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America weakened and dismantled institutions created to respond to pandemics.

Covid-19 was not the first global pandemic in modern times. In 1918, the “Spanish flu” swept around the world, killing more than 600,000 people in the United States, which at the time had a population of approximately 100 million citizens. This pandemic was the greatest public health hazard ever faced by the United States, but it would not be the last new virus to threaten the country. In later years, there would be outbreaks of swine flu, AIDS, Ebola, influenza and Zika. Although these threats were serious, they did not kill as many people in such a short period of time as the terrible pandemic of 1918. Experts predicted, however, that it would be only a matter of time before another great pandemic arose that would rival or exceed the death and suffering caused by the Spanish flu.

Based on the lessons learned from earlier outbreaks of infectious disease, the United States created institutions to contain and defeat future onslaughts, including the Centers for Disease Control and Prevention (CDC), the leading agency in the world for dealing with infectious disease. The second Bush administration created a playbook to deal with pandemics, as did the Obama administration. The Obama administration also created a pandemic response team and placed a pandemic advisor on the National Security Council. Other countries also created disease control agencies, in many cases inspired by and assisted by the U.S. CDC. On the global level, the World Health Organization (WHO) was created under the umbrella of the United Nations. Although this organization would receive some criticism for its handling of Covid-19, it played an invaluable role in coordinating responses to disease on a global level. In fact, WHO led a successful effort to eradicate smallpox over a period of several years, and by 1980 was able to declare that there were no more cases of this dreaded scourge, the first time that any disease had been eliminated from the face of the earth.

Prior to the pandemic, funding for the CDC was reduced. From the beginning of the pandemic, the CDC, the preeminent disease agency in the world, was sidelined and hobbled. In prior epidemics, the CDC had frequently briefed the public, but now it was eerily silent, prompting concerned observers to wonder what was wrong with the CDC. When the CDC did issue guidelines, the administration either undermined them (as with facemasks) or pressured the CDC to water them down (as with reopening businesses and schools). The administration also encouraged states and localities to reopen when the federal government’s own reopening guidelines issued by the CDC had not been met.

The Trump administration also weakened and attacked the WHO. Even before the pandemic hit, the United States had reduced its contributions to the WHO fund devoted to responding to pandemics. After its mishandling of the pandemic became politically embarrassing to the administration, the President decided to cut funding for WHO and withdraw the United States from that organization. Ironically, the WHO developed an effective Covid-19 test before the United States did, and offered that test to the United States, which refused to use it.

The Trump administration inherited a national stockpile of ventilators and other supplies and equipment that would be needed for a respiratory pandemic such as Covid-19. The President would later claim that the “cupboard was bare” when he took office, but when questioned was unable to come up with a good answer about what he had done to restock the shelves during the first 3.5 years of his term. The Trump administration also allowed a contract to maintain the equipment to expire, and when the pandemic hit, many of the ventilators in the inventory did not work. The prior administration had also paid to have a private company design a machine which could manufacture a million masks a day. This machine was never funded or built, despite a critical shortage of masks for health care workers. Doctors and nurses were forced to wear disposable masks that were never meant to be reused.

America ignored early warnings of the coming crisis, reacting slowly to the threat.

On December 31, 2020, the CDC learned of the first cluster of cases in China. On January 3, 2020, the White House received its first formal notification of the outbreak. Within a few days, intelligence agencies had issued a warning about the virus in the President’s Daily Briefing. By January 8, 2020, the CDC had issued a public alert about the new disease. Despite these early warnings, the United States did almost nothing over the next 70 days to prepare for the coming storm. On January 22, 2020, the President claimed that the virus “was totally under control.” By July 29, 2020, however, there were more than 4 million cases of Covid-19 in the United States with no end in sight.

The President’s main talking point when questioned about why his administration was so slow to respond to this crisis, is to boast that he acted early to ban travel from China. On January 31, 2020, the government announced restrictions on non-citizens entering the United States who had been in China during the preceding two weeks. Many other countries imposed similar restrictions before or at the same time as the United States, and during the month before the announcement of a travel “ban,” 300,000 people came to the United States from China. Even after the “ban” went into effect on February 2, 2020, more than 27,000 Americans returned from Mainland China in the month after restrictions were imposed. U.S. officials lost track of more than 1600 of these people who were supposed to be monitored for virus exposure. Furthermore, the restrictions did not apply to China’s Hong Kong and Macao territories, and more than 8000 Chinese and foreign nationals based in these territories came to the United States after the ban.

Meanwhile, the virus was spreading around the world, and Europe would become the next epicenter of the virus. On March 11, 2020, the Trump administration ordered a halt to air traffic from Europe. During the month prior to this order, hundreds of thousands of people crossed the Atlantic, many of them arriving in New York, which would eventually take its turn as the epicenter of the global pandemic, with hospitals renting refrigerated trucks to store the overflow from their morgues.

Despite the horrific examples of China and Europe, America did little to stockpile needed supplies and equipment, expand hospital capacity, increase manufacturing of critical items,, and ramp up testing. When cases surged in the United States, there were widespread shortages of personal protective equipment, especially masks; ventilators; and critical testing supplies such as swabs and chemicals used in testing. Something as simple as swabs, essentially cotton balls on sticks, were in short supply in the greatest industrial power in the history of the world.

The President was repeatedly urged to use the National Defense Production Act to increase production of needed supplies and equipment, but seemed reluctant to do so, although he did use the act to urge meatpacking plants to remain open despite outbreaks of virus in those facilities.

On March 13, 2020, President Trump declared a state of national emergency but dozens of states did not issue stay at home orders or close businesses until weeks later. For example, Florida and Georgia did not issue orders until April 3, 2020, and South Carolina waited until April 7, 2020. According to a study done at Columbia University, if broad based social distancing measures had been implemented in the United States one week earlier, on March 8, 2020 instead of March 15, 2020, 36,000 deaths could have been prevented between March 15, 2000 and May 3, 2020, and if such measures had been implemented two weeks earlier, 54,000 lives could have been saved. According to other studies, if the United States had taken early decisive measures like other countries, at least 70% of its deaths could have been avoided.