Cleaveland: Administrative malpractice in the COVID-19 pandemic

Staff photo by Doug Strickland / Dr. Cliff Cleaveland poses for a photograph in the Times Free Press studio in July 2019. Dr. Cleaveland was selected as a 2019 Champion of Health Care.
Staff photo by Doug Strickland / Dr. Cliff Cleaveland poses for a photograph in the Times Free Press studio in July 2019. Dr. Cleaveland was selected as a 2019 Champion of Health Care.

From its outset, the Trump Administration systematically dismantled the nation's protections against pandemic disease. We are currently paying a heavy price for those actions.

The Los Angeles Times reported in April that the administration had ended support for a program charged with identifying emerging pandemic threats. Following the SARS outbreak in 2002, the U.S. Agency for International Development (USAID) launched an initiative to train and to provide support for scientists in labs in foreign countries, including China, to identify potential pandemic threats before they could spread. Eventually, 60 nations participated. The program had the support of both the Bush and Obama administrations. Labs within the network focused upon diseases that occurred at the interface between animals and people. Affiliated scientists identified hundreds of potential causes for epidemics, including 160 novel coronaviruses. The linked research laboratories served as a worldwide, early warning system for possible pandemics. Work at the labs ceased in September 2019 when funding ended.

In 2015, in response to an Ebola epidemic in Africa, the Directorate for Global Health Security and Biodefense Unit was established as a part of the National Security Council. The unit had primary responsibility for preparing for possible pandemics. The guiding principle for the unit was swift response to threats of pandemic so that spread could be limited. The unit was disbanded in May 2018 without replacement.

Reuters news agency reported in March 2020 that during the preceding two years, staff at the Beijing office of the Centers for Disease Control and Prevention had been reduced from 47 to 14. Dismissed staff included epidemiologists and other medical experts, who worked with their Chinese counterparts in the assessment of infectious diseases. No explanation for the decreased manpower was offered.

In 2016, the National Security Council assembled a 69-page manual for addressing pandemics. Titled, "Playbook for Early Response to High Consequence Emerging Infectious Disease Threats and Biological Incidents," the document outlines policies and tactics for addressing a wide array of such challenges. Topics range from assessing risks to the U.S., establishing a chain of command, assuring availability of adequate protective equipment, managing international borders, informing the public, and employment of the Defense Production Act to meet shortages of critical equipment. In a section dealing with possible, highly contagious, respiratory infections, the playbook lists coronaviruses, referencing previous outbreaks of SARS and MERS, both of which were caused by coronaviruses.

The playbook was included in materials provided during the transition from Obama to Trump administrations. It is not clear who, if anyone, may have read the manual after the transfer. The document can be accessed in the March 25 issue of Politico. The manual is nowhere to be found on government websites.

Did this administration from the outset not understand the risk posed by pandemics? Or did it choose to ignore such a possibility? Did politics lead to the abandonment of relevant programs developed during the Obama Administration? Did no one among the president's senior advisers in matters of health sound an alarm when the first cases of coronavirus were reported from China? Whatever the explanation, the current administration is guilty of malpractice.

Tens of thousands of Americans have perished and our economy has been disrupted by as a consequence of a pandemic that could have been foreseen and contained.

Contact Clif Cleaveland at ccleaveland@timesfreepress.com.

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