When leadership matters


There are legitimate fears of a coronavirus pandemic — don’t panic, it’s an emerging threat, not a full blown emergency — and that’s when it’s a good idea to prepare. We should have a strong medical infrastructure, plans in place, people organizing now, just in case. In the US, however, our plan to respond to potential medical threats is a shambles.

For the United States, the answers are especially worrying because the government has intentionally rendered itself incapable. In 2018, the Trump administration fired the government’s entire pandemic response chain of command, including the White House management infrastructure. In numerous phone calls and emails with key agencies across the U.S. government, the only consistent response I encountered was distressed confusion. If the United States still has a clear chain of command for pandemic response, the White House urgently needs to clarify what it is—not just for the public but for the government itself, which largely finds itself in the dark.

Who is to blame for the chaos? It seems Obama had a thorough, if flawed, response team in place. One man and one party have been actively working to dismantle the entire system.

In the spring of 2018, the White House pushed Congress to cut funding for Obama-era disease security programs, proposing to eliminate $252 million in previously committed resources for rebuilding health systems in Ebola-ravaged Liberia, Sierra Leone, and Guinea. Under fire from both sides of the aisle, President Donald Trump dropped the proposal to eliminate Ebola funds a month later. But other White House efforts included reducing $15 billion in national health spending and cutting the global disease-fighting operational budgets of the CDC, NSC, DHS, and HHS. And the government’s $30 million Complex Crises Fund was eliminated.

In May 2018, Trump ordered the NSC’s entire global health security unit shut down, calling for reassignment of Rear Adm. Timothy Ziemer and dissolution of his team inside the agency. The month before, then-White House National Security Advisor John Bolton pressured Ziemer’s DHS counterpart, Tom Bossert, to resign along with his team. Neither the NSC nor DHS epidemic teams have been replaced. The global health section of the CDC was so drastically cut in 2018 that much of its staff was laid off and the number of countries it was working in was reduced from 49 to merely 10. Meanwhile, throughout 2018, the U.S. Agency for International Development and its director, Mark Green, came repeatedly under fire from both the White House and Secretary of State Mike Pompeo. And though Congress has so far managed to block Trump administration plans to cut the U.S. Public Health Service Commissioned Corps by 40 percent, the disease-fighting cadres have steadily eroded as retiring officers go unreplaced.

But here’s what worries me most: the systemic incentive to continue to wreck what system we have. There is no price the Republicans will have to pay. People will die, the country could be thoroughly disrupted, and the demagogues will just blame it all on the Democrats, or the Chinese, or Islamic terrorists, or filthy disease-ridden immigrants, and people will want to believe them, and everything will just get worse. In fact, catastrophe will strengthen their grip on the country.

Heckuva job, Trumpy.

Comments

  1. says

    This is that old conservatism can’t fail it can only be failed thing. I have a theory and when that theory breaks up on reality, it isn’t the theory’s fault it is reality’s fault.

  2. says

    If this coronavirus grown into a full blown epidemic here in the states, it’s going to hit the poor urban minorities hardest. That’s how it always happens. The most marginalized and vulnerable are the first to start dying. I really hope it doesn’t go this way, but we have no systems in place to prevent this disease from spreading out of control.

    It’s too much to hope that this will serve as a wake up call. 50% of the country will just shrug it’s shoulders and say “Well we didn’t want them brown people here anyway”.

  3. whywhywhy says

    Related to this is the discussion of universal health coverage in any form. A healthy population where everyone has access to healthcare is one of the best things a country can have to withstand an outbreak. This is an argument that seems ready to be made that might fight through the anti-poor (and flat out racist) message used to fight universal coverage. Because if the poor in this country are healthy this protects everyone including the wealthy (and white).

    Is the Masque of the Red Death not required reading anymore?

  4. komarov says

    Re: whywhywhy (#5):

    A healthy population where everyone has access to healthcare is one of the best things a country can have to withstand an outbreak.

    But that’s just the herd immunity argument for vaccination in a slightly different context. An argument that’s roundly ignored by people who’d rather believe tha vaccination doesn’t work (or worse) The same would happen here. Sensible thinking, no matter how obvious it might seem, is easily dismissed in the face of self-interest or personal belief, apparently. And the Republicans are busily demonstrating that self-interest and (possibly) personal belief are the core values of the party.

  5. springa73 says

    I wonder if Trump’s crippling of the US efforts to fight disease is part of his “have to undo anything that Obama did” complex.

  6. benedic says

    Much panic work wide . headlines about “a” death. Meanwhile I am told ,here in France, more than one hundred folk are projected to have died of the Flu Virus. Nothing about that in the Press.

  7. robro says

    Ray Ceeya @ #3 — I made a similar case to my partner, because it’s generally true, but she reminded me that the 1918-1920 Flu Pandemic or Spanish Flu “resulted in a higher than expected mortality rate for young adults” (WikiPedia citing a PLOS ONE study from 2013). Death knows no age, and viruses don’t know the rules.

  8. Akira MacKenzie says

    In 2018, the Trump administration fired the government’s entire pandemic response chain of command, including the White House management infrastructure.

    Remember, Trump is one of the assholes who was shrieking to close the borders during the last big Ebola outbreak a few years back. So it doesn’t surprise me that’s what he’s trying to do now with China rather than… I don’t know… actually deal with the disease.

  9. cartomancer says

    The thing that confuses me most about the state of things in the US is that there have been almost no calls by individual states to break away from the federation and set up something more sensible and progressive.

    Why not? Separatist movements abound in most nations – from our own Scottish and Irish regions here in the UK to the Basques and Catalans, to the French Canadians and many others. What is it about the Californians or the New Yorkers or the rest of you that doesn’t recognise what to most regions with progressive majorities in otherwise regressive nations is the obvious choice.

  10. leerudolph says

    Is the Masque of the Red Death not required reading anymore?

    Was it ever?

    It was (or so I think I remember) in the Cleveland OH public school system 60 years ago (while I was in the 7th or 8th grade at Wilbur Wright Junior High School).

  11. F.O. says

    In fact, catastrophe will strengthen their grip on the country.

    This is what scares me shitless.
    Those in power have an incentive to let things go south.
    It’s a perverse vicious circle.

  12. a_ray_in_dilbert_space says

    The thing is that when your entire philosophy of government is that government sucks, there really isn’t any incentive to make government better. Quite the contrary–since anything of value that the government provides to people shows that government can work to make peoples’ lives better.

    This is why Rethugs want to privatize anything they can make a buck off or and dismantle anything they can’t: roads, weather forecasting, facts from the Census or scientific research organizations. They’ve all got to go so the billionaires can buy more yachts and houses and paintings. And if a few people have to die of flu or corona virus, well that’s just the price of freedom

    Think I’m exaggerating? The National Review is accusing Michael Bloomberg of lying in his add saying nearly 2900 children dye of gun violence every year. Why? Because the number includes 18- and 19-year olds. Remove these, and it’s still nearly 1500, but somehow 1500 kids + nearly1400 18 and 19 year olds dying of gunshot wounds is acceptable.

    I really cannot empathize with these people, and what’s more, I don’t want to.

  13. springa73 says

    cartomancer @12

    There are a few reasons, I think:

    The US Civil War set the precedent that the federal government will not allow states to leave if they don’t like the policies of the federal government. Whether the federal government would react the same way over 150 years later is an open question, but most people don’t want to test it
    In a related point, most people in the US associate states trying to leave the US with massive bloodshed. Depending on estimates, anywhere between 600,000 and nearly 1 million people died during the US Civil War, more than the US killed in every other war in US history combined. Today, with the US population more than 10 times larger than in 1860, a war of comparable magnitude could kill between 6 million and 10 million. Again, whether there would be a major war is an open question, but these are the associations that I think a lot of people carry in their minds. I certainly do.
    When people have talked of breaking away from the US, it has usually been people on the far right. For more than 150 years, both actually breaking away and threatening to break away from the US have been associated mainly with the far right. I think that this also makes people on the left and center even more reluctant to support breaking away.

  14. a_ray_in_dilbert_space says

    Regarding secession, first, as long as the South held fire on Fort Sumter, the Federal gummint did not consider their actions an insurrection. Second, the slavery issue was one that could be defined by geography–the slave states were in the South and the Free states in the North.

    Contrast that to the situation we have now. The cities, by and large are blue–even in red states–and the hinterland is largely red–even in blue states. So, if a state secedes, it takes its problems with it.

  15. says

    @#3, Ray Ceeya

    The coronavirus currently has a fatality rate of about 2.07% — 362 fatalities worldwide out of 17488 cases. (That has actually dropped over the last couple of days — last time I did the calculation, the rate was over 2.3%.) Because the US population is large, it would cause a lot of deaths here as a pandemic, but it wouldn’t be some kind of apocalyptic dying-people-crawling-through-a-collapsing-cityscape disaster.

    In a certain sense, we’re lucky that we got coronavirus now, when Trump has dismantled things, rather than the ebola outbreak from a few years back.

    @#9, benedic

    Yes.

    @#10, robro

    Wikipedia is understating the facts, there, IIRC. The usual annual graph of mortality by age for flu is approximately U-shaped — infants and the elderly die in large numbers, older kids and adults don’t die unless they have prior issues to complicate things. But the 1918 flu had a mortality graph which was more W-shaped; people from 18-30 died in very large numbers as well.

    (The reason seems to be that people with very strong immune systems ended up having major responses to it, which caused their bodies to build up the waste products — mucus and dead white blood cells and so on — faster than could be eliminated, so that people choked to death as their lungs filled up, and so on. Not by any means a pleasant way to die — but there is no sign whatsoever that the current coronavirus epidemic does that.)

    @#12, cartomancer

    Among other reasons stated above, if California and/or New York were to leave the US, it would suddenly mean they shared vast land borders with a country which not only had the world’s largest military and nuclear arsenal but which would have a government which would be permanently and irretrievably majority-right-wing. Trump would look reasonable and sane compared to what the remaining US government would be after that.

    @#2, Ronald Couch

    This is that old conservatism can’t fail it can only be failed thing. I have a theory and when that theory breaks up on reality, it isn’t the theory’s fault it is reality’s fault.

    Yeah, it’s terrible. Good thing only one party has an ideology which consistently fails but gets reinforced after every failure. It would be absolutely horrifying if the alternative to mindless conservatism was a bunch of mindless centrists who insist on enabling the Republican party time after time after time. Can you imagine if the Democratic party had lost to Trump by backing a pro-war, pro-Wall-Street candidate, and then were pushing another one in 2020? Why, sane rational people would be storming the DNC headquarters and demanding heads on pikes. Good thing that hasn’t happened, huh?

    @#15, a_ray_in_dilbert_space

    The National Review is accusing Michael Bloomberg of lying in his add saying nearly 2900 children dye of gun violence every year. Why? Because the number includes 18- and 19-year olds. Remove these, and it’s still nearly 1500, but somehow 1500 kids + nearly1400 18 and 19 year olds dying of gunshot wounds is acceptable.

    Yes, the argument there is deliberately misleading — but this is also a perfect example of centrist behavior. This quibble is a matter of “technical correctness is the best kind of correctness” — nobody really counts 18- and 19-year-olds as “children”, so the objection was technically reasonable and entirely foreseeable. Bloomberg (or, at least, his campaign) could have made a perfectly good and shocking ad using the reduced claim, or could have modified the wording to be technically correct, but they arrogantly assumed that nobody would question their claims enough to fact-check them, and as a result they left a handle for the right to nullify one of the very few progressive policies Bloomberg might actually be expected to undertake. If I thought Bloomberg actually had any chance of getting to the White House, I would suggest that this was done on purpose, so that he would be able to do nothing on that issue without getting called out on it, but as it is it’s just another bit of arrogance and stupidity from centrists.

  16. nomdeplume says

    You know another cult that set about dismantling civilised society when it gained power? ISIS.

  17. unclefrogy says

    knowing trump’s business history why is anyone surprised. his self-inflicted failure is the usual course of action he takes, then declare bankruptcy of that entity as separate from the main business and make money on the lose, leaving the debt to someone else to clean up or sue over which also precipitates the further collapse.
    He is incompetence personified and does and says all for show
    only we are the ones holding the bag when it all goes south.
    this is going to be an interesting year or two!
    uncle frogy

  18. F.O. says

    @nomdeplume #20
    ISIS are literally Muslim supremacists.
    Their ideology is the same as that of white supremacists.

  19. brucegee1962 says

    If one state or group of states were to vote to leave the US, first of all, there would be a maelstrom of court madness on the question of whether such a vote was legal in the first place. The last time secession was declared, it was rendered illegal not through the courts, but through fire, the sword, and blood. Isn’t that a precedent that should take priority over any and all legal precedents?
    Also, suppose that, say Texas, Louisiana, and Mississippi were to all secede due to a decade of liberal governance. They want to set up a new constitution, which will strip rights from its minority citizens. But a bedrock of American belief is that if citizens have civil rights, then those rights cannot be taken away by any majority vote — so the Supreme Court could not sit by if citizens of the new nation claimed they were still US citizens and demanded protection. But the new nation, of course, would not recognize jurisdiction of the US Supreme Court. So then what?
    Also, in the scenario above, the remaining conservatives in the US would realize they would always be in the minority and outvoted for the foreseeable future — so they’d have a strong incentive to secede as well, if the original state or states got away with it. Splitting up into 6-12 smaller subnations seems the most likely outcome.
    The best case scenario in such a situation might be something like the India-Pakistan split, where red state liberals and blue state conservatives try to swap properties. But that’s hardly a reassuring scenario, since that particular historical example had plenty of violence.
    And after the US splits up, there will still be bad blood between all the smaller states. How are they going to cooperate when they’ve already shown they can’t fundamentally get along?
    I think all these reasons are why secession movements haven’t caught on yet. Nevertheless, if political divisions here keep on as they have, I’d give even odds for all of what I just wrote happening by 2100.

  20. ardipithecus says

    I’d be wary of stats that show the lethality of the beerflu dropping. The vast majority of those infected haven’t had the disease long enough to die from it yet, which makes it look less deadly that it is.

  21. says

    @Cartomancer #12
    One thing to understand about America vs. other countries, is that in most of the countries with active separatist movements have ethnic, cultural, and/or linguistic groups with hundreds of years of distinct history, and a region of an old, established country is practically a nation all to itself.

    America has none of that. Its population moves around constantly, driven hither and yon by the job markets. It is not made of places but properties, not land but real estate. In the post-WWII suburban boom, America accomplished through “democracy” what Stalin could only dream of doing through dictatorial control–to annihilate all semblance of locality and rootedness among the people, dispersing and homogenizing them across the whole country, and regional culture hardly extends past music scenes and barbecue styles. The “melting pot” stripped even Western European immigrants of their unique cultures and turned them into plastic Anglos, even worse than the WASPs themselves. There are only two groups left with a sense of regional and cultural identity in the United States–Latin@ people who resist assimilation, and Native American people. Incidentally, both do have separatist movements, far more vigorous and dedicated than any possessed by Anglo people, and if either of them got what they want and deserve, “America” not just as a political entity but as an idea would have to disappear–because that idea is centered on denying the destruction of their nations and the theft of their land, without which America never would have existed.

    When the cheap energy stops and the dream is over, the bloodshed in America will make modern failed states look like a joke. There are not even pieces for America to break into, no borders to lay mines across; no foundation on which to build a New York Liberation Army or Atlantan Commonwealth. it will be as close as any place has ever come, maybe ever will come, to a true Hobbesian war of all against all.

  22. katahdin says

    Michael Lewis talked about these cuts in his fascinating book “The Fifth Risk.”

  23. jack16 says

    In “Catching Fire” Richard Wrangham has a discussion of the 1918 influenza epidemic and explains its special morbidity.

    jack16

  24. says

    @#24, ardipithecus:

    From livescience.com:

    In the beginning of an outbreak, the initial cases that are identified “skew to the severe,” which may make the mortality rate seem higher than it is, Alex Azar, secretary of the U.S. Department of Health and Homeland Security (HHS), said during a news briefing on Tuesday (Jan. 28). The mortality rate may drop as more mild cases are identified, Azar said.

    Currently, most of the patients who have died from the infection have been older than 60 and have had preexisting conditions.

    Whether you want to believe Alex Azar on that or not is another question, but note that last sentence: most of the mortality comes from people who are both older and already ill in some way.

    I would love to quote an authority on the speed of the progression of the illness, but I can’t find any definite information other than the rate of onset of symptoms (2 to 14 days, with a current suggested average of 5) and the added information that most coronavirus infections (of the whole family, not this specific variety) tend to last 2 to 3 days. If that is the case with the new variety, then actually the somewhat decreasing mortality statistics are potentially valid, because most of the reported cases from last week have already resolved.