Home / World / Denial and dysfunction plagued the US government when the corona virus raged

Denial and dysfunction plagued the US government when the corona virus raged

When Donald Trump declared himself president of the war – and the corona virus an enemy – the United States was already on the way to seeing more people die than in the wars of Korea, Vietnam, Afghanistan and Iraq combined.

The country has taken a number of warfare measures that have never been used together in U.S. history – banning incoming travelers from two continents, stopping trade, attracting industry to produce emergency equipment, and detaining 230 million Americans in their homes in a desperate situation Offer to survive an invisible enemy attack.

Despite these and other extreme moves, the United States is likely to go under as the country that is said to be best prepared to fight a pandemic, but has been catastrophically surpassed by the novel corona virus and suffered more severe losses than any other nation.

It didn̵

7;t have to be that way. While not perfectly prepared, the United States had more expertise, resources, plans and epidemiological experience than dozens of countries that were ultimately much better off fighting off the virus.

The failure is reminiscent of the time before September 11: warnings were issued, including at the highest government level, but the President was deaf to them until the enemy had already struck.

The Trump administration received its first formal notification of the Corona virus outbreak in China on January 3. Within a few days, U.S. spy agencies signaled the severity of the threat to Trump by inserting a warning about the corona virus – the first of many – in the President’s Daily Letter.

And yet, it took 70 days from this initial notification for Trump to control the coronavirus not as a distant threat or harmless flu strain, but as a deadly force that had outstripped America’s defense and was ready to kill tens of thousands of citizens. This stretch of more than two months is now a critical time that has been wasted.

Trump’s unsubstantiated claims these weeks, including his assertion that everything would “miraculously disappear”, have caused considerable public confusion and contradicted the urgent messages from public health experts.

“While the media would rather speculate about outrageous claims by palace intrigues, President Trump and this government continue to focus entirely on the health and safety of the American people to slow the spread of the virus, expand the tests and, 24/7 the vaccine is accelerating development, “said Judd Deere, a spokesman for the president.” With the leadership of the President, we will emerge from this challenge healthy, stronger and with a prospering and growing economy. “

The president’s behavior and combative statements were only a visible layer over deeper malfunctions.

The most serious failure was that efforts to develop a diagnostic test that could be mass-produced and distributed in the United States had collapsed, allowing authorities to map outbreaks early and take quarantine measures to contain them. At one point, an official from the Food and Drug Administration came across laboratory workers from the Centers for Control and Prevention of Disease, telling them that their protocol errors, including concerns that the laboratory did not meet the criteria for sterile conditions, were so serious that the FDA would do so if the CDC were a commercial rather than a government entity.

Other errors cascaded through the system. Administration often seemed to be weeks behind the curve when it responded to the spread of the virus and closed doors that were already contaminated. Prolonged clashes between the White House and public health officials over funding, coupled with a shortage of emergency supplies, left large parts of the country’s health system unprotected until the outbreak became a pandemic. Infighting, lawn wars and abrupt changes in leadership hampered the work of the Coronavirus Task Force.

It may never be known how many thousands of deaths or millions of infections have been prevented with a more coherent, urgent, and effective response. But even now there are many signs that the government’s response to the crisis could have been devastating.

National Guard 25-year-old Kevin Darrah has his mask applied at the Javits Center in Manhattan on April 1st. (Demetrius Freeman for the Washington Post)

Even the President’s base has started to face this reality. In mid-March as Trump renamed himself a war president and belatedly urged the public to slow the spread of the virus. Republican leaders rallied over gloomy poll data suggesting that Trump lulled his followers into a false sense of security over a deadly threat.

The poll found that far more Republicans than Democrats were influenced by Trump’s dismissive portrayals of the virus and comparatively contemptuous coverage of Fox News and other conservative networks. As a result, troubled Republicans refused to change travel plans, follow “social detachment” guidelines, replenish supplies, or otherwise take the corona virus threat seriously.

“Rejection is probably not a successful survival strategy,” concluded GOP pollster Neil Newhouse in a document that was shared with GOP leaders on Capitol Hill and discussed in depth at the White House. Trump’s most passionate supporters, it said, “put themselves and their loved ones at risk”.

Trump’s message changed as the report went through the higher ranks of the GOP. In the past few days, Trump has recalled that he once claimed that the number of cases would soon drop to “zero”.

To date, more than 7,000 people have died from the corona virus in the United States. Around 240,000 cases have been reported. However, Trump has acknowledged that new models suggest that the national death toll could range from 100,000 to 240,000.

Aside from the suffering facing thousands of victims and their families, the outcome has changed the international reputation of the United States and damaged and diminished its reputation as a global leader in times of extraordinary adversity.

“This was a major blow to the feeling that America was competent,” said Gregory F. Treverton, former chair of the National Intelligence Council, the government’s leading provider of intelligence analysis. He left NIC in January 2017 and now teaches at the University of Southern California. “It was part of our global role. Traditional friends and allies looked at us because they thought we could be competently asked to work with them in a crisis. That was the opposite of it. “

This article, which traces the failures in the first 70 days of the coronavirus crisis, is based on 47 interviews with government officials, public health experts, intelligence officials and other people involved in fighting the pandemic. Many spoke anonymously about sensitive information and decisions.

Vice President Pence; Deborah Birx, the White House Coronavirus Response Coordinator; and CDC director Robert Redfield arrive at McChord Field near Tacoma, Washington, to meet with Governor Jay Inslee on March 5. (David Ryder / Reuters)

Scan the horizon

Health authorities belong to a special generation of officials – along with counter-terrorism officers, military planners, aviation authorities, and others – whose careers involve considering worst-case scenarios.

The arsenal they use against viral invaders is powerful, able to stifle a new pathogen while looking for a cure, but slightly overwhelmed if not mobilized in time. As a result, officials from the Department of Health and Human Services, the CDC, and other agencies spend their days scanning the horizon for new threats.

The CDC learned of a number of cases in China on December 31 and began developing reports for HHS on January 1. The clearest warning that US officials received about the corona virus came on January 3 when Robert Redfield, the CDC director, received a call from a colleague in China. The official told Redfield that a mysterious respiratory illness was spreading in Wuhan, a congested commercial city of 11 million people inside the communist country.

Redfield quickly passed the troubling news on to Alex Azar, the secretary of HHS, the agency that oversees the CDC and other public health organizations. Azar, in turn, made sure the White House was notified and instructed his chief of staff to report the Chinese report to the National Security Council.

From that moment on, the administration and the virus were involved in a race against a ticking clock, a competition for the upper hand between pathogens and prevention, which would determine the extent of the outbreak when it reached the American coast and how many would get sick or die.

The initial response was promising, but officials also faced obstacles immediately.

On January 6, Redfield sent a letter to the Chinese offer to send help, including a team of CDC scientists. China declined the offer for weeks, declined support, and deprived the U.S. authorities of an early chance to get a sample of the virus, which is critical to developing diagnostic tests and potential vaccines.

China has hindered the US response in other ways, including by withholding accurate information about the outbreak. Beijing has a long track record of downplayed diseases that have occurred within its borders. This is an impulse that US officials attribute to the desire of the country’s leaders to avoid embarrassment and accountability to China’s 1.3 billion people and other countries on the pathway.

China stuck to this costly script in the case of the corona virus and reported on January 14 that it saw “no clear evidence of human-to-human transmission.” US officials treated the allegation with skepticism, which intensified when the first case outside of China with a reported infection appeared in Thailand.

A traveler wearing a mask to protect against the corona virus will pass Beijing Railway Station on January 17. (Mark Schiefelbein / AP)

A week earlier, senior HHS officials had started an agency task force, including Redfield, Azar, and Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases. The following week, there were also occasional meetings in the White House with officials from the National Security Council and the State Department, mainly focusing on when and whether government officials should be returned to China.

US officials began preparatory steps to counter a possible outbreak. By mid-January, Robert Kadlec, an Air Force officer and doctor, who served as deputy secretary for readiness and response at HHS, had instructed subordinates to prepare contingency plans for the enforcement of the Defense Production Act, a measure that would allow the government to help individuals to force companies to make devices or devices that are critical to the security of the country. The helpers were bitterly divided over whether they should implement the law, and nothing happened for many weeks.

On January 14, Kadlec scribbled a single word in a notebook he was carrying: “Coronavirus !!!”

Despite the numerous activities at lower levels of his administration, Trump was not fully informed about the corona virus until January 18 when he received a call from Azar during his weekend in Mar-a-Lago.

Before the Minister of Health could say anything about the virus, Trump interrupted him and started criticizing Azar for dealing with the virus Federal ban on vaporizing products canceled, an issue that annoyed the President.

At the time, Trump was in an impeachment battle for his alleged attempt to impose political favors on the leader of Ukraine. The acquittal seemed safe from the GOP-controlled Senate, but Trump was busy with the process, calling on lawmakers late at night and making lists of alleged enemies that he wanted to punish when the case against him was closed.

In retrospect, officials said, Azar could have urged Trump to focus at least part of his attention on a threat that would soon put his presidency to an even more severe test, a crisis that cost the lives of Americans and the last Year would consume from Trump’s first term.

But the secretary, who had a tense relationship with Trump and many others in the administration, assured the president that those responsible were working on the problem and monitoring it. Azar told several employees that the president believed he was “alarming,” and Azar attempted to draw Trump’s attention to the issue and even asked a confidant for advice.

Within a few days there were new reasons for the alarm.

Secretary of Health and Human Services Alex Azar speaks during a White House briefing on January 31st. (Jabin Botsford / The Washington Post)

On January 21, a Seattle man who had recently traveled to Wuhan was tested positive for the corona virus, making it the first known infection on US soil. Then, two days later, the Chinese authorities took it drastic step to close Wuhan and transform the teeming metropolis into a ghost town with empty highways and closed skyscrapers, with millions of people stuck in their homes.

“It was like whoa,” said a senior US official who was involved in White House meetings on the crisis. “At that time, the Richter scale reached 8.”

It was also when US officials began to grapple with the mistakes of their own response efforts.

Azar, who was in senior positions at HHS through crises such as the September 11, 2005 terrorist attacks and the bird flu outbreak in 2005, was very familiar with the crisis management game book.

He instructed subordinates to take swift action to establish a nationwide surveillance system to monitor the spread of the coronavirus – an intensified version of what the CDC is doing every year to monitor new strains of normal flu.

However, this would require assets that U.S. officials would miss for months – a diagnostic test that would allow large numbers of those infected with the new virus to be identified and manufactured on a large scale for rapid deployment in the U.S., as well as money for the implementation of the system.

Azar’s team also encountered another obstacle. The Chinese still refused to share the collected virus samples and used them to develop their own tests. US officials looked frustrated with other possible routes.

A biocontainment laboratory at the medical department of the University of Texas at Galveston had a research partnership with the Wuhan Institute of Virology.

Kadlec, who knew the Galveston laboratory manager, hoped that scientists could arrange a transaction themselves without government intervention. The Wuhan laboratory agreed at first, but officials in Beijing intervened on January 24, blocking any laboratory-to-laboratory transmission.

Deputy National Security Advisor Matthew Pottinger (left) and National Security Advisor Robert O’Brien listen during a coronavirus briefing at the White House on January 31 (Jabin Botsford / The Washington Post).

There is no evidence that officials have attempted to escalate the matter or persuade Trump to intervene. In fact, Trump has repeatedly praised Chinese President Xi Jinping despite warnings from U.S. intelligence and health officials that Beijing is hiding the true scale of the outbreak and hindering cooperation on key fronts.

The CDC issued its first public warning about the corona virus on January 8, and on January 17 it monitored major airports in Los Angeles, San Francisco and New York, where large numbers of passengers from China arrived every day.

In other ways, however, the situation was already getting out of control, with Seattle cases multiplying, the Chinese unyielding, the public asking more and more questions, and nothing preventing the infected travelers from arriving abroad.

Trump was out of the country because of this critical period and attended the annual global economic forum in Davos, Switzerland. He was accompanied by a contingent of high-ranking officials, including national security advisor Robert O’Brien, who accepted an anxious transatlantic call from Azar.

Azar told O’Brien that there was “chaos” in the White House and that HHS officials were forced to give almost identical briefings to three viewers on the same day.

Azar urged O’Brien to let the NSC take control of an issue with a potential impact on air travel, immigration, the State Department and the Pentagon. O’Brien seemed to understand the urgency and asked his deputy Matthew Pottinger, who had worked as a journalist for the Wall Street Journal in China, to coordinate the still young US response.

But the growing fear within the administration didn’t seem to register with the president. On January 22, Trump received his first question about the corona virus in an interview on CNBC in Davos. When asked if he was worried about a possible pandemic, Trump said, “No. Not at all. And we have it completely under control. It is a person who comes from China. . . . It will be fine. “

Spread uncontrollably

The NSC’s move to take control of the response provided an opportunity to realign U.S. strategy to contain the virus as much as possible and to provide resources that hospitals would need in the event of a U.S. outbreak, including basic equipment such as protective masks and Ventilators.

But instead of mobilizing for what was to come, US officials seemed to be more concerned with logistical problems, including how to evacuate Americans from China.

In Washington, then chief of staff Mick Mulvaney and Pottinger began convening meetings with senior officials from HHS, the CDC and the State Department at the White House.

The group, which included Azar, Pottinger and Fauci, and nine other members of the administration, formed the core of the administration’s future Coronavirus Task Force. However, the main focus was on efforts to prevent infected people in China from traveling to the U.S., despite the fact that thousands of U.S. citizens were evacuated. The meetings did not seriously focus on tests or deliveries, which have since become the most difficult administrative problems.

The task force was officially announced on January 29.

“The origin of this group was border control and return,” said a senior official who was involved in the meeting. “It wasn’t a comprehensive, government-wide group that led everything.”

According to the participants, the State Department’s agenda dominated these early discussions. Officials began making plans to charter planes and evacuate 6,000 Americans stranded in Wuhan. They also discussed the language of travel warnings that the state could issue to prevent other trips to and from China.

On January 29, Mulvaney chaired a meeting in the Situation Room at the White House, during which officials discussed moving travel restrictions to Level 4, which was a State Department recommendation to “not travel.” Then, the next day, China took the draconian move to block the entire Hubei Province, which includes Wuhan.

On March 4th, a hand sanitizer will be available at every gate in Terminal B of Oakland International Airport in California to stop the spread of the corona virus. (Melina Mara / The Washington Post)

Beijing’s move ultimately led to the Trump administration taking appropriate action. On January 31, Azar announced restrictions that prohibit non-US residents who have been to China in the past two weeks from entering the United States.

Trump has rightly pointed to the restriction on China as evidence that he reacted aggressively and early to the outbreak. It was one of the few interventions during the crisis that matched the president’s instincts, who often seem to be fixated on setting borders and keeping foreigners out of the country.

At that time, 300,000 people from China had come to the United States last month. According to the World Health Organization, there were only 7,818 confirmed cases worldwide at the end of January – but it is now clear that the virus has spread unchecked.

Until then, Pottinger pushed for another travel ban, this time restricting the influx of travelers from Italy and other countries of the European Union, who quickly emerged as important new hubs of the outbreak. Pottinger’s proposal was endorsed by key health officials, including Fauci, who argued that it was important to block any path the virus could take in the country.

This time, the plan met with resistance from Treasury Secretary Steven Mnuchin and others who were concerned about the impact on the US economy. It was an early sign of tensions in an area that would divide administration and those who gave priority to public health over those who were determined to avoid disruptions in an election year due to expansion and employment growth.

Those who supported the economy prevailed with the president. And it took more than a month for the government to issue a delayed and confusing ban on flights from Europe to the United States. During this time hundreds of thousands of people crossed the Atlantic.

A label for N95 masks can be seen on March 13th under an empty shelf at Dayton General Hospital in Washington State. (Nick Otto for the Washington Post)

Lewis Neace heads the dayton, Washington hospital emergency room, which has an aging population. (Nick Otto for the Washington Post)

LEFT: A label for N95 masks can be seen on March 13th under an empty shelf at Dayton General Hospital in Washington State. (Nick Otto for the Washington Post) CORRECT: Lewis Neace runs the emergency room of the Dayton, Washington hospital, which has an aging population. (Nick Otto for the Washington Post)

A wall of resistance

While fighting for air travel took place in the White House, public health officials panicked about an astonishing shortage of critical medical equipment, including protective masks for doctors and nurses, and a rapidly shrinking money pool needed to pay for such things.

In early February, the government quickly used a $ 105 million convention fund to respond to infectious disease outbreaks. The coronavirus threat to the United States still seemed distant, if not entirely hypothetical, to much of the public. However, a disaster seemed increasingly inevitable for health officials tasked with stocking worst-case scenarios.

A national supply of N95 protective masks, clothing, gloves and other relief supplies was already completely inadequate after years of underfunding. The prospect of replenishing this business was suddenly threatened by the spreading crisis in China that disrupted the offshore supply chain.

Much of the manufacture of such equipment had long since emigrated to China, where factories were now closed because the workers were to remain in their households. At the same time, China bought up masks and other equipment to prepare for the outbreak of its own corona virus, increase costs, and monopolize supplies.

In late January and early February, HHS officials sent two letters to the White House Administration and Budget Office asking them to use their transfer agency to convert $ 136 million of departmental resources into corona virus-fighting pools could be used. Azar and his aides also began to address Congress with the need for an additional multi-billion dollar budget request.

However, the White House budget falcons argued that appropriating too much money at the same time, if there were few US cases, would be considered alarming.

Joe Grogan, chairman of the Home Affairs Council, clashed with health officials because of the willingness. He mistrusted how the money would be used and questioned how health officials had used previous resources.

Azar then spoke to Acting Director of the White House Administration and Budget Office, Russell Vought, during Trump’s speech on the state of the Union on February 4. Vought appeared to be accessible and asked Azar to submit a proposal.

Azar did the next day, drafting a supplemental request for more than $ 4 billion, a sum that OMB officials and others in the White House welcomed as outrage. Azar arrived for a tense meeting in the Situation Room at the White House that day, which according to three people familiar with the incident broke out in a screaming match.

A member of the Budget Office accused Azar of preemptively promoting Congress for a gigantic amount that White House officials were not interested in granting. Azar resisted the criticism and defended the need for an emergency infusion. But his reputation with White House officials, which was shaky even before the onset of the coronavirus crisis, was further damaged.

White House officials gave way weeks later when the feared increase in coronavirus began to materialize in the United States. The OMB team has lowered Azar’s claims to $ 2.5 billion, money that would only be available in the current fiscal year. Congress ignored this number and approved an $ 8 billion additional bill that Trump included in the law on March 7.

But here, too, delays proved costly. The disputes resulted in the United States missing a narrow window to store fans, masks, and other protective equipment before the government bid against many other desperate nations, and government officials, fed up with coping with federal failure, began to do so themselves to look for supplies.

At the end of March, the administration ordered 10,000 ventilators – well below what public health officials and governors thought was necessary. And many will not arrive until summer or autumn, when models expect the pandemic to recede.

“It’s kind of a joke, actually,” said an official who was involved in the late-purchase consultation.

Clinicians place a nasal swab in a container after testing a patient on March 12 at a drive-through Covid 19 test station on Kaiser Permanente’s French campus in San Francisco. (Michael Short für The Washington Post)

Das Labortestkit der CDC für das neue Coronavirus. (CDC / AP)

LINKS: Kliniker legen einen Nasentupfer in einen Behälter, nachdem sie am 12. März einen Patienten an einer Durchfahr-Covid-19-Teststation auf dem französischen Campus von Kaiser Permanente in San Francisco getestet haben. (Michael Short für The Washington Post) RECHTS: Der Labortest der CDC Kit für das neue Coronavirus. (CDC / AP)

Nicht schlüssige Tests

Obwohl Viren unsichtbar sind, haben Beamte des öffentlichen Gesundheitswesens ausgefeilte Methoden entwickelt, um ihre Bewegungen abzubilden und zu verfolgen. Die Eindämmung eines Ausbruchs oder die Verlangsamung einer Pandemie hängt in vielerlei Hinsicht von der Fähigkeit ab, die Bevölkerung schnell in infizierte und nicht infizierte Personen aufzuteilen.

Dies hängt jedoch von einem genauen Test ab, mit dem Patienten diagnostiziert und schnell in Labors im ganzen Land eingesetzt werden können. Die Zeit, die benötigt wurde, um dies in den Vereinigten Staaten zu erreichen, war für die amerikanischen Bemühungen möglicherweise kostspieliger als jedes andere Versagen.

“Wenn Sie die Tests hätten, könnten Sie sagen:” Oh mein Gott, in Seattle ist ein Virus im Umlauf, lasst uns darauf loslegen. In Chicago zirkuliert ein Virus, lasst uns darauf loslegen “, sagte ein hochrangiger Verwaltungsbeamter, der an der Bekämpfung des Ausbruchs beteiligt war. “Wir hatten diese Sichtbarkeit nicht.”

Der erste Rückschlag kam, als China sich weigerte, Proben des Virus zu teilen, und den US-Forschern die Möglichkeit nahm, mit Medikamenten und Therapien zu bombardieren, um nach Wegen zu suchen, das Virus zu besiegen. Aber selbst wenn Proben beschafft worden waren, wurden die Bemühungen der USA durch systemische Probleme und institutionelle Hybris behindert.

Zu den kostspieligsten Fehlern gehörte eine fehlgeleitete Einschätzung von führenden Gesundheitsbehörden, dass der Ausbruch in den Vereinigten Staaten wahrscheinlich in begrenztem Umfang begrenzt sein würde – wie dies bei jeder anderen Infektion seit Jahrzehnten der Fall war – und dass man sich darauf verlassen konnte, dass sich die CDC selbst entwickelt ein Coronavirus-Diagnosetest.

Die CDC, die in den 1940er Jahren ins Leben gerufen wurde, um einen Malaria-Ausbruch in den südlichen Vereinigten Staaten einzudämmen, hatte die Führung bei der Entwicklung diagnostischer Tests bei größeren Ausbrüchen wie Ebola, Zika und H1N1 übernommen. Die CDC wurde jedoch nicht für Massenproduktionstests gebaut.

Der Erfolg der CDC hatte eine institutionelle Arroganz gefördert, ein Gefühl, dass es angesichts einer möglichen Krise nicht dringend erforderlich war, private Labors, akademische Einrichtungen, Krankenhäuser und globale Gesundheitsorganisationen einzubeziehen, die ebenfalls in der Lage waren, Tests zu entwickeln.

Einige befürchteten jedoch, dass der CDC-Test nicht ausreichen würde. Stephen Hahn, der FDA-Kommissar, beantragte Anfang Februar die Genehmigung, private Diagnose- und Pharmaunternehmen anzurufen, um ihre Hilfe in Anspruch zu nehmen.

Als hochrangige FDA-Beamte die Führungskräfte von HHS konsultierten, wurde Hahn, der die Agentur etwa zwei Monate lang geleitet hatte, aufgefordert, zurückzutreten. Es gab Bedenken, dass er sich persönlich an Unternehmen wandte, die von seiner Agentur reguliert wurden.

Zu diesem Zeitpunkt schien Azar, der HHS-Sekretär, einem Plan verpflichtet zu sein, den er verfolgte, um seine Agentur im Mittelpunkt der Reaktionsbemühungen zu halten: einen Test von der CDC zu sichern und dann ein nationales Coronavirus-Überwachungssystem aufzubauen, indem er sich auf ein bestehendes stützte Netzwerk von Labors zur Verfolgung der normalen Grippe.

In Sitzungen der Task Force drängten Azar und Redfield auf 100 Millionen US-Dollar, um den Plan zu finanzieren, wurden jedoch aufgrund der Kosten abgeschossen. Dies geht aus einem Dokument hervor, in dem die von der Washington Post erhaltene Teststrategie dargelegt wurde.

Es wäre problematisch gewesen, sich so stark auf die CDC zu verlassen, selbst wenn es gelungen wäre, schnell einen wirksamen Test zu entwickeln, der im ganzen Land verteilt werden könnte. Das Ausmaß der Epidemie und die Notwendigkeit von Massentests, die weit über die Möglichkeiten des Grippennetzwerks hinausgehen, hätten Azars Plan überwältigt, der nicht vorsah, kommerzielle Laborunternehmen für bis zu sechs Monate zu engagieren.

Beamte bereiten sich auf eine Pressekonferenz in Seattle am 29. Februar vor. Ein Mann in den Fünfzigern mit zugrunde liegenden Gesundheitszuständen aus dem Bundesstaat Washington wurde zum ersten Coronavirus-Tod auf US-amerikanischem Boden. (Elaine Thompson / Associated Press)

Blumen werden am 13. März vor dem Life Care Center, einer Langzeitpflegeeinrichtung in Kirkland, Washington, die mit mehreren Coronavirus-Fällen in Verbindung gebracht wurde, mit Bändern an Bäume gebunden. (Lindsey Wasson / Reuters)

LINKS: Beamte bereiten sich auf eine Pressekonferenz in Seattle am 29. Februar vor. Ein Mann in den Fünfzigern mit zugrunde liegenden Gesundheitszuständen aus dem Bundesstaat Washington wurde zum ersten Coronavirus-Tod auf US-amerikanischem Boden. (Elaine Thompson/Associated Press) RIGHT: Flowers are tied to trees with ribbons on March 13 outside Life Care Center, a long-term-care facility in Kirkland, Wash., that was linked to multiple coronavirus cases. (Lindsey Wasson/Reuters)

The effort collapsed when the CDC failed its basic assignment to create a working test and the task force rejected Azar’s plan.

On Feb. 6, when the World Health Organization reported that it was shipping 250,000 test kits to labs around the world, the CDC began distributing 90 kits to a smattering of state-run health labs.

Almost immediately, the state facilities encountered problems. The results were inconclusive in trial runs at more than half the labs, meaning they couldn’t be relied upon to diagnose actual patients. The CDC issued a stopgap measure, instructing labs to send tests to its headquarters in Atlanta, a practice that would delay results for days.

The scarcity of effective tests led officials to impose constraints on when and how to use them, and delayed surveillance testing. Initial guidelines were so restrictive that states were discouraged from testing patients exhibiting symptoms unless they had traveled to China and come into contact with a confirmed case, when the pathogen had by that point almost certainly spread more broadly into the general population.

The limits left top officials largely blind to the true dimensions of the outbreak.

In a meeting in the Situation Room in mid-February, Fauci and Redfield told White House officials that there was no evidence yet of worrisome person-to-person transmission in the United States. In hindsight, it appears almost certain that the virus was taking hold in communities at that point. But even the country’s top experts had little meaningful data about the domestic dimensions of the threat. Fauci later conceded that as they learned more their views changed.

At the same time, the president’s subordinates were growing increasingly alarmed, Trump continued to exhibit little concern. On Feb. 10, he held a political rally in New Hampshire attended by thousands where he declared that “by April, you know, in theory, when it gets a little warmer, it miraculously goes away.”

The New Hampshire rally was one of eight that Trump held after he had been told by Azar about the coronavirus, a period when he also went to his golf courses six times.

A day earlier, on Feb. 9, a group of governors in town for a black-tie gala at the White House secured a private meeting with Fauci and Redfield. The briefing rattled many of the governors, bearing little resemblance to the words of the president. “The doctors and the scientists, they were telling us then exactly what they are saying now,” Maryland Gov. Larry Hogan (R) said.

That month, federal medical and public health officials were emailing increasingly dire forecasts among themselves, with one Veterans Affairs medical adviser warning, ‘We are flying blind,’” according to emails obtained by the watchdog group American Oversight.

Later in February, U.S. officials discovered indications that the CDC laboratory was failing to meet basic quality-control standards. On a Feb. 27 conference call with a range of health officials, a senior FDA official lashed out at the CDC for its repeated lapses.

Jeffrey Shuren, the FDA’s director for devices and radiological health, told the CDC that if it were subjected to the same scrutiny as a privately run lab, “I would shut you down.”

On Feb. 29, a Washington state man became the first American to die of a coronavirus infection. That same day, the FDA released guidance, signaling that private labs were free to proceed in developing their own diagnostics.

Another four-week stretch had been squandered.

Trump, with Azar, left, and Steve Monroe of the CDC, holds a picture of the coronavirus during a tour of the CDC in Atlanta on March 6. (Jim Watson/AFP/Getty Images)

Life and death

One week later, on March 6, Trump toured the facilities at the CDC wearing a red “Keep America Great” hat. He boasted that the CDC tests were nearly perfect and that “anybody who wants a test will get a test,” a promise that nearly a month later remains unmet.

He also professed to have a keen medical mind. “I like this stuff. I really get it,” he said. “People here are surprised that I understand it. Every one of these doctors said, ‘How do you know so much about this?’ ”

In reality, many of the failures to stem the coronavirus outbreak in the United States were either a result of, or exacerbated by, his leadership.

For weeks, he had barely uttered a word about the crisis that didn’t downplay its severity or propagate demonstrably false information. He dismissed the warnings of intelligence officials and top public health officials in his administration.

At times, he voiced far more authentic concern about the trajectory of the stock market than the spread of the virus in the United States, railing at the chairman of the Federal Reserve and others with an intensity that he never seemed to exhibit about the possible human toll of the outbreak.

In March, as state after state imposed sweeping new restrictions on their citizens’ daily lives to protect them — triggering severe shudders in the economy — Trump second-guessed the lockdowns.

Jackie Copeland wipes down her cart in an effort to protect against the coronavirus before shopping at a Walmart in Fairfield, Calif., on Feb. 29. (Nick Otto for The Washington Post)

People wear masks in Times Square in Manhattan on March 4 as the number of coronavirus cases started climbing. (Sharon Pulwer for The Washington Post)

LEFT: Jackie Copeland wipes down her cart in an effort to protect against the coronavirus before shopping at a Walmart in Fairfield, Calif., on Feb. 29. (Nick Otto for The Washington Post) RIGHT: People wear masks in Times Square in Manhattan on March 4 as the number of coronavirus cases started climbing. (Sharon Pulwer for The Washington Post)

The common flu kills tens of thousands each year and “nothing is shut down, life & the economy go on,” he tweeted March 9. A day later, he pledged that the virus would “go away. Just stay calm.”

Two days later, Trump finally ordered the halt to incoming travel from Europe that his deputy national security adviser had been advocating for weeks. But Trump botched the Oval Office announcement so badly that White House officials spent days trying to correct erroneous statements that triggered a stampede by U.S. citizens overseas to get home.

“There was some coming to grips with the problem and the true nature of it — the 13th of March is when I saw him really turn the corner. It took a while to realize you’re at war,” Sen. Lindsey O. Graham (R-S.C.) said. “That’s when he took decisive action that set in motion some real payoffs.”

Trump spent many weeks shuffling responsibility for leading his administration’s response to the crisis, putting Azar in charge of the task force at first, relying on Pottinger, the deputy national security adviser, for brief periods, before finally putting Vice President Pence in the role toward the end of February.

Other officials have emerged during the crisis to help right the United States’ course, and at times, the statements of the president. But even as Fauci, Azar and others sought to assert themselves, Trump was behind the scenes turning to others with no credentials, experience or discernible insight in navigating a pandemic.

Foremost among them was his adviser and son-in-law, Jared Kushner. A team reporting to Kushner commandeered space on the seventh floor of the HHS building to pursue a series of inchoate initiatives.

One plan involved having Google create a website to direct those with symptoms to testing facilities that were supposed to spring up in Walmart parking lots across the country, but which never materialized. Another centered an idea advanced by Oracle chairman Larry Ellison to use software to monitor the unproven use of anti-malaria drugs against the coronavirus pathogen.

So far, the plans have failed to come close to delivering on the promises made when they were touted in White House news conferences. The Kushner initiatives have, however, often interrupted the work of those under immense pressure to manage the U.S. response.

Anthony S. Fauci, left, director of the National Institute for Allergy and Infectious Diseases, attends a White House briefing with Trump on April 1. He is one of the core members of the administration’s coronavirus task force. (Jabin Botsford/The Washington Post)

Current and former officials said that Kadlec, Fauci, Redfield and others have repeatedly had to divert their attentions from core operations to contend with ill-conceived requests from the White House they don’t believe they can ignore. And Azar, who once ran the response, has since been sidelined, with his agency disempowered in decision-making and his performance pilloried by a range of White House officials, including Kushner.

“Right now Fauci is trying to roll out the most ambitious clinical trial ever implemented” to hasten the development of a vaccine, said a former senior administration official in frequent touch with former colleagues. And yet, the nation’s top health officials “are getting calls from the White House or Jared’s team asking, ‘Wouldn’t it be nice to do this with Oracle?’ ”

If the coronavirus has exposed the country’s misplaced confidence in its ability to handle a crisis, it also has cast harsh light on the limits of Trump’s approach to the presidency — his disdain for facts, science and experience.

He has survived other challenges to his presidency — including the Russia investigation and impeachment — by fiercely contesting the facts arrayed against him and trying to control the public’s understanding of events with streams of falsehoods.

The coronavirus may be the first crisis Trump has faced in office where the facts — the thousands of mounting deaths and infections — are so devastatingly evident that they defy these tactics.

After months of dismissing the severity of the coronavirus, resisting calls for austere measures to contain it, and recasting himself as a wartime president, Trump seemed finally to succumb to the coronavirus reality. In a meeting with a Republican ally in the Oval Office last month, the president said his campaign no longer mattered because his reelection would hinge on his coronavirus response.

“It’s absolutely critical for the American people to follow the guidelines for the next 30 days,” he said at his March 31 news conference. “It’s about life and death.”

Julie Tate and Shane Harris contributed to this report.

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