As President of the US, how would you have handled the COVID-19 pandemic?

The Quarantine Zone
21

I’m not interested in being fair with an administration that doesn’t believe in science and has, from day one, politicized the response. There aren’t “both sides” here.

The difference is that health experts will inevitably make mistakes with a new outbreak. Health agencies in many, many countries made mistakes, but most of the countries - the ones that we consider our allies and peers at least - tried to get the response right. We didn’t. We’re still not. And it’s so bad that now the administration is taking control of the data from the agency that’s always been responsible for collecting and reporting it, which ought to tell you everything.

No, there’s no need to be fair and I certainly don’t intend to be. Everything traces back to the fact that this administration doesn’t care about healthcare, doesn’t care about science, doesn’t care about the truth: every ‘mistake’ or ‘error’ in judgment traces back to that fact.

22

Actually they HAD been there …

There WAS enough warning to start executing plans, modifying them based on information as it happened, and prioritizing which questions were answerable and needed to be answered with the most urgency. The team of experts was in place to create the plans specific to the details and to trigger the processes needed to cause it to happen.

I can easily come up with a list of things that “Blue Ribbon Panel” would have likely advised (using the early warning to get testing in place as part of the influenza surveillance network, prioritizing research that confirmed or disproved the surprising early finding out of China that children seemed to transmit this poorly, and on) but as president my role would not be to develop those plans but to have those actual best people in the room, to delegate the implementation of those specific plans to teams of those best people, and to use my bully pulpit to get the nation united in understanding the importance of working together, making sacrifices for each other as the situation requires. Part of that would have been explaining that understanding of this virus is incomplete and that there is much we do not know but we do not have the luxury of waiting the years to get all the answers. The role of president in such a circumstance to get broad cooperation with that which seems to be prudent based on what is currently known while neither inducing panic not minimizing the seriousness of the risks of inadequate action.

If I was president I fear I would not have had the skills to do that so well. But not sure anyone other than our current leader would have done it as poorly.

23

Assuming hindsight I’d have ordered a lock down earlier, as well as prepare the ground work for the economic fallout. I certainly wouldn’t have allowed the donation of our PPE to China to help them ‘contain’ this thing, and I’d have not allowed China to secretly buy up the worlds PPE while getting the WHO to tell us all that things were under control.

Without hindsight, however, I think the main difference between my own response and Trump’s would have been listening more to the subject matter experts, injecting less chaos into the system by constantly contradicting my own people, rallying the governors and state political entities to the flattening the curve strategy and getting buy in from the major stake holders, including the American people, and generally trying to limit how far behind the curve we were going to be, regardless. I don’t think that pushing for a crash vaccine program would be all that helpful, any more than what we’ve done. Really, contact tracing and solid and wide spread testing and test kits would have been more effective early on, and hopefully the early cluster fuck wrt the CDC and our own attempts at test kits could have and would have been avoided, but really the key would be limiting the spread, flattening the curve, and figuring out how to mitigate the economic and social impacts of quarantine. Figuring out how to get our own production of PPE and secure supplies would have been another critical task, but I’m unsure how that would have worked considering how China moved behind the scene to almost monopolize supply while telling the world everything was under control. Like I said, this is a with or without hindsight sort of thing.

24

I was amazed and appalled that when we started hearing about a huge disease outbreak in China in January, that we didn’t immediately stop all flights from there, and then from Europe when it made it there.

From there, I’d probably have tried to strongarm governors into shutting everything down earlier and longer than we did, and also do stuff at a Federal level to support and extend that- as well- maybe ground planes, quarantine entire areas (like what Australia’s doing right now), and stuff like that.

I’d also have greased the skids for PPE manufacturing, purchasing, etc…- loans, bulk buys, etc, Defense Production Act, etc…

The big issue though, is that so much is in the hands of the states- even a President’s best efforts could be for naught, if you have morons like Abbott, DiSantis and Ivey running things in those states.

25

But Trump explicitly, loudly and immediately made the whole thing a partisan issue. He encouraged the worst possible behavior from these governors.

26

Exactly. trump set the tone for not taking this thing seriously. Had HE taken it seriously all the Republican governors would have gone all in because their must-please-orange-messiah instincts would have been working in the right direction.

27

Back in January, I would’ve done the following.

Stopped all travel from China. This is one thing Trump did right. I would’ve let returning US citizens come home but only with strict monitored 14 day quarantine.

Enacted the Defense Production Act for ventilators, PPE, and associated supplies such as swabs and reagents. I would NOT have left this to the free market.

Acknowledged the probability of lockdowns in order to give businesses time to prepare and develop a national plan for contact reductions and lockdowns based on local metrics ie…when the situation in your county gets to x point, businesses reduce on premise staff by 25% and ban all gatherings over 250 people. When it reaches point Y, reduce on premise staff by 50% and ban gatherings over 25.

This would’ve given businesses time to prepare and get online infrastructure and planning in place. As I see it, some of the biggest economic hits happened in the first month. Many restaurants closed for a week or two until they got their plans for opening as takeout joints lined up. The yoga studios I attend were completely down for about 3 weeks until they worked out the logistics of going online. Some economic hit was inevitable, but it could’ve been mitigated with proper planning.

The government should’ve, as part of this plan back in January, set the same kind of metrics for easing lockouts and reopening. While such metrics would need to remain fluid, I think that going into these massive shutdowns without having a plan for reversing them in place was short-sighted at best.

We pay, through our taxes, for massive amounts of expertise, yet the agencies were sidelined while the President tried to handle the situation with his friends instead. This was crony capitalism at its worst. Yes, no one could’ve predicted, specifically, a toilet paper shortage. But they should’ve been able to predict that consumer irrationality would cause a shortage of something, and they should’ve had stockpiles and distribution plans for all the most common consumer perishables. They should have anticipated extra demand, not just for disinfectants or hand sanitizers but for things like food takeout containers .Theses government agencies are huge, they should have anticipated every single contingency. They should’ve realized that lockdowns would cause changes in food distribution patterns and had planning in place to correct that. They could have come up with distance learning strategies in advance that could’ve been implemented as soon as schools closed.

Maybe China did lie, but they shouldn’t have gotten away with it. Our tax dollars pay for what should be the largest and most effective intelligence gathering agencies in the world. One of the most enlightening things about the Rick Bright emails was the amount of time effort the scientists put into trying to profile the virus based on the data from the infected cruise ships. They owed it to us to get the data from China and they failed us.

We don’t get anything anymore from our tax dollars investment in intelligence and national security. It’s all about the personal relationship of Trump and Xi . It’s horrifying.

They should’ve never dismantled the pandemic response team. And to be clear, they did dismantle it. They claim the duties were just transferred to the bioterrorism team, but that’s the same kind of BS every company hands out when they eliminate a position. But that ass Bolton is such a warmonger that he didn’t recognize other types of threats.

In short, Trump only did one thing right ( the China travel ban) and he did that for the wrong reason. His insistence on treating the government agencies he ultimately bears responsibility for as enemies is a problem. The fact that he has spent the past three years trying to disempower those agencies and dismantle them from within has come back to bite all of us.

28

But he never did. He imposed restrictions, but Americans (citizens and permanent residents) were exempt, so they were going back and forth from China after the “ban” and others easily skirted the restrictions by traveling to/from China through another country. And unless they had been to Hubei province itself, they didn’t have to undergo mandatory screening or quarantine.

Worse, by the time he announced it, it was already endemic in the US and in Europe. So, rather than full credit, at best he gets partial credit for very late action. By that point, we should have also limited travel from other countries and limited travel to/from hotspots inside the US itself (mainly Seattle at that point, but possibly California as well). New York was hit by infected travelers to/from Europe, after all, so even at the time, people recognized the travel ‘ban’ to China was kind of silly.

It’s questionable how much good it did at the time and, worse, Trump complained that people were telling him it was “too soon” rather than too late and he out loud said he didn’t think it was necessary. He accidentally took an action that was insufficient and much too late in any event.

Instead, I would have imposed travel restrictions earlier and imposed them on other nations as well on top of possibly restricting air travel to/from hotspots within the US (or at least imposed health screenings earlier at airports). And had people undergo mandatory screenings and quarantines and not just those who had gone to Hubei Province. This is more in line with what we did during the Ebola scare a few years back, and it makes even more sense in hindsight.

29

Travel restrictions are very hard to lay blame about. Almost no countries implemented them, and whilst in hindsight they would maybe have helped, with the information available at the time they were difficult to judge. Here in Oz we did place an early travel ban, and with large numbers of returning students getting ready to come into the country for the start of the academic year, it almost certainly did help us. The timing was lucky.
In a post-covid world we might expect travel restrictions to be brought in much more aggressively when new infectious diseases emerge. Those countries with first-hand experience of SARS had good idea what to do.
Ideas about what one would have done based on 20:20 hindsight are easy.

30

Taiwan did very, very well. They had gotten hit very badly by SARS and decided to be as prepared as possible. Of course, many places get burned once and don’t learn from them so they do deserve the praise.

They were ready for a possible Round II with plans for activating a command center, Central Epidemic Command Center (CECC); had an emergency team ready; and over a hundred action items including, an increase in mask production, already set up. Minister of Health and Welfare Chen Shih-chung (陳時中) was selected as head of CECC and gave daily briefings, in which he wore masks and they practiced social distancing.

31

Exactly. By the time Trump stopped travel from China it was far too late…hell, by the time China finally acknowledged that there was human to human transmission (around January 20th) it was too late. The majority of infections that happened in the US were coming in from Europe and European travelers to the US, who had already gotten infected themselves from Chinese still allowed by their government to leave the country even after they were banned from going to other provinces.

It’s hindsight at this point to think that we would or could have stopped all international travel, and if we didn’t do that we were going to get hammered pretty much as we did, especially without adequate testing policies, equipment, doctrine and training.

32

Taiwan did the best of any country, full stop. And they tried to warn others as far back as late December. They also had contact with many mainland doctors as well as mainland people, so they had a clearer idea of what was happening and what was being covered up. And, as you said, they had also learned hard lessons from the previous SARS outbreak and had things in place to deal with it when it happened…and they pulled the trigger on those things very quickly. They were and are the model for how this thing should have been dealt with at each stage.

33

Vietnam may have done even better yet. Unlike Taiwan, they share a direct land border with China itself, have a far larger population (4x Taiwan’s,) and are comparatively less wealthy, and yet they’ve gotten even fewer infections and not a single Covid death yet.

34

Hard to say, as, again, they have a totalitarian Communist regime that controls the narrative. While I don’t think they are hiding things to the extent the CCP is, I don’t trust their numbers as much as I trust the ones from Taiwan. YMMV of course, but I don’t think having a land border is that key. The real key is that while the relations between China and Vietnam aren’t cold war, they aren’t exactly warm and fuzzy, while Taiwan was and even still is a major trade partner and vacation destination for the mainland, as well as having close family ties, so a LOT of mainlanders were in Taiwan for business and leisure, especially in the run up to the Chinese New Year…which, to my mind, makes what Taiwan accomplished even more remarkable.

35

This, for sure. I have to think we would have been better positioned if we had actual experts who were in charge of looking at these things.

And this. If you look at an early thread here, I was worried about this back in Jan, and I bought some masks for my household then. (Actually, I checked my supply left over from SARS1, and decided we had enough. I misjudged that, but I did think to put in a supply.) My thought was, “the worst that happens is I have extra masks lying around, and I can afford this.”

As a nation, we could have afforded to manufacture and stockpile PPE. Also testing supplies – a lot of the early backlogs in testing were due to a shortage of nasal swabs, which other nations had been stockpiling. I wouldn’t have thought of that myself, but I suspect that pandemic team would have. And sanitizers, and ventilators, CPAPs, and the like, as recommended by that pandemic team.

I read somewhere that the government actually thought about this and decided to discourage civilians from hoarding masks rather than make more. (I don’t have a good source.) If true, that was probably the worst single decision the nation has made.

I’d have made sure TSA had an ample supply of PPE, too. And had them take temperatures and quiz incoming travelers about exposure. I would have missed a lot due to pre-symptomatic transmission, but I probably would have succeeded in keeping TSA from itself spreading the disease.

I would also have pushed the airline industry and other forms of public transit to have their staff (at least, the staff that faces the public) wear PPE, and be trained and supplied so they could do it right.

I think it makes sense for a nation this large to make a lot of decisions at the state and local level, but I’d have my pandemic response team collect data and issue guidance. I’d have national testing of sewage in every major municipal center to track the spread of the disease and its rise and fall regionally.

I’d wear a mask in public, and promote that as being responsible and patriotic. If I had a sexy spouse, I would have them work with the fashion industry to make masks sexy. And I’d have publicists working on PSAs about how to correctly wear a mask, with the goal that everyone except the most media-isolated of citizens would have seen videos of proper use of masks several times.

Probably some other stuff recommended by that pandemic response team, too. But those are my initial thoughts.

36

Sure, but who’s to say that a hypothetical President Clinton would have got better cooperation from them? There seems to be only one avenue of decent behavior by GOP governors- a Republican president who behaves properly.

Which is a problem- they should be mature and non-idiotic enough to look out for their state, regardless of the national level politics going on in Washington DC.

37

Governors are not as often as knee-jerk oppositionally partisan as Senators and Representatives are. A clear cohesive battle plan from the CDC, the Surgeon General, a Pandemic Response Team, articulated and supported by a President speaking in “unite together against this threat to us all” terms, would be endorsed by most GOP governors even if coming from HRC.

38

I guess I’m less optimistic about that than you are. I think that it’s true that governors are often not in lock-step with the DC politicians, but that goes both ways. They have a tendency to do what they feel like most of the time- just because the CDC and the President are pushing something doesn’t mean that the governors are automatically going to fall in line, especially if it’s perceived as a partisan issue.

That’s where Trump fucked things up- he deliberately made mask-wearing a partisan issue. What makes it worse is that so many people’s political identities and personal identities are so wound up that they can’t separate the two and just wear a mask out of common sense.

39

A lot of the things that many are saying that “Trump should have done” he or at least the whole USG apparatus did infact do.
There are few worse people to have in charge at this time than Trump (actually, just one, Kanye), and he has done badly even by his standards, but I don’t think there could have been a better outcome under any other President.

Follow the “science”? What the hell does that mean. The science, there is little to go on. It’s a novel disease, just look at the opinion back in March versus now.

“Listen to experts”? Which ones. People have expertise in narrow areas, there is no such thing as an all encompassing “expert”.
Medical experts, economic experts, industry experts, policing experts, all of them need to work together to come up with a wholistic strategy. That wasn’t happening, it seems experts haven’t actually done much work outside their specific area. In March and April we had people saying with a straight face that “public health experts did not need to worry about the economy”, say what? That should have been top,of their worries, how long could the measures they called for be sustained.

Trump failure isn’t in the disaster. It’s in the fact he couldn’t reduce its impact.

40

Almost every one of our peer countries has done better than we have. I find it implausible that we couldn’t have done better. And look at my list – those are all things I would have done differently from trump – objectively different choices that I believe would have led to objectively less-bad outcomes.