His plan was needed, but they weren't going to implement it - until "some point down the road." How does that make any sense at all?Over a critical period beginning in mid-April, President Trump and his team convinced themselves that the outbreak was fading, that they had given state governments all the resources they needed to contain its remaining “embers” and that it was time to ease up on the lockdown.
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For scientific affirmation, they turned to Dr. Deborah L. Birx, the sole public health professional in the [White House coronavirus advice group, and response coordinator of the coronavirus task force]. A highly regarded infectious diseases expert, she was a constant source of upbeat news for the president and his aides, walking the halls with charts emphasizing that outbreaks were gradually easing.
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On April 11, she told the coronavirus task force in the Situation Room that the nation was in good shape. Boston and Chicago are two weeks away from the peak, she cautioned, but the numbers in Detroit and other hard-hit cities are heading down.
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Mr. Trump’s bet that the crisis would fade away proved wrong. But an examination of the shift in April and its aftermath shows that the approach he embraced was not just a misjudgment. Instead, it was a deliberate strategy that he would stick doggedly to as evidence mounted that, in the absence of strong leadership from the White House, the virus would continue to infect and kill large numbers of Americans.
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Key elements of the administration’s strategy were formulated [...] by aides who for the most part had no experience with public health emergencies and were taking their cues from the president. Officials in the West Wing saw the better-known White House coronavirus task force as dysfunctional, came to view Dr. Fauci as a purveyor of dire warnings but no solutions and blamed officials from the Centers for Disease Control and Prevention for mishandling the early stages of the virus.
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Mr. Trump’s bizarre public statements, his refusal to wear a mask and his pressure on states to get their economies going again left governors and other state officials scrambling to deal with a leadership vacuum.
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Not until early June did White House officials even begin to recognize that their assumptions about the course of the pandemic had proved wrong. Even now there are internal divisions over how far to go in having officials publicly acknowledge the reality of the situation.
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By mid-April, Mr. Trump had grown publicly impatient with the stay-at-home recommendations he had reluctantly endorsed.
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At the meetings in [Chief of Staff Mark] Meadows’s office, the issue was clear: How much longer do we keep this up?
To answer that, they focused on two more questions: Had the virus peaked? And had the government given the states the tools they needed to manage the remaining problems?
On the first question, Dr. Birx and [Kevin A. Hassett, a top economic adviser,] were optimistic: Mitigation was working, they insisted, even as many outside experts were warning that the nation would remain at great risk if it let up on social distancing and moved prematurely to reopen.
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If the point was to sustain a monthlong lockdown, the numbers told them, the administration succeeded. If it was to squelch the virus to containable levels, later events would show the officials were oblivious to how widely it was already spreading.
The members of his group believed they had succeeded on the second question, too, although shortages of protective gear continued in some places (and would flare again months later).
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The group thought governors should no longer have trouble getting what they needed for hospitals, doctors and first responders. And they grew increasingly frustrated by what they saw as politically motivated complaining about a lack of federal help and the inability of some states to make effective use of the supplies they were receiving.
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On April 14, the country passed what the group saw as a milestone, administering its three millionth test. Inside the West Wing, [Jared] Kushner was insistent on that point: Given their assumption that infections would not surge again until the fall, there was enough testing ability out there.
Those outside experts who disagreed were largely brushed off. In mid-April, Dr. Ashish K. Jha, director of the Harvard Global Health Institute, urged a top administration official to embrace his call for conducting 500,000 coronavirus tests a day — far more than was happening at the time.
The official, Adm. Brett P. Giroir, the administration’s testing czar, who had been delivering upbeat descriptions of the nation’s growing testing capacity, eventually conceded to Dr. Jha that his plan seemed to be needed. But he made clear the federal government was not prepared to get there quickly.
“At some point down the road,” is what Dr. Jha said Admiral Giroir told him.
NYT
Yeah. Like who is a Democrat and who is a Republican - who does Trump want to punish?On April 10, Mr. Trump declared that, in his role as something akin to a “wartime president,” it would be his decision about whether to reopen the country. “That’s my metrics,” he told reporters, pointing to his own head.
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Three days later, he reiterated his responsibility. “When somebody is the president of the United States, the authority is total and that’s the way it’s got to be,” he said.
The next day, Dr. Birx and Dr. Fauci presented Mr. Trump with a plan for issuing guidelines to start reopening the country at the end of the month. Developed largely by Dr. Birx and held closely by her until being presented to the president — most task force members did not see them beforehand — the guidelines laid out broad, voluntary standards for states considering how fast to come out of the lockdown.
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On April 16, when Mr. Trump publicly announced the guidelines, he made the message to the governors explicit.
“You’re going to call your own shots,” he said. Their critics notwithstanding, White House officials came to feel that they had in fact accomplished their job: giving governors the tools they needed to deal with remaining outbreaks as infections ebbed.
The wind down of the federal government’s response would play out over the next several weeks. The daily briefings with Mr. Trump ended on April 24. The Meadows team started barring Dr. Fauci from making most television appearances, lest he go off message and suggest continued high risk from the virus.
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By June the president was regularly making nonsensical statements like, “If we stop testing right now, we’d have very few cases, if any.”
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Inside the White House, Dr. Birx was the chief evangelist for the idea that the threat from the virus was fading.
Unlike Dr. Fauci, Dr. Birx is a strong believer in models that forecast the course of an outbreak. Dr. Fauci has cautioned that “models are only models” and that real-world outcomes depend on how people respond to calls for changes in behavior — to stay home, for example, or wear masks in public — sacrifices that required a sense of shared national responsibility.
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In his decades of responding to outbreaks, Dr. Fauci, a voracious reader of political histories, learned to rely on reports from the ground. Late at night in his home office this spring, Dr. Fauci, who declined to comment for this article, dialed health officials in New Orleans, New York and Chicago, where he heard desperation unrecognizable in the more sanguine White House meetings.
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As the pandemic worsened, Dr. Fauci’s darker view of the circumstances was countered by the reassurances ostensibly offered by Dr. Birx’s data.
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There were warnings that the models [Birx] studied might not be accurate, especially in predicting the course of the virus against a backdrop of evolving political, economic and social factors. Among the models Dr. Birx relied on most was one produced by researchers at the University of Washington. But when Mr. Hassett reviewed its performance by looking back on its predictions from three weeks earlier, it turned out to be hit or miss.
The authors of the University of Washington model spoke to Dr. Birx or members of her team almost daily, they said, and often cautioned that their work was only supposed to offer a snapshot based on key assumptions, like people continuing to abide by social distancing until June 1.
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Colorado health officials wrote to the administration on April 10, pleading that the White House not use the model to allocate supplies to the state, saying its predictions were rosier than the grim reality they were encountering. (When those concerns were relayed to her, Dr. Birx replied that decisions on allocating equipment were based on factors beyond the one model.)
Gee, how long ago was that impeachment? You know, where it was stressed that letting Trump get away with demanding a quid pro quo from Ukraine could lead to him demanding it of American states? Seems like eons, but it was about six months.[D]espite the outside warnings and evidence by early May that new infections, while down, remained higher than anticipated, the White House never fundamentally re-examined the course it had set in mid-April.
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Dr. Fauci, a friend of Dr. Birx’s for 30 years, would describe her as more political than him, a “different species.” More pessimistic by nature, Dr. Fauci privately warned that the virus was going to be difficult to control, often commenting that he was the “skunk at the garden party.”
By contrast, Dr. Birx regularly delivered what the new team was hoping for.
“All metros are stabilizing,” she would tell them, describing the virus as having hit its “peak” around mid-April. The New York area accounted for half of the total cases in the country, she said. The slope was heading in the right direction. “We’re behind the worst of it.” She endorsed the idea that the death counts and hospitalization numbers could be inflated.
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She routinely told colleagues that the United States was on the same trajectory as Italy, which had huge spikes before infections and deaths flattened to close to zero.
“She said we were basically going to track Italy,” one senior adviser later recalled.
Dr. Birx would roam the halls of the White House, talking to Mr. Kushner, Ms. Hicks and others, sometimes passing out diagrams to bolster her case. “We’ve hit our peak,” she would say, and that message would find its way back to Mr. Trump.
Dr. Birx began using versions of the phrase “putting out the embers,” wording that was later picked up by the press secretary, Kayleigh McEnany, and by Mr. Trump himself.
By the middle of May, the task force believed that another resurgence was not likely until the fall.
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But the models and analysis embraced by the West Wing failed to account for the weakening adherence to the lockdowns across the country that began even before Mr. Trump started urging governors to “liberate” their residents from the methodical guidelines his own government had established.
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Dr. Birx’s belief that the United States would mirror Italy turned out to be disastrously wrong. The Italians had been almost entirely compliant with stay-at-home orders and social distancing, squelching new infections to negligible levels before the country slowly reopened. Americans, by contrast, began backing away by late April from what social distancing efforts they had been making, egged on by Mr. Trump.
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The real-world consequences of Mr. Trump’s abdication of responsibility rippled across the country.
During a briefing on April 20, Mr. Trump mocked Gov. Larry Hogan of Maryland, a fellow Republican, for the state’s inability to find enough testing. Dr. Birx displayed maps with dozens of dots indicating labs that could help.
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But when Frances B. Phillips, the state’s deputy health secretary, reached out to one of those dots — a National Institutes of Health facility in Maryland — she was told that they were suffering from the same shortages as state labs and were not in a position to help.
“It was clear that we were on our own and we need to develop our own strategy, which is very unlike the kind of federal response in the past public health emergencies,” Ms. Phillips recalled.
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After offering to help acquire 350,000 testing swabs during an early morning conversation with one of [California Governor Gavin] Newsom’s advisers, Mr. Kushner made it clear that the federal help would hinge on the governor doing him a favor.
...but hey, do what you want...you will anyway.“The governor of California, Gavin Newsom, had to call Donald Trump, and ask him for the swabs” [and publicly thank him] recalled the adviser, Bob Kocher, an Obama-era White House health care official.
Mr. Newsom made the call as requested and then praised Mr. Trump that same day during a news conference where he announced the commitment, giving Mr. Trump credit for the “substantial increase in supply” headed to California.
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Other nations had moved aggressively to employ an array of techniques that Mr. Trump never mobilized on a federal level, including national testing strategies and contact tracing to track down and isolate people who had interacted with newly diagnosed patients.
“These things were done in Germany, in Italy, in Greece, Vietnam, in Singapore, in New Zealand and in China,” said Andy Slavitt, a former federal health care official who had been advising the White House.
“They were not secret,” he said. “Not mysterious. And these were not all wealthy countries. They just took accountability for getting it done. But we did not do that here."
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By early June, it was clear that the White House had gotten it wrong.
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Digging into new data from Dr. Birx, they concluded the virus was in fact spreading with invisible ferocity during the weeks in May when states were opening up with Mr. Trump’s encouragement and many were all but declaring victory.
With the benefit of hindsight, the head of the Centers for Disease Control and Prevention, Dr. Robert R. Redfield, acknowledged this week in a conversation with the Journal of the American Medical Association that administration officials — himself included — severely underestimated infections in April and May. He estimated they were missing as many as 10 cases each day for every one they were confirming.
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On Thursday, there were more than 75,000 confirmed new cases, a record.
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Mr. Trump’s disdain for testing continues to affect the country. By the middle of June, lines stretched for blocks in Phoenix and in Austin, Texas. And getting results could take a week to 10 days, officials in Texas said — effectively inviting the virus to spread uncontrollably.
Dr. Mandy K. Cohen, the top health official in North Carolina, contacted the Trump administration after a surge in June, asking the government to quickly open 100 new testing sites in her state, in addition to the 13 it was then operating.
“We will keep those 13 open for another month — you are welcome,” Dr. Cohen said, mocking the response she received.
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