC – along with corporate America – rejected the notion that it would be safe to reopen that fast. Nonetheless, Trump pressed for ending the protective lockdown.

President Trump’s effort to distance himself from responsibility in America’s great crisis is actually part of his political strategy. The Wall Street Journal has reported that President Trump “asked White House aides for economic response plans that would allow him to take credit for successes while offering enough flexibility to assign fault for any failures to others.” While this does seem to pose a challenge, the possibility of achieving the no-responsibility goal is plainly maximized when the president provides no leadership and takes no actual action – other than attacking the painful interventions that are needed to defeat the pandemic.

When confronted in early August with the rising toll – one thousand individuals lost to coronavirus each day – Trump could only respond: “it is what it is.” Then he turned to his trademark repertoire of denial, boasting and blaming. “It’s under control,” he said yet again, “the virus is receding.” “We have done a great job. We’ve gotten the governors everything they needed. They didn’t do their (jobs) – many of them didn’t . . .”

That same day three Republican and three Democratic governors formed a compact to work together to try to address the problem of widespread delay in receiving coronavirus test results, delays that mean “it’s like having no testing” to bring the virus under control AWOL in providing leadership on this or any other coronavirus problem: the president of the United States.

Coronavirus politics: the “new hoax” and Covid denialism

During February, while Trump was dismissing the “unnecessarily frightening” recommendations of CDC experts and the supposed “alarmism” of his own Health and Human Services Secretary, some in Congress were growing alarmed at Trump’s passivity in the face of an emerging threat to the nation. Their expressions of concern were the occasion for Trump to politicize the outbreak by condemning such worries as the Democrats’ “new hoax.”

Seemingly Trump calculated that turning the coronavirus outbreak into “us versus them” would consolidate the support of his base and energize it. It is yet to be seen whether it will work for candidate Trump politically to divide a nation confronting a pandemic. But Trump has succeeded in inducing a large proportion of his fellow Republicans to become skeptical of the seriousness of the coronavirus and the need for precautionary measures.

Trump seeks to posture himself as the “good parent” who wants to return us to happier days while characterizing Democrats as the “mean parent” who won’t let you go to the movies or restaurants or anything, and won’t even let you play with your friends.

In the real world, of course, it was not just Democrats who recognized that it’s better to take your medicine as long as you need to and that it’s dangerous to make believe you’re all better when you’re not. But too many Republicans have imbibed Trump’s message that the coronavirus contagion is really not all that serious.

From the start Trump literally modeled coronavirus denialism by refusing to wear a face mask. Indeed, he made the bizarre suggestion some Americans are wearing masks “as a way to signal disapproval” of him, rather than following the best guidance from the Center for Disease Control in order to stay alive. Of course Trump’s suggestion sends the message that not wearing a mask is the way for Trump supporters to signal their approval of him, and many have responded by going out among other people without a mask. In May, he reinforced that view with a retweet attacking mask use as “slavery and social death.” Trump followers have been vociferous, persistent and aggressive in their hostility to mask use.

Notwithstanding Trump’s recent supposed conversion to mask use, the many months he refused to wear one in which he regularly undermined the CDC’s recommendations cannot be easily undone. And particularly in the states where Trump-supporting Republican governors have followed his guidelines-free lead on reopening, mask-resisters have played a disturbing role in the recent eruption of covid cases.

President Trump briefly flirted with the notion of styling himself as a “wartime president” in mid-March. But he leads no “war” on coronavirus. Instead he has inspired and directed a guerilla war of resistance to the social distancing, masking and business closures that have been our actual defenses against Covid-19. So, for example, when small groups of Trump supporters (some heavily armed) violated stay-at-home orders by congregating closely together and demonstrating without protective masks at the state capitols in Michigan, Minnesota and Virginia (not coincidentally states with Democratic governors), Trump tweeted them on, urging the demonstrators to “LIBERATE” their states.

“Liberation” and reckless endangerment

When the president himself appears to claim that the lockdown and mask requirements are needless infringements on liberty – and when he endorses defying the law to resist these so-called “infringements” – we shouldn’t be entirely surprised that some of Trump’s supporters go to extreme lengths to protect their imaginary right to ignore pandemic precautions and infect themselves and others.

An anti-mask patriot in San Antonio, Texas shot at a bus, hitting a passenger, after being told he could not get on unless he wore a mask. In Flint, Michigan a security guard who insisted that masks be worn was shot and killed. Assault and verbal abuse have become common, and death threats have driven a number of public health officials out of their jobs, with dozens leaving their posts out of fear just when we desperately need their expertise.

Of course, those who shun masks need not be assaultive to endanger others. By congregating unprotected, they can spread coronavirus to each other and, inevitably, to others. Since the president encourages such conduct, he is responsible for the ensuing illnesses and deaths.

Trump engaged in further reckless endangerment by holding large public rallies where efforts at safe behavior are discouraged, exposing his MAGA followers to the risk of contagion. The dangers are exacerbated because Trump does not require rally attendees to wear masks and because his campaign does its best to pack his fans close together in the stands.

The staff at the Tulsa, Oklahoma arena where a Trump rally occurred in June had placed “Do Not Sit Here Please!” stickers on many of the seats to encourage social distancing. Trump campaign workers went around systematically removing them. Yet as a condition of attending a Trump rally, his campaign makes his supporters sign a waiver of their right to sue over catching coronavirus at the rally.

Two weeks after the June Trump rally a wave of coronavirus cases washed over the Oklahoma county where the rally took place. The rally “likely” contributed to the increase in cases, say Tulsa Health Department officials.

Former Republican presidential candidate and Trump supporter Herman Cain might well have been among those who contracted Covid-19 at the political event. He attended the Tulsa rally and was photographed without a mask. On July 30 Cain died of coronavirus.

Texas Rep. Louie Gohmert illustrates the power of Republican denial. When Gohmert – who refused to wear a mask on the House floor – tested positive for coronavirus, he blamed his occasional mask use.

Heedless reopening: the path to death

Since the beginning of the lockdown President Trump has pressed relentlessly to end the protective steps in order that (he erroneously believed) the economy could reopen and so he could point to his alleged economic success. Trump has been indifferent to the likely lethal consequences if reopening were handled carelessly, hostile to making any reopening subject to conditions to ensure safety, and oblivious to the reality that there cannot be an economic recovery while a pandemic rages.

Politics as Trump sees them, not public health, are in command. Hence he has insisted that schools reopen fully this fall and threatened local districts that are not inclined to yield. “May cut off funding if not open!” But the virus is not harmless to school-age children, who can also suffer death, multisymptom inflammatory syndrome and other harms not yet clearly understood – and of course children can transmit infections to their parents and other older people. (In fact, a recent study indicated that infected children can have at least as much coronavirus in their systems as infected adults, and younger children, much more.)

Nonetheless, CDC guidelines for school reopening have been weakened in response to the president’s demand because “we just don’t want the guidance to be too tough,” explained Vice President Pence.

Trump’s approach has shaped the reopening disaster that Americans are now enduring in many states, particularly in those controlled by Republican state governments. “Despite the [CDC] guidelines and the recommendations to open up carefully and prudently,” Dr. Fauci noted in July, “some states skipped over those and just opened up too quickly.” Eight of the ten states with the highest rates of new infections have Republican governors; nine of the ten have big majorities who supported Trump in 2016, many of whom now appear to scorn social distancing and using masks.

President Trump has encouraged Americans to believe that precautions and guidelines doesn’t matter because they needn’t be concerned about coronavirus any more. In comments reminiscent of his see-no-pandemic days of January and February, the president recently stated “we’re going to be very good with the coronavirus” and that “at some point that’s going to sort of just disappear.”

Trump’s not-to-worry message is utterly at odds with reality. Scientists don’t think coronavirus will just disappear. Nine-nine percent of coronavirus cases are not, as Trump asserted, “totally harmless.” In the real world, 20% of those who get a case of coronavirus experience severe disease, including pneumonia and respiratory failure. And – when the illness is not fatal – long-term effects from Covid-19 on the liver, kidneys, brain, lungs, heart, gastrointestinal tract and psyche are not uncommon among people of all ages.

Thanks to Trump’s stance, however, the pandemic is already over as far as his believers are concerned, including the majority of Republicans. According to a CNN poll taken in early June, three-quarters of Republicans said they were comfortable returning to their regular routine. And among Americans who rely on Trump for Covid-19 news, two-thirds believe “the outbreak has been made a bigger deal than it is.”

The misbeliefs harbored by people who rely on Trump for their information are not harmless. They lead directly to illness and death. Trump’s misinformation has fed the political pressure that many states felt to reopen their economies without regard to safety. And even in states that have tried to reopen carefully, the misinformation spewed by the president encouraged his followers to ignore social distancing and other behavior that must be observed to control the pandemic.

The result: a new coronavirus explosion of serious illnesses and deaths that could have been avoided if only Trump had suspended his war on science and embraced the precautions required to control the pandemic.

On the last day of July, 1,315 Americans died of coronavirus, one life lost each minute of the day and night. In the first week of August, we suffered an average of 54,000 new Covid-19 cases each day – one-third of a million cases in just seven days – an average of 1,049 deaths per day. If the pace of infection and death isn’t slowed by strong, national action, by Christmas America will have had more than 13,000,000 coronavirus illnesses and we will be mourning 300,000 dead.

Trump’s response to the ever-mounting crisis? “No question it will go away. Hopefully sooner rather than later.” Nothing, it appears, can cause Donald Trump to face reality.

The chilling rise in coronavirus cases should demand a new assessment of the president’s insistence on ending the shutdown and reopening everything everywhere. But Donald Trump will have none of that. And he intends to prevent public health authorities from getting in the way of his unworkable strategy – if reopening with no plan at all for limiting the contagion can be called a strategy

In May, the Center for Disease Control had developed a 17-page manual intended to provide step-by-step guidance and detailed advice to local officials in reopening businesses, schools, restaurants, summer camps, churches, day care centers and other institutions at the appropriate time. But the Trump administration suppressed the manual – it was never distributed or made available. Trump has no interest in a guided reopening that can be adjusted if things go badly – or when things go disastrously. President Trump wants to claim the economy has recovered no matter how many die as a result.

It is important to keep in mind that Donald Trump actually has no plan to address the pandemic itself. No plan at all. He urges businesses and schools to re-open, but says not one word about how to bring the coronavirus contagion under control. Apparently no plan is needed, in Trump’s estimation, because “it will go away like things go away.”

And so death and debilitating illness will continue to afflict countless Americans.

The Cost of Donald Trump’s “Leadership”:

One Hundred Thousand Dead. An Economy in Ruins

Had Donald Trump exercised real presidential leadership – had he heeded the warnings repeatedly given in late January and early February, mobilized the federal government and ordered the tough but necessary steps recommended by experts – had he guided the CDC to solve the early challenges – had he placed the federal government at the head of a consistent, nation-wide strategy to defeat the pandemic – had he united the nation – in all likelihood most of the Americans now dead of Covid-19 and most of the millions who suffered from the disease would have been spared. And America would likely not be facing a new Great Depression.

The precise number of those who died because of Donald Trump’s neglect cannot be known. But the analyses of researchers indicate that a shockingly large proportion of coronavirus victims – between 80% and 90% – would not have suffered or died had the president led the federal government in responding decisively.

As mentioned earlier, the researchers from Columbia University’s School of Public Health and from the Imperial College of London concluded that if even the limited measures that were taken in mid-March had begun two weeks earlier, over one million cases of Covid-19 and 54,000 of the 65,300 who had died as of May 3 would likely have been saved from the disease. But the effects of Trump’s misfeasance did not end in early May.

If a large majority of the infections that existed as of early May – over one million – had been prevented by earlier timely adoption of social distancing and the lockdowns that Trump had opposed, most of the new cases that arose out of those avoidable infections would also have been avoided. The million victims with avoidable illnesses went on to infect others, and they in turn, still more victims. Those further cases and deaths could have been avoided.

All of these, with their exponential consequences, were the result of the delays that Donald Trump caused when he ignored the warnings, falsely claimed coronavirus was under control, refused to take action, and did his best to sabotage the prescribed precautions for controlling the pandemic. Almost certainly, well over 100,000 lives have already been lost due to Donald Trump’s criminal neglect, and many more are at risk.

The suffering that has come from the worst economic disaster of our lifetimes – what should be described as the Second Great Depression – is also Trump’s legacy. Had Trump taken the steps urged on him at the outset of the crisis, the economic harm would likely have been far more limited. Recognizing the real challenge – instead of simply engaging in denial because “the stock market will be spooked” – would actually have prevented mostly of the economic carnage.

When a president ignores grave warnings of imminent harm, places his electoral prospects ahead of his duties to the American people, divides the nation, and undermines his own government’s efforts to respond to a lethal pandemic, he is responsible for what follows: death and illness on a massive scale. The buck stops with President Trump.