Image source: Unsplash/Charles Deluvio
Gavin Yamey, professor of global health and public policy at Duke University, and Gregg Gonsalves, assistant professor of epidemiology at Yale School of Public Health, say Trump’s “astounding incompetence” was a political determinant of the US COVID-19 epidemic. They describe how, after dismissing prescient advice on pandemic preparedness from the outgoing Obama administration, the Trump administration went on to weaken the nation’s pandemic response capabilities.
The sense of fear is palpable in the images and videos of hospital intensive care units (ICUs) and emergency departments that are broadcast on television and posted on social media. Fear and heartbreak can be heard in the voices of physicians and nurses who describe what they are experiencing.
For example, in May 2018, it eliminated the White House global health security office that Obama established following the 2014-2016 Ebola epidemic to foster cross-agency pandemic preparedness, and in late 2019, it ended a global early warning program, PREDICT, that identified viruses with pandemic potential. There were also cuts to critical programs at the Centers for Disease Control and Prevention (CDC), part and parcel of Trump’s repeated rejections of evidence-based public health policymaking. And after the US confirmed its first case of COVID-19 on January 22 2020, President Trump responded with false reassurances, delayed federal action, and the denigration of science, they add.
Trump’s anti-scientific pronouncements during COVID-19 have been particularly perilous, they write. On 28 February, he said that the coronavirus would soon disappear on its own “like a miracle” while on the day that the CDC advised the public to wear face masks, Trump said he would not wear one himself. And on 23 April, Trump suggested that injecting disinfectant or bringing “light inside the body” could cure COVID-19, prompting experts to urgently warn the public against inhaling or ingesting bleach.
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But his latest, and arguably most dangerous, act was to call last week for mass public protests by his supporters to “liberate” states from their stay-at-home orders, specifically targeting states with Democratic governors. Trump has also sought to deflect blame for the US epidemic on Obama, Democrats, China, and most recently the World Health Organization, and has refused to acknowledge any failings of his own.
The US is likely to experience years of mass unemployment, multiple cycles of stay-at-home orders, a public mental health crisis, other excess deaths otherwise avoided outside of a crisis, and other social dislocations in response to epidemic resurgence, warn Yamey and Gonsalves.
They call for a new social movement, inspired by the AIDS movement of the last 40 years—one that pushes local, state, and federal leaders to provide universal health coverage, universal sick pay, and rent and food assistance, focusing particularly on the poor, the homeless, the marginalized, and people in jail, prisons, and juvenile and immigration centers. “Trump’s astounding incompetence was a political determinant of the US COVID-19 epidemic. A new “politics of care” could be the corrective,” they conclude.
Source: The BMJ