Followers in a Time of Crisis…the Virus Crisis – V

This is the fifth in a series of posts that explore followers in a pandemic – this pandemic. During the coronavirus crisis leaders have been regularly, even relentlessly examined, explored, deciphered, and dissected. The American obsession with the American president, Donald Trump, has been especially virulent, as if he alone is solely responsible for everything bad that has happened, and for that matter everything good. In other words, as is typical, followers, in this case Trump’s followers, have been ignored. More precisely, they have been ignored not in individual instances – but as a group. They have been ignored as a group that was deeply involved in bringing us to this point – and now in our frantic effort to cure what ails us. Each of these posts is, then, intended as a corrective. A corrective to the misleading, mistaken idea that our fixation on Trump is warranted – as if he were not just the leading actor but the only actor. In brief, if there is blame, blame must be shared.  

V – The Experts

Dr. Anthony Fauci, who has been head of the National Institute of Allergy and Infectious Diseases for thirty-six years, has become during the coronavirus crisis a celebrity. His calm, serious, and yes, elderly, appearance and demeanor; his readiness to respond reasonably honestly to whatever the reporters’ questions; and his long experience and extensive expertise in viral epidemics; have made him the administration’s most prominent medical professional. They have also made him one of America’s most admired men. In a mid-April poll conducted by none other than Fox News, 80 % of Americans approved of Fauci’s response to the pandemic, whereas only 50% approved of Trump’s. And just this past weekend the nation’s leading comic barometer, “Saturday Night Live,” enshrined Dr. Fauci by having him played by none other than Oscar-winning middle-aged heartthrob, Brad Pitt.      

But though Fauci has become the best known of the medical experts, he is by no means the only similar professional to have been involved from the start. Since early this year, when it became known, at least to those in the know, that a virus crisis might be looming, were more than a handful of American scientists and physicians who knew about the new coronavirus. For example, as reported by the New York Times, early this year was the start of an e mail chain that came to be known, variously, as Red Dawn Breaking, Red Dawn Rising, and, later in the inevitable progression, Red Dawn Raging. It was hosted by the chief medical officer at the Department of Homeland Security, Dr. Duane Caneva. According to the Times, what started originally as a chain that included just a small core of medical experts gradually grew to include dozens. (See Eric Lipton, “Email Chain Shows Alarm Experts Felt in Early Days,” April 14, 2020.)               

Just a few outtakes reveal the extent to which several medical experts understood early on the possible magnitude of the national threat. They further reveal the extent of the frustration that the administration was not doing more to forestall a crisis that increasingly seemed imminent. Among the experts was growing “anger as their advice seemingly failed to break through to the administration, raising the chances that more people would die.”

  • On January 28 Dr. Carter Mecher, a senior medical advisor at the Department of Medical Affairs, wrote that “Any way you cut it this is going to be bad.” He went on, “The projected size of the outbreak already seems hard to believe.” Moreover, even then Mecher was raising the possibility that mitigation might mean closing schools, colleges, and universities.  
  • The same day, January 28, Dr. James Lawler, an infectious disease doctor at the University of Nebraska who advised Presidents George W. Bush and Barack Obama on health issues, wrote sarcastically about “great understatements in history.” They included describing Pompeii as “a bit of a dust storm” – and the coronavirus as just another “bad flu season.”   
  • On February 17 Dr. Eva Lee, a researcher at the Georgia Institute of Technology who frequently worked with the federal government, wondered why, if the cruise ship Diamond Princess had become infamous in this circumstance for “the worst form of social gathering,” it would it be any “different than a mall with everyone walking around for 3-6 hours, eating, drinking, touching everything?”      
  • By late February, concern among medical experts who were tracking the virus was turning to alarm. On the 23rd, Robert Kadlec, the top disaster response official at the Department of Health and Human Services, responded to Dr. Lee, “Eva is this true? … So spreading and its wide scope is unavoidable because there exists these very healthy individuals who can spread effectively – even during incubation period -while they remain perfectly healthy.”

On February 21 Kadlec had convened the White House coronavirus task force – which included Dr. Fauci, Dr. Robert Redfield, head of the Center for Disease Control and Prevention, and Alex Azar, Secretary of Health and Human Services – in what by then was a state of high alert. Kadlec was hardly oblivious to the threat posed by a possible pandemic. In fact, one year earlier he had conducted a hypothetical exercise, a war game if you will, called “Crimson Contagion”  in which it was projected that in a pandemic Americans could suffer 110 million infections and more than a half a million deaths. Now, though, the threat of such a pandemic was real, which meant that Kadlec’s task force had to decide how to proceed. Specifically, it had to decide when to recommend abandoning “containment” in favor of “mitigation” – at least until such time as a vaccine was widely available.* More to the point of this post, the task force as a group, and each of its members as individual, had to decide how to proceed if the White House, if President Trump, remained impervious or perhaps oblivious to their cry of alarm.

It was decided that Kadlec and his group would meet with the president to present him with a plan named, “Four Steps to Mitigation.” But it never happened. For reasons ranging from a presidential blowup, to administration infighting, to a procedural glitch, the effort stalled. Moreover, once the stock market crashed in the wake of Dr. Nancy Messonier’s public warning about the dangers that lay ahead, the possibility of a more reasoned, conciliatory approach came to an end. (Messonier was the director of the National Center for Immunization and Respiratory Diseases. In issuing the warning, it appears that she jumped the gun or, at least, that she did not coordinate her remarks with Dr. Kadlec.) Trump became even more defensive than he usually is. Azar’s authority was further reduced. Additional messages that could be interpreted as alarmist were forbidden. And Vice President Mike Pence was put in charge of the administration’s response to the coronavirus. It could reasonably be concluded that by the beginning of March the window of early warning was closed. What the experts thought they knew in early January, and what the experts were sure they knew by late February, did not get heard when it matter most, early on; or where it mattered most, in the highest reaches of the White House.

This brings us back to Dr. Fauci – and to his associate at President Trump’s repeated (up to now) and repetitive (up to now) daily news conferences, Dr. Deborah Birx. In recent days, Dr. Birx has found herself in the decidedly unenviable position of having to defend, more or less, the president who had made the particularly egregious error of suggesting that an injection “inside the body” of a disinfectant such as bleach could help combat the virus. Birx has been assailed by those who found her semi-defense of the president inexcusable. And she has been defended by those more sympathetic to what they see as her impossible position. Impossible because she is on the one hand charged with protecting the public interest, and on the other hand reporting to a man for whom the public interest has usually seemed not primary but secondary.

Which returns us again, inevitably, to Dr. Fauci. Fauci is faced with a similar if not the same dilemma. How to straddle the line between personal politics and public responsibility? Fauci is not a novice. Not only is he a veteran of the political wars, he is a veteran of the culture wars. In the 1980s he played a central if not the pivotal medical role in the virus crisis that was H.I.V./AIDS. It’s why all along he has claimed a simple credo: “You stay completely apolitical and non-ideological, and you stick to what it is that you do. I’m a scientist and I’m a physician. And that’s it.”**  

Still, I cannot help but wonder – as I did in the case of General James Mattis – what exactly is a good soldier? Does a good solder go along even if he, or she, thinks that going along is the wrong thing to do? Or does a good soldier not go along if he, or she, thinks that not going along is the right thing to do?

A counterfactual: What if some of the good doctors, even all the good doctors referenced in this post had spoken truth to power early in the year? Had spoken out loudly and clearly and, if necessary, publicly, not in March or April but in January or February? Would things have turned out differently?  What, in short, are the virtues in cases like these of speaking out – versus those of shutting up? 

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*For a fuller description of the sequence of events see, Eric Lipton, David Sanger, Maggie Haberman, Michael Shear, Mark Mazzetti, Julian Barnes, “Despite Timely Alerts Trump Was Slow to Act,” New York Times, April 12, 2020.     

**Quoted in The New Yorker, by Michael Spector, “The Good Doctor,” April 20, 2020/

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