The Coronavirus Pandemic and the Flim-Flam Man in the White House

Bob Sheak, April 10, 2020

bobsheak@gmail.com

In this post, I draw on sources documenting that for many weeks Trump paid little attention to the emergence and spread of the coronavirus in the United States. He did acknowledge its existence enough to order a loosely enforced travel ban on China. However, many weeks would pass before the president would acknowledge the presence and spread of the coronavirus domestically. Then, his responses were often to minimize the problem and to tell the public that it was under control and would shortly go away. As the outbreak spread and the contagion became a full-blown pandemic, Trump still failed to face up to the unfolding crisis. In the meantime, we learned how states, cities, hospitals, and other places did not have the basic medical supplies to deal with the growing number of infected people. And there were shortages in all aspects of the growing health crisis, including few tests to identify who had the disease, not enough personal protective equipment for medical personnel, under-resourced hospitals unable to ensure there would be enough beds, ventilators and personnel to treat patients afflicted by the COVID-19 virus.

Recent news reports are mixed. On one hand, the federal government and a variety of for-profit and non-profit organizations are filling some of the gaps in testing, medical supplies, and even deploying the army engineers to help in some places. However, there are also reports and news accounts documenting scarcities of medical supplies and personnel and how the prices for medical gear are being driven up by intense competition. Though the president brags at the press conference on April 9 that there have been two million tests for the virus, the great majority of Americans, even in the hotspots, have not been tested. Lastly, while Trump tells us that he is in regular contact with governors and mayors, he has failed to provide a plan that would provide leadership and only a patchwork of responses to the unfolding pandemic.

Rather, Trumps has said himself that he is a “backup” addressing the crisis in a helter-skelter manner. Then he also portrays himself as a “cheerleader,” with the responsibility to keep the morale of the people up by painting a rosy picture that the pandemic will soon be vanquished (the end of April, he suggests),  the social-distancing restraints on people and businesses will be eased, and the economy will rebound to unprecedented heights of prosperity and growth. In the meantime, the federal government itself is running out of supplies to share and, because most people have not been tested for the virus, the scope and location of the contagion cannot be sufficiently identified. At the same time, the Congress, the president, and the central bank have poured trillions of dollars of assistance and loans for businesses, many unemployed workers, with direct cash payments to many Americans, and assorted aide for hospitals and others. At this point in time, though, the country is in a period of unprecedented disruption, with many people and communities left to fend for themselves.

 The Trump and his administration were slow to respond

In a detailed and lengthy report published in The New York Times, Yasmeen Abutaleb and her colleagues document how Trump’s responses to the coronavirus threat were to deny it as a problem for the US, then to downplay its seriousness, and then only after the facts of the contagion were indisputable, acknowledge the scale of the problem. He then began telling the public how the federal government was releasing large quantities of personal protective equipment and ventilators to some states and cities for healthcare workers who are treating patients with COVID-19. The focus of the report by Abutaleb et. al. is that the president spent many weeks downplaying the problem before acknowledging the serious of the contagion and thereby delayed a response by the federal government that was warranted. The report is based on “47 interviews with administration officials, public health experts, intelligence officers and others involved in fighting the pandemic” ((https://washingtonpost.com/nationa-security/2020/04/04/coronavirus-government-dysfunction/?arc404+=true).

Abutaleb et. al. write that the Centers for Disease Control and Prevention (CDC) first “learned of a cluster of cases in China on December 31 and began developing reports for HHS [Health and Human Services] on Jan 1.” Two days later, on January 3, “The Trump administration received its first formal notification of the outbreak of the coronavirus in China.” It took 70 days from that notification “for Trump to treat the coronavirus not as a distant threat or harmless flu strain well under control, but as a lethal force that had outflanked America’s defenses and was poised to kill tens of thousands of citizens.” The journalists add that as a result critical time was “squandered.” During this time, Trump made many baseless and dismissive assertions about the coronavirus, “including his claim that it would all just ‘miraculously’ go away,” assertions that “sowed public confusion and contradicted the urgent messages of public health experts.”

These lost weeks were a time when there could have been “efforts to develop a diagnostic test that could be massed produced and distributed across the United States, enabling agencies to map early outbreaks of the disease, and impose quarantine measures to contain them.” There were protracted “arguments between the White House and public health agencies over funding, combined with a meager existing stockpile of emergency supplies.” The delay “left vast stretches of the country’s health-care system without protective gear until the outbreak became a pandemic.” Consequently, there may have been thousands of deaths from the virus about which we’ll never know. Polls showed that “far more Republicans than Democrats were being influenced by Trump’s dismissive depictions of the virus and the comparably scornful coverage on Fox News.” But their number of Trump’s faithful is in the tens of millions.

There was preliminary action in parts of the administration. The CDC “issued its first public alert about the coronavirus on January 8. On January 10, senior officials at HHS began convening an intra-agency task force that included Robert Redfield, the CDC director, Alex Azar, the secretary of HHS, and Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases. Then by January 17, the CDC had started “monitoring major airports in Los Angeles, San Francisco and New York, where large numbers of passengers arrived each day from China.” Despite such activities, “Trump was not substantially briefed by health officials about the coronavirus until January 18, “when, while spending a weekend at Mar-a-Largo, he took a call from Azar.” Still, the unfolding coronavirus pandemic apparently remained a side-issue of little concern for the president.

On January 21, “a Seattle man who had recently traveled to Wuhan [China] tested positive for the coronavirus, becoming the first known infection on US soil.” Azar then “instructed subordinates to move rapidly to establish a nationwide surveillance system to track the spread of the coronavirus,” but the government did not have the “assets” to adequately support this project. In an interview on CNBC on January 22, “Trump received his first question about the coronavirus,” and answered that he was not worried about a potential pandemic arising in the US, saying: “No. Not at all. And we have it totally under control. It’s one person coming in from China…It’s going to be just fine.” We recently learn that the contagion in New York City came from people traveling from Europe, not China. Kelly McCarthy reports that researchers have determined that the coronavirus outbreak in New York City originated in Europe. She writes: A new study has found evidence that the first COVID-19 cases in New York City originated in Europe and occurred as early as February.” She continues:

“The study, published online by medRxiv and led by researchers at Icahn School of Medicine at Mount Sinai, traced the origin of the outbreak in New York City by analyzing complete genomes of the virus across four boroughs and two neighboring towns prior to March 18” (https://abcnews.go.com/Health/york-coronavirus-outbreak-originated-europe-study-finds/story?id=7006264).

An official task force was set up by then acting chief of staff Mick Mulvany, the existence of which was formally announced on January 29. The Coronavirus Task Force. Its primary focus was “to keep infected people in China from traveling to the United States. Trump announced a travel ban on people traveling from China to the US. However, by this point, “300,000 people had come into the United States from China over the previous month.” In early February, “the administration was quickly draining a $105 million congressional fund to respond to infectious disease outbreaks.” And: “A national stockpile of N95 protective masks, gowns, gloves, and other supplies, was already woefully inadequate after years of underfunding,” including underfunding during the first three years of Trump’s presidency.

Two letters were sent by leaders at HHS to the White House Office of Management and Budget asking to use its transfer authority to shift $136 million of department funds into pools that could be tapped for combating the coronavirus,” and Azar and his aides “began raising the need for a multibillion-dollar supplemental budget request to send to Congress.” After some contentious meetings, the OMB “whittled Azar’s demands down to $2.5 billion,” but Congress went on to approve an $8 billion supplemental bill that Trump signed into law on March 7. Then in late March, “the administration ordered 10,000 ventilators – far short of what public health officials and governors said was needed,” noting also that many of them would not arrive until the summer or fall. On March 11, he ordered a halt to incoming travel from Europe, but the announcement was so botched that White House officials spent days trying to correct the president’s erroneous statements.

Abutaleb and her colleagues describe the wrangling in the administration over how to address the scarcity of effective tests for the coronavirus. Without tests for the virus, the government is flying blind. By March this problem had not been resolved. That didn’t faze Trump. On March 6, he “toured the facilities at the CDC wearing a red ‘Keep America Great’ hat,” and boosting “that the CDC tests were nearly perfect and that ‘anybody who wants a test will get a test,” a promise which even today (April 8), remains insufficiently met, although the number of available test kits is rising. But the evidence that the number of people affected by the coronavirus kept rising. On March 13, Adam Carlson reported that Trump had declared a “national emergency” on that day and did so under the authority of the Robert T. Safford Disaster Relief and Emergency Assistance Act (known as the Stafford Act) (https://people.com/politics/donald-trump-declare-national-emergency-over-coronavirus-pandemic). Carlson writes: “An emergency declaration would allow a state to request a 75% federal cost-share for expenses that include emergency workers, medical tests, medical supplies, vaccinations, security for medical facilities, and more.”

The Navarro memos

There are other sources that confirm that Trump and/or his senior aides were informed about the seriousness of a threat of a new coronavirus long before the president took the threat seriously. Maggie Haberman reports that Peter Navarro, President Trump’s trade adviser, sent a memo to “Trump administration officials in late January [January 29] that the coronavirus could cost the United States trillions of dollars and put millions of Americans at risk of illness or death”(https://nytimes.com/2020/04/06/us/politics/navarro-warning-trump-coronavirus.html). At the time, the administration was considering a travel ban on China, which was approved by the president on January 31, going into effect on February 2. Foreign nationals who had traveled to China in last 14 days would not be allowed to enter the US. Any US citizen who has traveled to China would have to undergo health screening upon entry into the country and asked to quarantine for 14 days. All incoming flights from China would have to land in one of only seven airports (https://theverge.com/2020/1/31/21117403/trump-coronavirus-ban-travel-non-us-citizens-china).

In a second memo sent on February 23 by Navarro to the White House Coronavirus Task Force, Navarro warned of an “increasing probability of a full-blown COVID-19 pandemic that could infect as many as 100 million Americans, with a loss of life of as many as 1.2 million souls.” The implication of the second memo, is based on the idea that it would ultimately be impossible to keep the virus out of the US. The memo focuses on the need for planning and funding to deal with this dire prospect. “The lack of immune protection or an existing cure or vaccine would leave Americans defenseless in the case of a full-blown coronavirus outbreak on U.S. soil. This lack of protection elevated the risk of the coronavirus evolving into a full-blown pandemic, imperiling the lives of millions of Americans.” At the time, “Mr. Trump was playing down the risks to the United States, though he would later go on to say that no one could have predicted such a devastating outcome.” Among other things, the memo called for an increase funding for the government to purchase personal protective equipment for health care workers, estimating they would need “at least a billion face masks” over a four-to-six-month period. As already referenced, the administration asked for $2.5 billion, and Congress approved $8.3 billion and the president signed the legislation into law on March 7.

 The US military had warned the Trump administration about the need to prepare for a pandemic and of the shortage of PPEs years before COVID-19 appeared

There is more evidence that confirms that the threat of a lethal infectious disease like the coronavirus was known in the higher circles of the federal government. Ken Klippenstein reports on how the US military warned the Trump administration back in 2017 about a shortage of ventilators, face masks, and hospital beds (https://www.thenation.com/article/politics/covid-military-shortage-pandemic). Klippenstein writes: “Despite President Trump’s repeated assertions that the Covid-19 epidemic was ‘unforeseen’ and ‘came out of nowhere,’ the Pentagon was well aware of not just the threat of a novel influenza, but even anticipated the consequent scarcity of ventilators, face masks, and hospital beds, according to a 2017 Pentagon plan obtained by The Nation.” Klippenstein continues: “‘The most likely and significant threat is a novel respiratory disease, particularly a novel influenza disease,’ the military plan states. Covid-19 is a respiratory disease caused by the novel (meaning new to humans) coronavirus. The document specifically references coronavirus on several occasions, in one instant saying, ‘Coronavirus infections [are] common around the world.’” This was not the military’s first expression of concern. The 2017 plan was an update of an earlier Department of Defense publication, dated October 15, 2013, on a “pandemic influenza response plan” involving the 2012 Middle Eastern Respiratory Syndrome Coronavirus.”

Klippenstein quotes Denis Kaufman, “who served as head of the Infectious Diseases and Countermeasures Division at the Defense Intelligence Agency from 2014 to 2017, [and who] stressed that US intelligence had been well-aware of the dangers of coronaviruses for years. (Kaufman retired from his decades-long career in the military in December of 2017.)” Kaufman explained that the “Intelligence Community has warned about the threat from highly pathogenic influenza viruses for two decades at least. They have increased their warnings about the potential threat of a coronaviruses for at least five years.” Additionally, “the military plan predicted with uncanny accuracy many of the medical supply shortages that [in a pandemic] it now appears will soon cause untold deaths.” Quoting from the 2013 plan, “Competition for, and scarcity of resources will include…non-pharmaceutical MCM [Medical Countermeasures] (e.g., ventilators, devices, personal protective equipment such as face masks and gloves), medical equipment, and logistical support. This will have a significant impact on the availability of the global workforce.” And, as we now know, such shortages have occurred, as reflected in how the Trump administration (e.g., FEMA), governors, mayors, hospitals, and others compete against one another for needed medical equipment, driving prices up and making it difficult or impossible for some locales to obtain what they must have to avoid being a position where healthcare workers will be at risk of being infected and where some patients may be denied treatment with ventilators for COVID-19. Trump and his administration have begun to address this issue. And in recent days, with the rate of contagion being leveled in Washington State and Oregon, those states are sending a small number of ventilators to other states.

Trump continuously sowed confusion and chaos

Philip Rucker and Robert Costa open an investigative report on how Trump has handled the present coronavirus pandemic with the following words: “In the three weeks since declaring the novel coronavirus outbreak a national emergency [that is, on Friday, March 13], President Trump has delivered a dizzying array of rhetorical contortions, sowed confusion and repeatedly sought to cast blame on others” (https://washingtonpost.com/politics/commander-of-confusion-trump-sows-uncertainty-and-seeks-to-cast-blame-in-coronavirus-crisis/2020/04/02/fc2db084-7431-11ea-85cb-8670579b863d_story.html). Describing himself as a “wartime president,” Trump has defined his role, not as a unifying national leader, but as a mere “backup,” not as one who coordinates and allocates scarce medical supplies so they go efficiently and timely to the locales where they are needed. And when there are shortages, Trump faults “governors for acting too slowly and, as he did Thursday (April 2), has accused [without evidence] overwhelmed state and hospital officials of complaining too much and of hoarding supplies.” That is, if there is anyone to blame for shortages, it’s not him. All the while, Trump tells Americans that he is doing a wonderful job, far better than any other president in history; indeed, as he frequently says in describing his self-considered performance, “incredible.”

Trump also causes confusion when he says America is winning the war against the virus, while “the death toll rises still, and in the best-case scenario [100,000 deaths, as estimates indicated as of April 8] more Americans will die than in the wars in Vietnam, Korea, Afghanistan and Iraq combined.” And that the fundamentals of the economy are strong and, once the virus is vanquished, “will rebound in no time.” Yet, Rucker and Costa point out, the “stock markets have “cratered and in the past two weeks [and] a record 10 million people filed for unemployment insurance, while the number of incidences, hospitalizations, and deaths from COVID-19 continue upward. [The stock market has rebounded somewhat in the second week of April on the news that the Federal Reserve will be channeling $2.3 trillion into the economy.]

At the April 8 televised press conference with Trump and the Coronavirus Task Force,  Deborah Birx, a top epidemiologist coordinating the government’s pandemic response, said that “they were cautiously hopeful that the United States may undershoot the worst-case predictions for deaths of the coronavirus,” according to a report by Philip Ewing and Barbara Sprunt at npr.org. on April 8. On April 9, she said the figure could be as low as 60,000. But she and Fauci also stressed that “the outcomes depend upon Americans adopting and sustaining the mitigation measures recommended by the Centers for Disease Control and Prevention – staying home, avoiding groups of more than 10, washing hands, wearing masks outside and so forth.” And the estimate is based on testing that is woefully inadequate.

The daily press conferences give Trump the opportunity to take credit for any progress there has been in the delivery of personal protective equipment and ventilators. The press conferences sometimes last for well over an hour and are televised to millions of Americans. In the process, Trump is attempting to erase from the collective memory his earlier delays and often baseless assertions. Isaac Stanley-Becker and Nick Miroff offer documentation of this point, reporting on examples of how Trump’s statements are often “aspirational” rather than factual, and aimed at embellishing his own image (https://washingtonpost.com/nation/coronavirus-white-house-promises-undelivered/2020/04/08/af4afc6e-77f5-11ea-8cec-530b4044458_story.html).

Going back in time, Rucker and Costa say the result of Trump’s utterances and behavior for weeks was confused people about whether to take the coronavirus  as serious as the experts were saying it was. They quote Austin Mayor Steve Adler (D) who reflected on the first 70 days of the unfolding coronavirus crisis: “We’re trying to get as much containment as we can by limiting the number of physical interactions taking place, but they’re hearing it’s not a big deal, it’s going to be over soon, and getting community buy-in becomes a harder thing to achieve.” Rucker and Costa add: “[The president] at times just says whatever comes to mind, or tweets, then someone on TV is saying the opposite,” Maryland Gov. Larry Hogan (R) said in a recent interview. “It’s critically important that the message is straightforward and fact-based for the public.” As noted earlier, he and his administration wasted many weeks by failing to acknowledge the seriousness of the coronavirus and how, in absence of comprehensive mitigation efforts in every state, the virus would not just go away like the annual flu but relentlessly spread from town to town, county to county, state to state.

While the first coronavirus case in the United States was reported on January 21, and while Trump restricted travel from China in late January, “he did not begin fully engaging the crisis until late February” and “did not release guidelines for social distancing and other ways citizens could slow the spread until March 16, well after the virus already had spread across the United States.” Amidst it all, Trump has not taken responsibility for the delayed federal response or the continuing chaos in the distribution of medical supplies. Rather, he casts blame on others. According to Rucker and Costa, “Trump alternately has blamed China for first spreading the virus; New York Gov. Andrew M. Cuomo (D) for being slow to contain what would become by far the biggest U.S. outbreak; governors generally for requesting federal help procuring ventilators, masks and other equipment and for not showing appreciation for assistance; hospital workers for hoarding supplies; and the media, first for allegedly overhyping the dangers and then for allegedly not giving him adequate credit for the steps he has taken. Now, Trump has, recently, also intermittently praised some mayors and frontline medical workers for doing a fine job.

Rucker and Costa also put the present situation into a larger context of administration policies that, during the first three years of Trump’ presidency, were aimed at “systematically discrediting and attempting to dismantle parts of the federal government’s national security, intelligence and scientific apparatus.” And: “He has harbored suspicions of career experts in part because he does not consider them sufficiently loyal to him personally, at times tuning out their advice and steadily working to erode their trustworthiness in the minds of his supporters.” Thus, Trump’s fumbling responses for over two months after early January undermined the efforts by frontline health providers and hospitals to become equipped to treat people infected with the virus, confused the public about whether the virus was really so serious, and offered little advice on how people and businesses should be prepared to deal with it.

The US has neglected public health

 This is the argument that Jeneen Interlandi makes (https://nytimes.com/2020/04/09/opinion/coronavirus-public-health-system-us.html). The thrust of her position is captured in the opening paragraph, where she writes: “A once-in-a-century public health crisis is unfolding, and the richest country in the world is struggling to mount an effective response. Hospitals don’t have enough gowns or masks to protect doctors and nurses, nor enough intensive care beds to treat the surge of patients. Laboratories don’t have the equipment to diagnose cases quickly or in bulk, and state and local health departments across the country don’t have the manpower to track the disease’s spread. Perhaps worst of all, urgent messages about the importance of social distancing and the need for temporary shutdowns have been muddied by politics.”

She offers evidence. For example: “Health care spending grew by 52 percent in the past decade, while the budgets of local health departments shrank by as much as 24 percent, according to a 2019 report from the public health nonprofit Trust for America’s Health, and the C.D.C.’s budget remained flat. Today, public health claims just 3 cents of every health dollar spent in the country.” And, while Trump exacerbated the problem, it did not start with his presidency, as reflected in how “local health departments eliminated more than 50,000 jobs — epidemiologists, laboratory technicians, public information specialists — between 2008 and 2017. That’s nearly 23 percent of their total work force.” Trump’s dismissive views toward the public sector are revealed in the following example. Interlandi writes: “In 2019, a consortium of public health organizations lobbied the federal government for $1 billion to help the nation’s public health system modernize its data infrastructure. They were granted $50 million. In the wake of Covid-19, that sum has been increased to $500 million. But much more is needed. There is a $5.4 billion gap between current public health spending and the cost of modernizing public health infrastructure, according to the Trust for America’s Health report.”

Margaret Flowers adds evidence on the long neglect of government support for  the US hospital system in an article titled “The US Wave of Hospital Closures Left Us Ill-Equipped for COVID-19” (https://truthout.org/articles/the-uss-wave-of hospital-closures-left-us-ill-equipped-for-covid-19). And The New York Times reports on April 6 of a study released by a government watchdog group based on interviews conducted March 23 through March 27 with more than 320 hospitals across 46 states, Washington DC, and Puerto Rico (https://nytimes.com/2020/04/06/world/coronavirus-news.html). The study found “that hospitals are facing severe shortages of critical supplies,” with shortages “in testing and proective equipment for medical staff,” “sharp increases in prices for items such as masks, gloves, and face shields,” and the need of thermometers, disinfectants, medical gas, linens, toilet paper and food.” The study found “doctors around the United States pleading for ventilators.” To make matters worse, the study “was issued days after reports that protective equipment in the government’s strategic national stockpile was nearly depleted, forcing the Federal Emergency Management Agency to conduct an international search for such equipment. Those efforts have also increased competition for states and localities.”

 Where are we?

The Congress agreed on March 26 to a $2.2 trillion dollar coronavirus stimulus bill, including measures to send checks directly to Americans with incomes in households with incomes under $75,000 (couples who filed joint tax returns $150,000), additional unemployment insurance benefits, additional spending for food stamps, support for businesses with zero-interest loans, tax breaks and other subsidies, including $500 billion in loans and subsidies to large businesses in “severely distressed industries,” and $100 billion for American hospitals.

The Federal Reserve providing $4 trillion or so in liquidity and the purchase of bad loans from the big banks and has just added another $2.3 trillion to such efforts. There is already discussion in Congress about the need for another bill that would aid state and local governments, provide more assistance to hospitals and to safety net programs. These government initiatives exceed even what the New Deal offered during the 1930’s Depression.

According to the latest estimates on the effects of COVID-19, more than 190 countries have cases of the virus, with 1.5 million reported cases and over 877,400 people known to have died from the disease. In the US, according to the CDC, there were 395,011 cases and 12,754 deaths as of April 8. The government’s projection is that, with adequate mitigation, the total number of deaths in the US from the virus will be from 100,000 to 220,000, though, as mentioned, experts on the president’s coronavirus task force have recently express cautious optimism that mitigation efforts may even lead to fewer than 100,000 deaths.

However, these estimates, cautiously optimistic or not, are based on modeling and estimates that are limited to people with symptoms of the disease who have sought medical assistance or who have been tested for the virus. The problems are that there are some unknown number of people, with and without symptoms, who have not been tested or have not sought medical assistance. In all these cases, there is a good chance that such people have been transmitted the disease to others. The implication of this probably vast number of people there are more people who have been infected than the current models and estimates indicate. Consider the following information.

More on the problematic estimates

In an article published in The Washington Post, William Wan, Josh Dawsey, Ashley Parker, and Joel Achembach, document how experts and even some of Trump’s advisers doubt White House’s 100,000 to 240,000 coronavirus deaths estimate (https://washingtonpost.com/health/2020/04/02/experts-trumps-advisers-doubt-white-house-240000-coronavirus-estimate). Trump sees these numbers as absolutely correct, that they represent the what will be the peak of the crisis, after which the number of infected people will decline and, within a month or so, the coronavirus guidelines can be made less restrictive, or even eliminated and the economy can return to “normal.” Contrary to this logic, Wan and his colleagues write: “Leading disease forecasters, whose research the White House used to conclude 100,000 to 240,000 people will die nationwide from the coronavirus, were mystified when they saw the administration’s projection this week. The experts said they don’t challenge the numbers’ validity but that they don’t know how the White House arrived at them.”

They refer as an example to “Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, [who] told others there are too many variables at play in the pandemic to make the models reliable: “I’ve looked at all the models. I’ve spent a lot of time on the models. They don’t tell you anything. You can’t really rely upon models.” And “Robert Redfield, director of the Centers for Disease Control and Prevention, and the vice president’s office have similarly voiced doubts about the projections’ accuracy, the three officials said. Other experts voiced similar reservations. Even if the number of cases and deaths fall in current hotspots, the numbers in the best scenarios will only decline gradually over some unknown period. And there is the continuing danger, in the absence of a vaccine, that the contagion could come back to those places which for a time experienced a decline in the reported infections, hospitalizations, and deaths. Furthermore, there will be waves of covid-19 in other parts of the country where current estimates are based on few tests for the virus.

Wan and his colleagues interviewed Jeffrey Shaman, “a Columbia University epidemiologist whose models were cited by the White House, [and who] said his own work on the pandemic doesn’t go far enough into the future to make predictions akin to the White House fatality forecast.” Shaman is quoted: “We don’t have a sense of what’s going on in the here and now, and we don’t know what people will do in the future,” he said. “We don’t know if the virus is seasonal, as well.” With decisive action, he did think that “we can come in under 100,000 deaths.” Marc Lipsitch, a leading epidemiologist and director of Harvard University’s Center for Communicable Diseases Dynamics, said that his initial response to the numbers was that they cannot be reliably and validly computed so fast. There are other questions. Some epidemiologists worried also that the administration’s use of such predictions and its desire for a quickly end to the economically-disastrous effects will  lead to a premature softening of the guidelines, rather than to a long-term strategy based on a national plan to “game out scenarios, foresee challenges and create a coherent, long-term strategy. In this case, the pandemic could be prolonged. Indeed, Trump has “extended the White House’s restrictions until only April 30 and made clear he wants to reopen the country as soon as possible.”

The Unwitting coronavirus transmitters

As already noted, there are major issues in the efforts to identify coronavirus cases because of the lack of testing kits (through increasingly available) and the limited populations that have been targeted to those who exhibit symptoms. Apoorva Mandavilli focuses on the population who have the coronavirus but who do not exhibit symptoms, pointing out that, according to the director of the Centers for Disease Control and Prevention, “25 percent of people infected with the new coronavirus may not show symptoms” (https://nytimes.com/2020/03/31/health/coronavirus-asymtomatic-transmission.html). This has led the CDC to broaden its guidelines on who should wear masks. And, as the CDC director, Dr. Robert Redfield, told National Public Radio in an interview on Tuesday, March 31, this is one reason why the virus continues to spread across the country.

Without a vaccine, experts emphasize the importance of social distancing, washing hands, and wearing masks (though many masks used by the public may not have much value), as the only feasible ways to minimize the community spread of the virus. Social distancing is most important method for stopping the chain of transmission over time. Mandavilli reports that “[s]everal studies have shown now that people infected with the new coronavirus are most contagious about one to three days before they begin to show symptoms.” And this new coronavirus, COVID-19, people affected by those who are asymptomatic often end up with “severe symptoms and a high fatality rate.” This is particularly true of people have suffer from diabetes, heart disease, and lung disease.

Masks may help. But experts kept returning to social distancing as the single best tool for stopping the chain of transmission in the long term — not lockdowns, necessarily, but canceling mass events, working from home when possible and closing schools. Dr. Carl Bergstrom, an expert in emerging infectious diseases at the University of Washington in Seattle, is quoted: “We can’t assume that any of us are not potential vectors at any time. Therefore, even though I’m feeling great and have felt great and haven’t been exposed to anybody with any symptoms of anything, that’s why it would be irresponsible of me to go out and about today.”

Concluding thoughts

The implication of the evidence reported in this post is that the COVID-19 will continue to afflict us until there is extensive testing of virtually everyone, testing of those who have been in contact with infected people, serological testing to identify those who have had the disease but never showed symptoms, available and adequate medical resources to treat those who require treatment, and quarantining of those with the illness , combined with widespread adherence of Americans to the mitigation guidelines (e.g., social distancing, washing hand, avoiding groups, wearing masks). In the final analysis, as Anthony S. Fauci has so often said, it will take the creation of a vaccine or vaccines to protect large numbers of people from being infected. But, even then, we still know to little about the virus but even then the virus is here to stay and is able to travel through human contact across states, national borders, and in many places (e.g., prisons, slums, immigrant camps and detention facilities, and under-resourced health systems).

Given so many unknowns and the likelihood of a prolonged pandemic or recurrent breakouts of the infection, the nation’s economy cannot simply return to the pre-pandemic normal, as the President continuously tells us it soon will. This is unlikely, until the virus is vastly more controlled than it now is. In the meantime, businesses, hospitals, and ordinary people will have to figure out how to institutionalize some level of mitigation into their everyday practices when they are able to go back to work. Ideally, the country would not have a president who is so deceptive, so opportunistic, so self-promoting and -aggrandizing, and so duplicity agile at finding scapegoats for every one of his tragic mishaps.