America: Trumped by coronavirus

The Pandemic President: Is Trump America’s chief problem in its struggle against COVID-19?

Rarely has there been such a huge disparity between the kind of leadership a country needs at a time of crisis and what, in fact, exists. As the number of confirmed cases of COVID-19 in the United States surges past the half-a-million mark, it is evident that President Donald Trump’s lack of leadership has created a national emergency of epic proportions.

Almost 19,000 fatalities have been reported so far, many times the number killed in the 9//11 attacks. Trump’s ineptitude and callousness is costing the country heavily in terms of human lives.

In New York, the epicentre of America’s coronavirus crisis, hospitals and morgues are overwhelmed. Doctors, nurses and other staff are struggling with an acute shortage of personal protective equipment like gloves, goggles, masks and overalls as well as medicines and ventilators needed to treat patients.

Trump is, of course, not to blame for the pandemic itself. The roots of the coronavirus outbreak lie in China. However, he cannot escape responsibility for America’s unpreparedness to fight the pandemic.

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According to Trump, “nobody knew there would be a pandemic or epidemic of this proportion.” That’s not true. American officials, including some in Trump’s own administration, and public health experts have been drawing attention for years to an impending pandemic risk to the US. A 2017 Pentagon report warned of a “likely and significant threat” from “a novel respiratory disease, particularly a novel influenza disease.” The report refers several times to the novel (meaning new to humans) coronavirus. A September 2019 report by Johns Hopkins Center for Health Security stressed the urgent need to improve preparedness for epidemics and pandemics that might be caused by high-impact novel respiratory pathogens. Other reports underscored the scarcity of ventilators, beds and personal protection equipment in the US.

Not only did the Trump administration ignore their warnings but also, it weakened and even dismantled institutions and departments set up specifically to deal with pandemic threats. It badly undermined the US’ capacity to assess the pandemic’s significance and spread by slashing the number of staff tasked with identifying health threats emerging in China. It repeatedly sought to slash funding for the US’ top public health agency, the Atlanta-based Centers for Disease Control and Prevention.

The National Security Council’s Directorate for Global Health Security and Biodefence that former president Barack Obama had set up in the wake of the Ebola crisis to lead federal coordination and preparation for disease outbreaks was disbanded by the Trump administration in 2018. Had it been left intact, the government may have been able to respond more swiftly before the virus engulfed America, officials say.

Public health infrastructure in the US has always been fragile. For this, Trump alone is not to blame; successive administrations have acted systematically to weaken it. Their actions have denied the poor and unemployed in the US access to healthcare. Trump’s contribution to this mess has been significant. A part of the problem is that Trump can only see issues in terms of dollars spent and profits made. Consequently, expert teams and institutions that are not yielding monetary profits or are not needed currently can be dispensed with. This logic appears to have driven his decision to dismantle the NSC directorate, for instance.

Trump has defended that decision by arguing that should the need for a pandemic team arise, it could be brought back “very quickly.”

But that is not the way a country prepares to fight a pandemic. Necessary infrastructure is built over the years, medicines and equipment are stockpiled and strategies charted well before the pandemic strikes. Capacity to fight the coronavirus cannot be built overnight.

An important reason for the US government’s poor preparedness to fight the coronavirus is its skewed priorities and for this, it is not just Trump who is to blame. Successive administrations have prioritised military preparedness over public health. According to one estimate, pandemic preparedness received a paltry $1 billion compared to $100 billion set aside for counter-terrorism efforts in 2016.

In the three years since he entered the White House, Trump has undermined US capacity to fight pandemics. He could have undone at least some of this damage had he sought the counsel of public health experts and put in place at least a few robust fire-fighting measures if not a coherent strategy. He did not.

Through February and March, his response to the pandemic was one of scapegoating, denial and disingenuousness. Trump’s energies were directed at blaming China instead of fixing the rot in the US public health system. He dismissed reports that the US was staring at, perhaps already engulfed in a massive public health crisis. He downplayed the lethality of the coronavirus and equated COVID-19 to the ordinary flu. The situation was “under control,” he repeatedly claimed.

Had he green-signalled mass testing for coronavirus infections in February or even March, the US could have identified coronavirus clusters and quarantined them swiftly. Even as the administration plodded along without direction or sensible and sensitive leadership, the coronavirus was silently spreading. The tragic and chaotic scenes visible in New York hospitals are the outcome of a failure of leadership.

Of particular concern now is Trump’s strong advocacy of an anti-malarial drug, hydroxychloroquine, in the treatment of COVID-19, with the President even threatening India into supplying the drug to the US. Little is known about its effectiveness in treating COVID-19; rigorous scientific studies and clinical trials on its efficacy in fighting the coronavirus are yet to be done. Still, the FDA has gone ahead with an emergency order authorising doctors to use hydroxychloroquine in treating COVID-19 patients.

Should hydroxychloroquine prove to be effective in treating coronavirus patients, several pharmaceutical companies—some of them are close to the President—stand to gain. Indeed, the Trump family holds stakes in Sanofi, a French drug-maker of hydroxychloroquine. Should the drug be sold at a high price, as is widely expected, it will remain beyond the reach of most Americans.

Infectious diseases experts have warned that administering hydroxychloroquine could prove disastrous. The drug has several deadly side-effects. It can, for instance, cause heart arrhythmia that can lead to cardiac arrest. It could, thus, worsen the problem rather than provide a solution.

If that comes to pass, it will reaffirm America’s problem: its President. And he cannot provide solutions to the coronavirus pandemic, when he is the problem.

(The writer is a foreign policy and security analyst based in Bengaluru)