Making America Resilient

  • by: Robert Goldberg |
  • 03/20/2020

Every time President Trump takes action, the response has been predictable.  

Critics said banning travel from Europe was a xenophobic decision that "injects past grievances and prejudices into delicate scientific and political equations. In this spiraling thriller cum horror novel, Trump's emergence, full of hostility and conspiracy…heralds a darkening turn—an early indication of the power of a pandemic to infect global decision making and international relations."

That's one way of looking at it. Another approach would be to note that the President's quick decision to restrict travel from China bought us the time we need. Or that other countries quickly followed suit.  

Of course, there are other reasons people give to claim that the President's handling of the pandemic has been a total failure. For instance, critics are blaming the President for the delay in the development and distribution of coronavirus test kits. The Food and Drug Administration was too busy rejecting test kits used in South Korea and delaying approval of American made diagnostics. The Centers for Disease Control were developing the only test available. The product's rollout was botched because its components were defective. 

The White House stepped in and now we have several tests commercially available and at no charge to Americans. He has forced the FDA to move faster (when outlets like the NY Times were urging the FDA to go slower). I hope that the Trump administration has learned from this experience and takes the same approach in ensuring the availability and use of “antibody tests to detect if someone has already had coronavirus.”

As Jim Pinkerton points out in an excellent article on Breitbart: “we should seize the opportunity to create a Medical E-Verify, which would stipulate that all employers must verify the contagious health status of all employees. “  Such testing will boost confidence and allow more workers to get back to their jobs quickly. 

Vice President Biden has claimed that "he" did a better job responding to the H1NI outbreak in 2009. Not really. 

First, while rapid test kits for H1N1 were available in 2009, many of the tests were inaccurate. " The rapid influenza detection test (RIDT) (developed at the time only detected 10-70% of influenza A viruses and couldn’t distinguish between swine flu and other types of influenza A viruses.

Moreover, Trump is not the first president wrongly accused of making an outbreak worse. In 2009, the Obama administration pledged to speed up the development and production of vaccines against the H1N1 virus. As a contemporary account notes: The Obama administration fast-tracked the production of a vaccine, but it will not have 120 million doses ready by the expected peak of the season, as it had hoped. Forty-five million doses will be available in mid-October, with 20 million more available each week afterward."

The lack of adequate testing and sufficient vaccine supply was not Obama's fault back then. It's not Trump's fault now.  

Now, critics are howling Trump has failed to ensure we have enough critical care beds for the likely surge in people with COVID-19. A recent report noted: "medical staff have been told to prioritize the patients with the highest chances of survival because of the lack of the equipment."

Oh wait, that was about Italy, one the many single health payer paradises that some Trump critics claim is superior to our system. The fact is, the United States has more critical care beds per capita than any other country.  It's probably not enough to handle the surge in patients who need ICU care, but we have a better chance of doing so than any other country. 

Then there is the need for ventilators. 

Trump critics are demanding the federal government take over the manufacture and distribution of equipment. Meanwhile, the European Commission, President Ursula von der Leyen is pleading with member states to "ramp up the production of medical equipment (mostly ventilators) and share those goods within the bloc. Von der Leyen said no country had the capacity to produce on its own what will be needed to treat patients in the fight against coronavirus.

America? We have several companies ready to roll. Indeed, our manufacturers will have the ability to make enough for the entire world now that the administration has cut the red tape inhibiting ramp up. (I will discuss the threat of potential drug shortages in another piece.)

We live in an age where everyone gives their opinion instantly and endlessly. No doubt that another president, regardless of party, would also be the subject of a diarrheic stream of commentary.  How can we drown out the psychotic chatter and evaluate presidential leadership in times of trouble?

As Tevi Troy demonstrates in his book, "Shall We Wake the President? Two Centuries of Disaster Management from the Oval Office" (Lyons Press. Kindle Edition), successful presidential responses consist of enabling people to cope in a resilient fashion with dangers when they manifest themselves.  Resilience, as Aaron Wildavsky notes, "is the capacity to cope with unanticipated dangers after they have become manifest, learning to bounce back." Making America Resilient: That describes the goal of President Trump's leadership and objective during this current crisis. After a slower than ideal start, we are heading in that direction.

Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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