May 16, 2020

Coronavirus 2020 and the Failures of January

by Hal Gershowitz

Comments Below

January 2020. That’s when things went bad. That’s when it all went wrong. That’s when high officials in our government knew something awful was happening and, I believe, knew we had to do something. Why we didn’t will be the subject of examination for years to come. If we do not learn and make the public aware of what we have learned, the tragic health crisis we are currently experiencing will most certainly happen again, and sooner than most people realize. By late January every nation had enough information to suspect that something very dangerous was unfolding on a worldwide scale.

The three most important questions historians and journalists will soon ponder are, (1) exactly when was CDC Director Robert R. Redfield apprised of a severe disease of unknown origin erupting in Wuhan, (2) when was Health and Human Services Secretary Alex Azar apprised of, essentially, the same information and (3) what did Director Redfield and Secretary Azar do with that information. Available information indicates they both knew of the outbreak of a severe respiratory disease of unknown origin in China during the first three days of January. They either (1) did nothing, (2) did something, or (3) were rebuffed at a higher level.

“Nobody ever thought this (the pandemic) would be a problem…nobody saw this coming,” the President insisted at a White House briefing in early March. Well, that just isn’t true. It is, indeed, embarrassingly false. We suspect that nearly all 4700 board-certified immunologists, 8,000 epidemiologists, and 8500 infectious disease doctors in the nation, and virtually every professional scientist at the United States Center for Disease Control (CDC) knew the chronic potential for a viral pandemic was always very high. They would not have been surprised that this one came along.

CDC Director Redfield and HHS Secretary Azar certainly saw the potential of Covid-19 erupting early in January. We know that the Administration’s Senior Trade Advisor, Peter Navarro, saw this coming because he sent an urgent letter to the White House later in January which forecast exactly what could happen. Even private citizen and infectious disease crusader Bill Gates predicted the potential of such an outbreak five years ago.

Dr. Anthony Fauci, Director of the Allergy and Infectious Disease Division of the National Institutes of Health has been pilloried by Fox and other social media outlets for taking a cautious position on February 29th stating there was, at that time, no evidence of community spread and that it was, therefore, not necessary for people to change their behavior. He did warn, however, that that could abruptly change as, indeed, it did. We could find no one in the public health service, however, who was dismissive of the threat.

We could find only one government official who, as late as March 6th was publicly declaring that, “within a couple of days, it was going to be down to close to zero.” That, of course, was over 1.5 million US infections and 90,000 US deaths ago.

There is currently a major effort underway to blame China for America’s late response to Covid-19. That is patently ridiculous—not because China was forthcoming and candid (they weren’t), but because we don’t maintain the $6.5 + billion investment in our CDC to wait for a phone call from China or any other country to tell us when it is time to worry. And, to be clear, while the Chinese government, initially, tried to publically manage and downplay the danger of Covid-19, China’s public health professionals notified both the US CDC and the World Health Organization that something very bad was happening in Wuhan. The Chinese sequenced the RNA of Covid-19 by late January and made that information immediately available to the international community.

Germany had a test ready to go and made it available to the international community by mid-January. South Korea, likewise, made the decision to begin testing for Covid-19 on January 27th after only four confirmed cases had been diagnosed in that country. They understood the danger. One week later they had an approved test ready to go, and would soon lead the world in testing. Why did German and South Korea (and several other countries) spring into action as fast as they did? They had no more information than we had, but they were keenly fixated on the public health problem rather than the political optics. They understood the danger at the very highest levels of government. We, apparently, didn’t.

So, as it turns out, January 2020 was the decisive month in the evolution of the Covid-19 pandemic. That was the month when the world knew enough to act decisively. Some nations did. Some nations didn’t. Speed, once the danger is apparent, is critical. In Germany and South Korea and many other nations, there was no squabbling among officials deciding whether public health imperatives or political imperatives would determine the respective nations’ messaging to their people.

In time, the history of the US government’s response to Covid-19 will be clear. January and February will be the months that will get the most scrutiny. That’s when a clear, high-level understanding of what we potentially faced was most essential. That’s also when clearly articulated and well-coordinated leadership was critical. That’s why we have a well-funded CDC that has been the envy of the world. That’s when something went very wrong at the very time we needed decisive leadership to go very right.

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12 responses to “Coronavirus 2020 and the Failures of January”

  1. susan duman says:

    Yet again you put it all together and remind me of what we should have done, could have done, but didn’t do.
    Thanks for keeping me up to date.

  2. Stephen E. Prover says:

    Excellent. Thank You.

  3. Betty Wolf says:

    Early on, CDC wasted over 30 days when they decided to make their own Covid19 test. They failed. Miserably. Their test was not reproducible and the reagents did not meet QA/QC protocols simple enough for a graduate student to follow and verify.

    CDC, with its bloated, off mission $6.5B annual budget, has over 10,000 employees. They have less than 1,000 dedicated to this epidemic. (Said by the CDC Director). If CDC is viewed as the envy of the world, the world needs to do a closer examination.

    Founded in 1946 to rid America from malaria, it was called the Communicable Disease Center. It had a $10M budget and close to 400 staff. In the early 1970s, its name was edited to the Center for Disease Control and Prevention.
    This is when CDC began its mission and bureaucratic drift as it aspired to duplicate (and compete with) the medical research work of NIH. Over the years, CDC is now heavily funded in areas of obesity, heart disease, smoking studies (Africa, funded by Bloomberg in excess of $40M), birth defects and social services.

    When I fundraised for CDC for nearly 3 years during Ebola, I worked with CDC Senior Executive Service MD/PhDs in meetings to address their woefully outdated computer
    systems that lacked capacity to examine and report on incoming state infectious data. It was stunning to me that our states’ IT systems were superior to the CDC mothership. This is one reason that CDC is dependent on outside data sources like Johns Hopkins and the IHME (Inst. of Health Metrics & Evaluation).

    Rather than citing many personal experiences I had (that were intellectually chilling), CDC needs total reform. It will require significant legislation – and in this hostile political environment – I hope there are people willing to undertake this massive task to put CDC back on mission to detect, respond and be prepared to protect America from infectious diseases.

    We are only one step ahead of the next contagion.

  4. Thomasin Savaiano says:

    This article provides a clarity we do not receive from our current Federal Leaders – and definitely timeline data that, based on their observed behavior, it seems they’d prefer we forget.
    The longer we live through this pandemic, the better the chances are this basic factual data gets buried – thanks for putting history out there now, when it is most needed.

  5. James Fisher says:

    Dear Hal, yet again you exhibit an apparent need to apologize for China’s primary role in the devastation caused by the Covid 19 pandemic and inexplicably display a fervent need to blame it on your fellow Americans.

    From a legal perspective, China’s actions – and its inactions- are indeed the proximate cause of over three hundred thousand deaths worldwide so far – and trillions of dollars of economic wealth that will be lost forever.

    Could our federal administration have acted more quickly – of course it could have – IN HINDSIGHT. Everything can always be done better IN HINDSIGHT. Even the universally respected Dr. Fauci admits he was blindsided early on by the severity of the pandemic.

    I find it patently ridiculous and unfair that whenever you describe China’s behavior early in the pandemic you ALWAYS fail to mention that:

    China stopped all flights from Wuhan to other internal Chinese cities;

    China kept all flights leaving Wuhan for the rest of the world open;

    China acted deliberately to purchase and hoard a good part of the world’s supply of PPE and other needed medical supplies;

    China provided the RNA sequence – but not the actual virus – to the world.

    We need the entire world to hold China’s feet to the fire and demand compensation for their historic, dastardly actions – not offer exculpatory routes for them to escape liability.

  6. Robert J. Fraiman says:

    Evidently the Obama administration left the incoming Trump administration a 69 page Pandemic Playbook. Senator McConnell says he was wrong to claim Obama didn’t leave a Pandemic Playbook . He said I clearly made a mistake in that regard” WOW!

  7. qua says:

    Clearly there is blame enough to go around, but given that in our
    lifetime we have never experienced such a pandemic outbreak
    with such enormous consequences.

    Much credit should be given to the President for his immediate
    halting of flights from China and his attempts to stop this virus.

    There is blame enough but I suggest it lies with China and China largely. Their hesitancy in truly notifying the World that
    yet again they were unleashing another Asian Flu, Sars or what’s now called Corona Virus. Aptly it should be called The
    China Flu.

  8. Reply to James Fisher: There is, of course, no apology whatever for China. One can focus on China’s mismanagement of Coronavirus information to whatever extent they wish, but the fact remains that China’s CDC Director promptly informed the US CDC and WHO in a timely manner. That is why Germany, South Korea and other countries swiftly swung into action to suppress the Coronavirus outbreak. There is plenty of room to criticize China, but we knew enough in January to act decisively. In fact, we did act early to turn down the German test offered to us by the end of January. Our mistakes simply cannot be blamed on China, simply because we lagged behind other countries in getting our testing effort underway. Furthermore, a number of other countries stopped or curtailed their flights to and from China a week to ten days before we took such action. We had both the capability and the information we needed to act swiftly and decisively. We did neither.

  9. Response to Qua: Contrary to Qua’s assertion, the United States lagged many other countries in canceling flights to and from China. South Korea, Germany, France, Canada the UK and many other countries canceled flights well before we did. Furthermore, the fact that we hadn’t experienced such an outbreak in our lifetime is the very reason we and other nations have invested so much to be ready to handle such an outbreak. That we would, sooner or later, face such an outbreak has been state-of-the-art consensus for decades. That’s why Germany, South Korea and other countries swiftly alerted their citizens and acted with swift dispatch to begin testing.

  10. James Fisher says:

    Thank you Hal for reminding me that “One can focus on China’s mismanagement of Coronavirus information to whatever extent they wish..”

    I would like to remind you again of the four widely-acknowledged steps taken by China that I mentioned above:

    China stopped all flights from Wuhan to other internal Chinese cities;
    China kept all flights leaving Wuhan for the rest of the world open;
    China acted deliberately to purchase and hoard the world’s supply of PPE and other needed medical supplies;
    China provided the RNA sequence – but not the actual virus – to the world.

    These despicable, calculated acts were not “mismanagement” – they were deliberate, hostile acts aimed at harming the rest of the world!

    So, how can you discuss the early stages of the virus and not call out the depravity of these actions by China? And why do you not admonish, or at least mention, the many Democrat leaders who excoriated President Trump for stopping the flights from China – calling him both a racist and xenophobe?

    • Additional Response to James Fisher’s additional comment: Mr. Fisher is on safe ground with his general criticism of China. Whether China’s actions, however, were attempts to manage a highly adverse event and downplay the danger of Covid-19 to the outside world or were “despicable acts calculated to harm the rest of the world” is simply not the subject of this essay. We do believe there are legitimate issues to explore regarding China’s need to secure medical supplies for its own use and, consequently, any attempt by China to dampen competitive demand elsewhere in the world. Nonetheless, the purpose of this week’s essay is to focus on the efficiency and speed with which we responded to the need to control the pandemic as compared to other countries. January and February were the months in which robust, decisive, and cohesive action was essential. Our early performance does not compare well with various other countries, especially when we consider our investment in disease control.

  11. Michael Gong says:

    Any attempts to fix blame for the current virus pandemic on a specific person or country are irrelevant, irresponsible and quite possibly dangerous. They are irrelevant because the most pressing problem is determining proper treatment and finding a cure. They are irresponsible because we do not have possession of all the necessary information to positively know who or what is to blame. And they are potentially dangerous. As a person of Chinese descent, although I was born, raised and have lived all of my 82 years in the US, blaming China at this time puts people who look like me at risk of hate crimes, and personal attack. Also, we could be wrong. So now is not the time to find out who is to blame. Now is the time to work together to overcome the damage.

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