Inside the Doomed US Coronavirus Response

US health-care expert Andy Slavitt’s new book, “Preventable”, is one of a growing stream of books on COVID-19.  It offers Slavitt’s “Inside Story of How Leadership Failures, Politics, and Selfishness Doomed the US Coronavirus Response”.

Slavitt brings to the book his long private and public sector experience working on health-care issues — from running the Centers for Medicare and Medicaid Services under President Obama, advising Jared Kushner in the Trump White House, to being a senior advisor for the COVID-19 response in the Biden White House.

Managing COVID would have been a challenge for any president, Democrat or Republican, according to Slavitt, but Trump made it worse than it needed to be.  He had been briefed in January 2020 on the potential seriousness of COVID, but then proceeded to deny reality for over two months, while people were dying in large numbers.  And when he started speaking of COVID, he was always downplaying it, using his improvisational nature to pander to his base with spurious analyses and bogus cures.     

Trump’s White House stopped public health officials from speaking to the press and the public for 45 days during COVID’s early days, out of fear that they would contradict the White House’s narrative of denial.  He also played to divisions in American society by politicising basic public health measures like masks and social distancing.

In short, Trump always saw COVID as a political problem, not a public health crisis, writes Slavitt.  He did not want COVID to adversely affect the stock market and the economy, and thus his reelection prospects.  One of his key strategies was to push blame for pandemic management onto others, notably state governors. 

Ironically, COVID offered Trump a great opportunity for demonstrating leadership, by which he could have pulled the country together, something which he regrettably abrogated.  The human costs of Trump’s appalling leadership have been enormous.  Slavitt estimates that had the US responded to COVID like Germany, it would have saved 70-80 percent of the lives lost.

Slavitt argues that COVID shines a light on many aspects of American society and politics.  He highlights America’s growing mistrust of science and expertise, and demagogues who belittle scientists for making a minor mistake and use that pretext for pushing their own views.  Slavitt insists that experts are necessary for understanding concepts like asymptomatic transmission and exponential growth.

Slavitt highlights how social inequality multiplied the impact of COVID on America.  He tells the story of Ahmed Aden who works in an Amazon warehouse in Minnesota.  Ahmed caught COVID, but since he could not afford a COVID test which would provide proof to his bosses, he lost his pay.  While he was suffering from COVID, he was stuck in his two bedroom, public-housing apartment with his wife and five kids.

The plight of America’s “essential workers”, about half the population, is a key focus of Slavitt’s book.  They have risked their lives to keep the economy going through COVID, and include farm workers, truck drivers, and people working in meat packing plants, grocery stores, delivering meals, in Amazon warehouses like Ahmed, and so on.  COVID has not been a major hardship for elites who have felt relatively safe through COVID, working from home, socially isolating, receiving deliveries from Amazon and others, using accumulated savings, while the lower strata have not.  According to Slavitt, one of the learnings of COVID has been that a lot of kids don’t eat lunch unless they go to school, and lots also don’t have Internet access at home.

One very positive story that Slavitt tells is that of Operation Warp Speed, a public–private partnership initiated by the United States government which invented the mRNA platform.  This research was driven by career civil servants, under the leadership of Anthony Fauci, Chief Medical Advisor to the President,.for two decades in response to SARS, MERS and other threats.  This meant that when Tony Fauci downloaded COVID’s genomic sequence on 13 January, work could be quickly started by Moderna and Pfizer on developing a mRNA COVID vaccine.  This is something that all Americans should be grateful for.

Will the US learn the lessons of its abject failures in responding to COVID-19, and be more effective when the next virus comes along?  According to Slavitt, there are some technical things that can be better managed — like developing vaccines more quickly, and building up an adequate strategic stockpile of PPE, ventilators, and masks.  The Centers for Disease Control and Prevention (CDC) desperately needs reform so that it could become a more effective resource.

However, social and cultural issues remain America’s great problem, writes Slavitt.  Like all the issues provoking social unrest like the tradeoff between individual liberty and the collective good, the mask mandate, lockdowns and vaccines.  Clearly better national leadership will be necessary, as will rational dialogue involving community leaders.  Slavitt argues that Americans are too long out of the habit of sacrificing for the common good.  America needs to become a better nation, one that protects its people.

For the moment, Slavitt argues that thanks to President Biden and science, America now has a manageable challenge, as opposed to a very scary one that we don’t know how to manage.  That said, many problems remain like low vaccination rates among people of colour and rural conservatives, continued identity politics around masks and social distancing, and popular disdain for science and scientists.

COVID-19 is generating a growing literature that examines the manifold aspects of the pandemic.  Slavitt’s new book makes a worthy contribution as it focuses on the nitty-gritty of America’s management of COVID. 

Reference:

Andy Slavitt.  Preventable:  The Inside Story of How Leadership Failures, Politics, and Selfishness Doomed the U.S. Coronavirus Response.

https://us.macmillan.com/books/9781250770165