How America Bungled the Plague | NYT Opinion

There is a graph that has to do with the coronavirus that leaves me speechless. Does it look like this. This graph shows coronavirus cases in the United States versus the European Union. Do you see what's happening here? They all experience a surge at about the same time, but while the European Union falls dramatically, the United States plateaus for a while and then soars. This surprises me because the United States is perhaps the most prepared country in the world for a pandemic. The US government has an actual manual that tells us what to do in the event of a pandemic.

Not to mention it's like the richest country in the world, with the best health institution in the world, the CDC, literally fighting pandemics in other countries and teaching even our peers how to do epidemiology. And yet, you look at this graph and wonder: what happened? I want to piece together a timeline to find out how this happened. How does the country work with more money and experts and the C.D.C. And a literal manual on a pandemic ends with so many deaths and ends with a graph like this? "The countries best and worst prepared for an epidemic, we are ranked number one in preparedness." "Europe has largely contained the virus." "Nearly 200,000 Americans dead from Covid." "We are very good. “Our country is doing very well.” As I piece together this timeline, I'll need help.

And for that I turned to Nick Kristof. He is a Pulitzer Prize-winning journalist. He speaks Mandarin. He has been around the world, reporting and explaining public health crises for decades. I always felt like I came from the country that helped invent public health. And now, my own country, arguably the most powerful country in the history of the world, has taken a challenge we knew what to do with and squandered it in ways that needlessly cost so many lives. So if I want to understand how this all developed and how we got a graph like this, where do we start?

Let's go back a long time, before we paid attention to this. I thought our timeline would start in January 2020, but Nick told me to go back even further, to 2005. That summer, President George Bush was vacationing at his ranch in Texas when he got his hands on this book. It was about the Spanish flu that killed tens of millions of people in 1918. This book scared George Bush. He returned to Washington and immediately got to work putting together a plan, a step-by-step guide to what the United States should do if a pandemic came to our country. He called it a manual for pandemic response.

President Obama developed his own playbook that included very specific plans for what the government should do in the event of a disease outbreak, including specifically citing coronaviruses. This pandemic playbook was then passed on to the Trump administration. "We left them the detailed manual, which specifically cited the new coronaviruses. Other than leaving a flashing neon sign in the Situation Room that said, 'Beware of a Pandemic,' I'm not sure what else we could have done. No one knew. when the big pandemic would come, what it would be like. But still, the previous two administrations were obsessed with making sure we were prepared “But if we wait for a pandemic to appear, it will be too late to prepare So now let's move forward to the moment.” in which the big problem occurred.

And that part of the story occurs on the last day of 2019. On December 31, 2019, a report comes in of 44 people with pneumonia from a fish market in China So, at this point, it seems. which is a pretty small issue. That's 40 people with pneumonia in China. So who in the US would care or have this on their radar in the first place, about the risk of that? This could be something serious. The World Health Organization was communicating with the CDC, the CDC was communicating with the administration, and in fact, it appears to have made it into the president's daily briefing in early January. "Let's start here with the outbreak of a mysterious virus in China that now has the World Health Organization on edge." I heard that China was hiding information.

And that didn't prevent American experts from getting a full picture of what was happening? Yes, absolutely, China behaved irresponsibly and was hiding information. But we had channels to China, to the World Health Organization. We got feedback about what was really happening. It's mid-January and coronavirus is potentially a cause for concern. Didn't you have an important phone call with President Xi Jinping? But what they talked about was trade. But it doesn't get any bigger than this, not just in terms of a deal. Tell President Xi: "President, go out and play a round of golf." It was a huge, huge missed opportunity, so we missed these first two opportunities to take those early reports very seriously and that call with Xi Jinping, which potentially could have been a health collaboration to stop the virus.

The coronavirus had not even been detected in the United States yet. “Gwen Stefani and Blake Shelton aren't engaged yet, right? “I’m definitely not married.” Then, as the United States prepared for the Grammys and the Super Bowl, the coronavirus quietly arrived in our country. The first case was reported in Seattle on January 21. Right now, Trump has been hearing more and more warnings from intelligence reports from him as well as from the CDC. And when news of the first case in the United States breaks, Trump heads to Switzerland to speak at the World Economic Forum, where he talks a lot about China, but not about the virus. "Our relationship with China right now has probably never been better." Man, maybe imagine what could have happened at this moment.

At the end of January, the president reads his report. He says, oh wow, this is real. This is spreading globally. We need to take this seriously. He calls Xi Jinping back and says, Hey, Xi Jinping, I know we've been talking a lot about trade, but why don't we talk about this virus coming from your country to mine? What should we do to solve it? And Xi Jinping says: yes, you're right, let's do it. Trump stands up to tell the nation that a pandemic is coming and that we have to be prepared for it, but don't worry because we are super prepared.

We have all the plans. We have a literal playbook for a pandemic. We have money. We have experts. We can crush this. “Have you been informed by the CDC?” "Yeah". “Are there words about a pandemic right now?” "No, not at all, and we have it totally under control. He is a person who comes from China, and everything will be fine." There was some hope that we really could have removed it by early January and avoided this catastrophe for the world. Instead, our leaders and our citizens were completely focused on other things: “The Grammy Awards are finally here.” "CNN Breaking News". "Kobe Bryant...

Has died in a helicopter crash." “Special coverage of the impeachment trial.” "I did not do anything wrong. Then, in late January, the virus arrived in the United States. There are cases reported here. Now we are aware that it is a problem. I guess what the answer is. What has the United States done in that moment? The first step in responding to a disease like this is to find out where it is, which means developing a test. “We have 12 cases, 11 cases and many of them are in good condition now. , then." The United States and South Korea had their first reported case of Covid-19 on the same day.

A month later, South Korea, which, by the way, has about a fifth of the number of people the United States has , had tested 13,000. Here in the United States we tested 3,000 people. “I'm not afraid of the coronavirus, and no one else should be that afraid of it either.” "This was in the old manuals. Testing and monitoring where the virus is is like a fundamental step in the response to a pandemic. They can't get the federal government to improve testing because they just want to say how good it is." "And testing won't be a problem at all." “So this fight to develop a test, wasn't it more of an issue between the FDA, the CDC and the HHS over who was going to do the testing?

Testing in the United States was the result of bureaucratic infighting, but if President Trump had shown the same passion for getting a test that he showed for building a wall or endorsing hydroxychloroquine to treat the coronavirus, we would all have had a test. ready to go live nationwide in late January/early February. “Hydroxychloroquine, we are hearing really positive stories. I think it's good. stories." Sierra Leone, in West Africa, had an effective test before the United States and, as a result, we didn't know where the virus was. "It seems like, in April, they were working hard. "In theory, when it's a little longer of heat, miraculously disappears." And then, Americans began to die.

It started with just one in February, but soon one became 10 and soon it was 100 a day, and then 200 a day, and 500 a day. the thousands And then April came. And in one month, 57,000 Americans died from Covid-19. So was there a moment when you realized this was getting out of control? and the ICUs at the beginning of the crisis. And that was when people were still talking about the coronavirus being like the flu and, meanwhile, these emergency rooms were packed. The doctors and nurses were traumatized. " "I need a fan." And the strength of those doctors contrasted with the irresponsibility of our political leadership. “And again, I said last night, we did an interview on Fox last night: they have to be calm.” “A lot of the places are actually in pretty good shape.

They have really done a fantastic job. We have to open our country. We cannot allow the cure to be worse than the problem itself. The problem. We have to be calm. I have seen many grim illnesses, but the combination in Covid of such a large number of people dying, completely alone because their loved ones cannot go with them, saddens me, but also angers me because this was so unnecessary. , so let's figure out where we are. It's April, and we haven't really figured out the early response, but now we're in the middle of a crisis. There is a crisis in the United States.

So the big question here is: what do you do once you're in the middle of this crisis? And in my conversations with Nick, and in all of these manuals, there's one topic that keeps coming up, which is health communications, which sounds like a boring government public service announcement: "Larry, you know this simple exercise can help you stay healthy." I didn't even know what that meant to begin with, but as I looked into it, I started to realize that there was something there, the Bush playbook says, the need for timely, accurate, credible, consistent information. The extent to which it is tailored to specific audiences cannot be understated.

So it turns out that, when a country is descending into pandemic chaos, one of the most important, if not the most important, things a government can do is communicate to its citizens how important and important it is. This is risky. “And on the 15th, in a couple of days, it will be reduced to almost zero.” "Staying at home also leads to death." “Are they telling Americans not to change any of their behaviors?” “No, I think you always have to… look, I do it a lot anyway, as you probably heard, wash your hands, stay clean. You don't necessarily have to hold on to every handrail unless you have to. you do certain things you do when you have the flu.

I mean, consider this the same way as the flu.” “The CDC recommends that Americans wear a cloth or basic cloth mask. “This is voluntary.” "It's easy to focus only on President Trump's failures, but look, there are a lot of failures everywhere, and this involves both blue states and red states. New York was particularly hard hit, in part because New York leaders initially did not They took this seriously enough. Mayor Bill de Blasio tweeted that people should get on with their lives and go out into the city. It would be hard to think of any signal a leader could send that was more wrong and more deadly than that. tonight, FEMA will bring in hundreds of ambulances to assist with record-breaking 911 calls in New York This morning, as an emergency field hospital is being built in iconic Central Park... "All those beds, all 20,000 of them, will have them. "We just blew it.

And the result was that Americans didn't take the virus as seriously as other countries. Okay, so the United States got it wrong when it came to health communications, while Europe and many countries around the world got it right. I want to know what is the real proof that this is the key to solving it. Is it just because the playbook says so or becauseNick says it? Well, I got some data that really helped me understand this. Google collected data from several people's phones to track before and during the pandemic how people's movement changed. If you put that data together on a map, you'll see something really interesting.

If you look over here, you can see these dark blue areas, which represent countries that closed between 80 and 100 percent. This means they didn't go out, they didn't go shopping, they didn't go to the movies. They stayed home as the government implored them. Austria closed at 64 percent, France at 80 percent, Ireland at 83 percent. This entire movement was shut down in the name of defeating the virus. Meanwhile, here in the United States, we're at about 39 percent that same day in late April. We never really closed. One of the basic things about this pandemic is that if people really take it seriously and for four or six weeks comply with the stay-at-home orders like Europe did, with 90 percent of travel closed, then the virus stops dead.

Other countries did it, one after another. The United States could never do that. We fought the virus and the virus won. Once again, I can't help but think about what could have happened if our president had stood up and said, "My fellow Americans..." This is going to be very difficult. We have to shut down our entire country. Not just urban points, the entire country. It's going to be painful, but it will help us reopen our economy more quickly and help save American lives. But that didn't happen. I remember looking at the charts in April and seeing the daily deaths increase so quickly, skyrocketing.

The natural response would have been to say, wow, slow down, we need to really adjust things and learn from other countries that have done better. But instead, the next day: Surprisingly, the president attacks stay-at-home orders in states across the country and encouraged his supporters to liberate states like Michigan. This was a neglect of science and public health advice, a lack of empathy for those who were dying. I don't know what to call that failure except an example of extraordinary incompetence. I find that really heartbreaking. This is where the graph starts to surprise me and really starts to get to the heart of my big question of why these lines look so different.

Notice how Covid cases are leveling off in the US, but in Europe, cases are starting to look like this. Our peers stepped up and did the hard work to get ahead of the virus by following the basic pandemic measures articulated in all plans, including our own playbooks. They saw the results of that. The United States, on the other hand, plateaus a bit and, in mid-June, starts to skyrocket again. "In the three most populous states in the country, things are going from bad to worse." "California, Texas and Florida are in crisis." “Today more than 5,000 Covid-related hospitalizations are reported.” And although Europe is experiencing a rebound now, this gap needs to be analyzed.

This gap represents a lot of unnecessary suffering and death for tens of thousands of Americans. I understand that we are going to make mistakes. This is a difficult thing. Many countries made mistakes. But what worries me is that we simply didn't learn from them. We don't self-correct. Instead, we double down on our mistakes. And then we just gave up. Ok, now I feel like I understand much better why our graph looks like this compared to other countries. It has a little to do with those early mistakes and whatever, but they're kind of forgivable. Rather, it's what happened once the pandemic hit and devastated and killed Americans.

Instead of having leaders telling us what we needed to do to get through this risky and uncertain time, we had leaders who denied that this was even a big problem and then eventually just gave up. The death certificates of more than 150,000 Americans will say something like Covid-19. In a broader sense, what should be written on those death certificates as the cause of death is "incompetence."