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Tuesday, July 28, 2020

'American Catastrophe: How Did We Get Here?': 5 key takeaways - ABC News

Tens of thousands dead. Millions more infected. An economy crippled. How did we get here?

When an outbreak of the novel coronavirus emerged late last year in Wuhan, China, few could have imagined the depth of its devastation. The virus crossed borders and oceans, eventually spreading throughout the United States and forever reshaping the lives of those left in its wake.

Now, months later, a wide-ranging ABC News investigation examines the evolution of the global pandemic through extensive interviews with current and former public health and national security officials.

Their collective voice tells the story of a viral infection that exposed gaps in leadership that left millions of Americans vulnerable.

Here are five key takeaways from the ABC News investigation:

'Red Dawn': A collection of former officials sounded an alarm. Were they heard?

In January and February, as the nascent coronavirus grew from outbreak to epidemic to pandemic, a group of former public health and national security officials, some of whom had helped craft a set of so-called "pandemic playbooks" to help guide a unified federal response, privately encouraged officials across the Trump administration to heed warnings of an impending disaster.

Dr. James Lawler, a former National Security Council (NSC) official during both the Bush and Obama administrations who worked specifically on pandemic preparedness, said this was "a serious group," with "many folks who had thought for a long time about pandemics."

To them, at least, the seriousness of the threat was clear.

"Our various groups that look at these things were giving each other the play-by-play on what we were hearing and what we were seeing," Lawler told ABC News. "It was obvious very early on, in January, that this had the potential to be a serious global event."

They exchanged concerns and ideas in a lengthy email thread, which they called "Red Dawn Rising" – a reference to the Cold War-era film by the same name in which a band of Americans work to repel Soviet invaders. In hindsight, the concerns they raised seem prophetic.

Frustrated with a president who seemed intent on downplaying the disease's threat, this band of experts – six of whom spoke with ABC News, many for the first time publicly – offered their unvarnished thoughts to senior administration officials, including top medical advisors in the departments of Defense, Homeland Security, Veterans Affairs, and Health and Human Services.

"The president began to say that nobody could imagine that something like this could actually occur," Dr. Dan Hanfling, a biosecurity and disaster response expert in Virginia, told ABC News. "The truth is that there was a group of us that had been trying to raise the alarm."

On the eve of crisis, a pandemic preparedness office scrapped

The White House National Security Council once featured a pandemic preparedness desk that monitored for biological threats to the security of the United States.

Its dissolution – less than a year before the novel coronavirus first emerged in China – has become fodder for the president's critics.

The office traced its roots back to 2015, when Ron Klain, who had been brought on to coordinate the Obama administration's Ebola response, suggested leaving a permanent position in place at the NSC to deal with pandemic preparedness. Obama agreed, and the White House's National Security Council Directorate for Global Health Security and Biodefense was born.

Then John Bolton took the helm as President Trump's third national security advisor. Eager to shake up the national security bureaucracy and downsize the staff, Bolton disbanded the office in 2018.

"It is my understanding that they were trying to reduce the size of the National Security Council, and there are a lot of arguments for why that is a good thing," said Elizabeth Neumann, who until recently served as the Trump administration's assistant homeland security secretary for threat prevention and security policy. "That said, the National Security Council plays a really critical role when it comes to crises and inter-agency coordination."

A senior administration official rejected claims that Bolton and Trump disbanded the office, telling ABC News that its work was absorbed elsewhere within the NSC to "optimize responsiveness to challenges in largely overlapping fields." The official added that "no positions related to pandemic preparedness were eliminated" in the re-shuffling.

Bolton echoed the administration official's denial, insisting the office's dissolution amounted to nothing more than a "streamlining" of the NSC, but critics feel strongly that Bolton's decision impeded the federal government's ability to react effectively to the novel coronavirus by removing a coordinating office and signaling that pandemic preparedness was not a priority.

"I play music," Hanfling told ABC News. "It's pretty helpful to have somebody leading, somebody who is actually signaling the changes and counting the time and so on, and I think that's what that office would have provided."

"In retrospect," he said, "not such a great move.

Lost time: After early action, opportunities squandered

Experts say that a delayed response from the federal government and a lack of cooperation from foreign counterparts hampered the nation's ability to prepare for the pandemic.

Robert Redfield, director of the Centers for Disease Control and Prevention, said the Chinese central government's resistance to help from the U.S., despite the CDC's offers, was a missed opportunity for American scient​ists to learn about the virus early in the crisis.

"I think that was unfortunate," Redfield told ABC News. "If we could've gotten in to assist China in the first weeks of January, I think there would be a different situation today. … We had literally 20, 30 people ready to go in and assist, and then to be sorta told, 'Stand down.' Yeah, it's frustrating."

Dr. Anthony Fauci, the nation's top infectious-disease expert, told ABC News the Chinese government's refusal to provide a sample of the actual virus to American scientists caused another significant delay in understanding that speed at which it the virus was spreading from person to person. By the time the outbreak in Washington state made it clear the virus was spreading through human contact, Fauci said, community spread had already progressed significantly.

"It isn't something where you know everything that you're going to know from day one," Fauci told ABC News. "The insidious aspect about community spread is that … you don't know who is infecting who. Once that happens, that is the big red flag that we have a real serious problem. And that's when we first started realizing the first community spread that was not related to an identifiable source. Now we see an explosion of that. That's exactly what went on in New York, went on in Chicago and New Orleans, and what is currently now, as you and I are speaking, which is going on in several of the southern states."

Once public health officials identified the potentially catastrophic nature of the contagion, the challenge was to act immediately and get leadership and the public on the same page, said Elizabeth Neumann, who until April served as assistant homeland security secretary for threat prevention and security policy.

"When you're an emergency management professional, you're constantly balancing not wanting to be Chicken Little," Neumann told ABC News. "'The sky is falling, the sky is falling.' Then nothing happens, and the next time you have to say the sky is falling, nobody believes you."

"So there's always a tension there," Neumann said, "in trying to clearly communicate to the public, clearly communicate to leadership, what the concerns might be, what the likelihood of a potential disaster could be."

Tom Bossert, former homeland security adviser to President Trump and an ABC News contributor, said sticking with containment efforts until there was hard evidence of community spread was a "sequential mistake" made during those critical early months as symptomatic and asymptomatic infectious people were "walking around in any community at any given time, unbeknownst to not only the public health authorities, but to the people that were sick."

"Once there's 1% or more prevalence," Bossert said, "it becomes very difficult for human, non-pharmaceutical interventions to contain it."

Inadequate testing blinds leaders

Until April, the United States lagged far behind numerous other countries on testing even as community spread was actively occurring across the country and around the world.

"Like any threat, you can't fight it if you don't know where it is," Klain told ABC News.

Assistant Secretary of Health Adm. Brett Giroir, the nation's top health official tapped by President Trump to oversee coronavirus testing, told ABC News the government was not prepared to ramp up its testing efforts early in the pandemic because testing supplies were not part of the national stockpile.

"When I looked to see what was there, there was nothing there," Giroir told ABC News. "We didn't know what industries were involved. We needed these strange things called swabs. Who makes swabs?"

According to CDC Director Redfield, companies were slow to jump into testing early on in the coronavirus crisis because of their past experience with SARS and MERS. Because those ailments never spread widely, private labs saw tests go unused, he said.

"By the time they developed the test there was no market for the test," Redfield told ABC News.

But the president's critics say the administration should have quickly used the Defense Production Act to boost testing efforts early on -- an effort that's now being implemented as several states and private labs are once again faced with testing shortages, supply issues and a significant lag in turnaround time for test results nearly half a year into the pandemic even after the federal government and states across the country have significantly ramped up testing efforts.

FDA Commissioner and White House Coronavirus Task Force member Stephen Hahn attributes the current testing shortage to an increase in demand as tests open up to asymptomatic people.

"I think it's a reasonable public health strategy that we've done that," Hahn told ABC News. "Our job at FDA is to say, 'Okay, where's the next generation of tests so that we can scale up by tens of millions per month?' Fortunately, that's happening."

But several states, including California, have recently reverted to prioritizing symptomatic patients. Former New York City Health Commissioner Dr. Mary Bassett told ABC News the lag in turnaround time for testing results -- which is as long as a week in some places -- are "not acceptable."

"It makes a complete mess of all public health prevention strategies of a communicable disease," said Bassett, who oversaw New York City's Ebola response. "You have to have rapid turnaround."

Mixed messages undermine a public's confidence in response

In 2005, when President George W. Bush dispatched his top public health officials to craft a pandemic preparedness plan, a top priority was to convey a clear, unified message to the American people about the federal government's response.

"It was interesting to go back and reread the pandemic plan from 2005," said Dr. Julie Gerberding, who directed the Centers for Disease and Control from 2002 to 2009 and helped convince Congress to adopt the Bush strategy. "If you go down the list, it included … communication capability development with trustworthy spokespeople."

Public health officials say President Trump's rhetoric has set back efforts to convey a unified message to Americans.

Both supporters and critics of the president have accused him of downplaying the threat of the pandemic.

"As I watched a lot of this evolve from January through February and March, I was worried about a number of mistakes that, it appeared to me from the outside, were being made, or at least in communication with the public were being made," said Tom Bossert, a former homeland security advisor to Trump who was also a security aide to Bush when the 2005 pandemic plan was enacted. "I mean, this is the part that's so hard for me. Yes, of course, there's bad leadership right now. It's so self-evident that you don't need me to say."

The president and his close political advisors often offered messages in direct conflict with his public health experts. The friction between the two factions came to a head earlier this month when the president's trade advisor, Peter Navarro, penned an op-ed in USA Today critical of Fauci, the administration's top infectious disease expert.

"What are people supposed to think when the federal government has a plan for reopening and the president is telling people to ignore his experts' own plan for reopening?" asked Klain. "That confuses everyone. It leads to politics, division, divisiveness. It leads to some of these protests you were seeing."

President Trump imposed a travel ban from Europe, which he has cited as an important early response. But some health experts say it also drove a massive number of people back to the U.S. at a time when social distancing was needed.

"He said he was banning everyone, and that led to a panic," Klain said. "It led to thousands and thousands of people coming back from Europe who didn't need to come back. It led to people being jammed up in U.S. airports and probably a lot of coronavirus was brought to this country and spread once in this country."

"The implementation of that could have gone much -- needed to have gone better, because people ended up in those crowded hallways for a long period of time," Neumann said. "And many were exposed, and reportedly have passed because of their exposure waiting to clear customs."

Public health experts haven't been immune from criticism for their mistakes. In early March, for example, Fauci characterized the risk of Americans contracting the illness as "really relatively low" while the surgeon general discouraged the use of masks.

Adm. Brett Giroir, the Trump administration's testing coordinator, described how conflicting messages erode public trust in the government's response – and the challenges of being the bearer of bad news.

"I can tell you I've tried – and all my colleagues have tried, to the best of our ability – to be completely transparent and open with the American people. I've been accused of being the person who's more negative," Giroir said. "I've tried to be right down the middle of the fairway. Because I believe it's important for the American people … to know that this is very serious."

This report was featured in the Tuesday, July 28, 2020, episode of “Start Here,” ABC News’ daily news podcast.

"Start Here" offers a straightforward look at the day's top stories in 20 minutes. Listen for free every weekday on Apple Podcasts, Google Podcasts, Spotify, the ABC News app or wherever you get your podcasts.

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'American Catastrophe: How Did We Get Here?': 5 key takeaways - ABC News
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