Conflicting statements about the potential severity of the coronavirus outbreak in the US from government officials is dangerous, public health experts warn.
“It’s really important for the U.S. government to be speaking with one common voice about these issues right now,” Tom Inglesby, an infectious diseases physician and director of the Center for Health Security of the Johns Hopkins Bloomberg School of Public Health, tells STAT.
That’s not happening. On Tuesday (February 25), a Centers for Disease Control and Prevention (CDC) official announced that COVID-19 could start spreading at the community level in the US shortly and that if the outbreak did hit the states, there could be “severe” disruptions to daily life. The next day, President Donald Trump held an evening press conference in which he said he didn’t think an outbreak in the US is inevitable. “I don’t think it’s inevitable because we’re doing a really good job in terms of maintaining borders and turning—in terms of letting people in, in terms of checking people,” he told reporters. He did not mention a new disease case reported the same day in California that couldn’t be accounted for by foreign travel or contact with someone known to be infected.
In the same press conference, Trump contradicted his own health officials. He predicted that there might be just one or two more people who report being infected in the next short period of time, yet, minutes later, Health and Human Services (HHS) Secretary Alex Azar and CDC Principal Deputy Director Anne Schuchat both said that they expected the number of infections to grow. There are currently 60 reported cases of COVID-19 in the US.
Earlier in February, Trump also said the spread of the virus could dissipate by April when the weather warms. While some viruses, such as the flu, don’t spread as easily in higher temperatures, it is not clear SARS-CoV-2, the coronavirus that causes COVID-19, is one of them. Government officials saying that the coronavirus outbreak is just like the flu isn’t entirely accurate, notes Ronald Klain, who oversaw the Ebola response in President Barack Obama’s administration. He responded to comments Tuesday by Chad Wolf, acting secretary of the Department of Homeland Security, in testimony before Congress. “The responsible answer [to whether the outbreak is like the flu] is ‘we don’t know yet,’” Klain said.
“Americans need facts and science—not reassurance that all will be well. The presidential press conference on the coronavirus pandemic was, sadly, a disappointment,” Arthur Caplan, a bioethicist at NYU Langone Health, says in a statement emailed to The Scientist.
Disagreement between the State Department and CDC about the decision to fly home 14 Americans infected with SARS-CoV-2 also led to questions about who was leading the effort to contain the disease in the US. The CDC recommended that the patients not be flown home from Tokyo after leaving quarantine on the Diamond Princess cruise ship, but the State Department overruled the recommendation, according to The Washington Post.
Unmixing the messages
Government messaging may become more consistent, as President Trump announced Wednesday (February 26) that Vice President Mike Pence would be coordinating the response to the disease threat going forward. Now, government health officials and scientists are required to coordinate any statements and public appearances with Pence’s office, officials tell The New York Times reports. That includes Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases.
“Presidents Reagan, Bush, Clinton, Bush and Obama trusted Tony Fauci to be their top adviser on infectious disease, and the nation’s most trusted communicator to the public. If Trump is changing that, it is a threat to public health and safety,” Klain wrote on Twitter.
On Thursday (February 27), Pence announced Deborah Birx, who currently directs the US effort to combat HIV and AIDS, will be the White House Coronavirus Response Coordinator. Azar remains the chairman of the government’s coronavirus task force, again leading to uncertainty.
“It is unclear who has the lead in responding to this epidemic. The Vice President? HHS Secretary Azar? The public needs a clear voice to give them factual information. The Vice President is not the appropriate person to lead. He solicits skepticism about matters of science because of past opinions that are viewed by many as anti-science or anti-public health. He is simply not a credible ‘czar’ to lead these efforts,” Caplan says.
Deficits of past decisions
In addition to making sure information from the administration is consistent, Pence and other coronavirus response leaders may face other challenges left lingering by Trump’s past decisions. It’s been two years since Trump disbanded the global health security team that was supposed to prepare the country for pandemics, such as what might develop from the new coronavirus outbreak. The President maintains he can build the response team he needs rapidly enough to counter a pandemic, but health experts aren’t so certain.
“You build a fire department ahead of time. You don’t wait for a fire,” Inglesby tells The Washington Post. “There is an underappreciation for the amount of time and resources required to build a prepared system.” To establish such a network, Trump will also have to rely on the very experts he’s criticized in the past, the Post reported in another piece.
There’s now also a whistleblower report claiming health workers who processed some of the repatriated citizens that had the virus or could have been exposed to it were not given proper safety gear to protect themselves from contracting SARS-CoV-2 and were not properly trained in how to monitor their own health until days after they’d interacted with potentially ill patients, the The New York Times reports.
The administration has requested $2.5 billion for emergency response efforts, but politicians from both parties have said the sum is not enough to combat a pandemic. Senate Minority Leader Chuck Schumer (D-NY) countered the administration’s request with a proposal of $8.5 billion. The President indicated he would be willing to spend what was needed, and Senate Majority Leader Mitch McConnell (R-KY) also seemed to indicate more money could be appropriated for the response.
“There seems to be little question that COVID-19 will eventually cause some degree of disruption here,” McConnell tells NPR. As a result, Congress “must be prepared to work together.”