WHEN THE Trump administration took office in January 2017 it inherited, among other things, plans to make cheaper ventilators and 20m reusable face masks, should the country need them. Nobody followed up.
In 2018 John Bolton, the national-security adviser, “streamlined” the National Security Council and, in the process, closed its pandemic preparedness office. The following year, the administration decided to no longer embed an epidemiologist from the Centres for Disease Control and Prevention (CDC) with China’s CDC.
The consequences of these decisions, like the consequences of President Donald Trump’s insistence up until four weeks ago that covid-19 was less serious than seasonal flu, can only be guessed at for now. It seems likely that covid-19 would always have hit America hard, as it has most other rich countries that did not feel the impact of SARS.
It also seems possible that America will suffer more than other rich Western democracies. If so, some portion of this exceptional excess mortality will be attributable to the president’s public-health advice and to decisions he avoided until too late.
Though the CDC has not held a public briefing for a month, it is sending Epi-Aids, teams of epidemiologists, around the country to find new outbreaks. The Federal Emergency Management Agency (FEMA) is flying in kit from China.
This is an improvement on the torpor that continued until the middle of March.
The governors of Kentucky, Ohio, Louisiana, Washington, Michigan, Illinois, New York and Arkansas have all said this is the case. Before the federal government stepped in, a handful of states went as far as arranging their own flights carrying protective equipment.
Distribution of supplies, according to Rear Admiral John Polowczyk, who is in charge of the White House’s logistics effort, is still being done by private companies rather than by the f, following the template used during Hurricane Katrina. The problem this time is that the emergency is not confined to one or two states, so everyone is bidding against each other for the same stuff.
“It’s a cage match,” says an employee of one of the country’s largest hospitals. State procurement officers swap tales of middlemen calling up with offers of millions of face masks at a few bucks over their retail price.
A second accusation is that the federal government is doling out scarce equipment to reward friendly governors. “How can it be that Kentucky and Florida get 100 percent or 100 percent-plus of what they need while Massachusetts doesn’t?” Elizabeth Warren asked Vox, a news website.
This does not seem to be true of how FEMA is working.
The agency is largely staffed by career civil servants who served the last president and, in many cases, the one before him. FEMA allocates medical kit according to a formula that considers need and the likelihood of an outbreak, insulating the process a bit from political considerations.
If Florida has received what it asked for, that might be because it has a large population in care homes and is at high risk. There is, though, a cost to the impression that the president is distributing supplies in a haphazard and political way.
What is harder to quantify is the extent to which this administration’s trade war has slowed the current supply of equipment to hospitals. At the same time as Mr Trump issued an executive order banning the export of certain categories of medical equipment from America, the federal government was trying to secure supplies of the same gear made abroad.
According to various people who worked with state governors to secure supplies, shipments were held up in China. Exports to America have become politically sensitive for party bosses in a way they used not to be.
That has created another layer of bureaucracy for suppliers with scruples, and a trade in fake permits for those without. The constraint on supplies from China does seem to have eased a bit after the president sent a tweet at 1am, when MAGA hat-wearers were tucked up in bed, praising Xi Jinping and calling the virus by the name most other people use, rather than the “Wuhan virus” or the “Chinese virus” which he had preferred, though that may be a coincidence.
Mr Trump has indeed been incompetent and irresponsible. He continues both to offer unfounded medical advice, most recently on the use of an anti-malarial drug, and to shush any expert who might contradict him in public.
The White House is as bizarre as ever.
The president had no chief-of-staff for much of March. In less than a week he has got rid of the inspectors-general of the intelligence community and the watchdog overseeing the $2 trn federal stimulus.
The Navy fired the captain of an aircraft-carrier for reasons that seem to have more to do with politics than with carrying aircraft. The Navy secretary then had to resign.