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The Coronavirus Called America’s Bluff

ANNE APPLEBAUM
Staff writer at The Atlantic

Courtesy of The Atlantic

Like Japan in the mid-1800s, the United States now faces a crisis that disproves everything the country believes about itself.

On July 8, 1853, Commodore Matthew Perry of the U.S. Navy sailed into Tokyo Bay with two steamships and two sailing vessels under his command. He landed a squadron of heavily armed sailors and marines; he moved one of the ships ostentatiously up the harbor, so that more people could see it. He delivered a letter from President Millard Fillmore demanding that the Japanese open up their ports to American trade. As they left, Perry’s fleets fired their guns into the ether. In the port, people were terrified: “It sounded like distant thunder,” a contemporary diarist wrote at the time, “and the mountains echoed back the noise of the shots. This was so formidable that the people in Edo [modern Tokyo] were fearful.”

But the noise was not the only thing that frightened the Japanese. The Perry expedition famously convinced them that their political system was incapable of coping with new kinds of threats. Secure in their island homeland, the rulers of Japan had been convinced for decades of their cultural superiority. Japan was unique, special, the homeland of the gods. “Japan’s position, at the vertex of the earth, makes it the standard for the nations of the world,” the nationalist thinker Aizawa Seishisai wrote nearly three decades before Perry’s arrival. But the steamships and the guns changed all that. Suddenly, the Japanese realized that their culture, their political system, and their technology were out of date. Their samurai-warrior leaders and honor culture were not able to compete in a world dominated by science.

The coronavirus pandemic is in its early days. But the scale and force of the economic and medical crisis that is about to hit the United States may turn out to be as formidable as Perry’s famous voyage was. Two weeks ago—it already seems like an infinity—I was in Italy, writing about the first signs of the virus. Epidemics, I wrote, “have a way of revealing underlying truths about the societies they impact.” This one has already done so, and with terrifying speed. What it reveals about the United States—not just this administration, but also our health-care system, our bureaucracy, our political system itself—should make Americans as fearful as the Japanese who heard the “distant thunder” of Perry’s guns.

Not everybody has yet realized this, and indeed, it will take some time, just as it has taken time for the nature of the virus to sink in. At the moment, many Americans are still convinced that, even in this crisis, our society is more capable than others. Quite a lot was written about the terrifying and reckless behavior of the authorities in Wuhan, China, who initially threatened doctors who began posting information about the new virus, forcing them into silence.

On the very day that one of those doctors, Li Wenliang, contracted the virus, the Wuhan Municipal Health Commission issued a statement declaring,“So far no infection [has been] found among medical staff, no proof of human-to-human transmission.” Only three weeks after the initial reports were posted did authorities begin to take the spread of the disease seriously, confirming that human-to-human transmission had in fact occurred. And only three days later did the lockdown of the city, and eventually the entire province, actually begin.

This story has been told repeatedly—and correctly—as an illustration of what’s wrong with the Chinese system: The secrecy and mania for control inside the Communist Party lost the government many days during which it could have put a better plan into place. But many of those recounting China’s missteps have become just a little bit too smug.

The United States also had an early warning of the new virus—but it, too, suppressed that information. In late January, just as instances of COVID-19, the disease caused by the coronavirus, began to appear in the United States, an infectious-disease specialist in Seattle, Helen Y. Chu, realized that she had a way to monitor its presence. She had been collecting nasal swabs from people in and around Seattle as part of a flu study, and proposed checking them for the new virus. State and federal officials rejected that idea, citing privacy concerns and throwing up bureaucratic obstacles related to lab licenses.

Finally, at the end of February, Chu could stand the intransigence no longer. Her lab performed some tests and found the coronavirus in a local teenager who had not traveled overseas. That meant the disease was already spreading in the Seattle region among people who had never been abroad. If Chu had found this information a month earlier, lives might have been saved and the spread of the disease might have slowed—but even after the urgency of her work became evident, her lab was told to stop testing.

Chu was not threatened by the government, like Li had been in Wuhan. But she was just as effectively silenced by a rule-bound bureaucracy that was insufficiently worried about the pandemic—and by officials at the Food and Drug Administration and the Centers for Disease Control and Prevention who may even have felt political pressure not to take this disease as seriously as they should.

For Chu was not alone. We all now know that COVID-19 diagnostic tests are in scarce supply. South Korea, which has had exactly the same amount of time as the U.S. to prepare, is capable of administering 10,000 tests every day. The United States, with a population more than six times larger, had only tested about 10,000 people in total as of Friday. Vietnam, a poor country, has tested more people than the United States. During congressional testimony on Thursday, Anthony Fauci, the most distinguished infectious-disease doctor in the nation, described the American testing system as “failing.” “The idea of anybody getting [tested] easily the way people in other countries are doing it? We’re not set up for that,” he said. “Do I think we should be? Yes, but we’re not.”

And why not? Once again, no officials from the Chinese Communist Party instructed anyone in the United States not to carry out testing. Nobody prevented American public officials from ordering the immediate production of a massive number of tests. Nevertheless, they did not. We don’t know all the details yet, but one element of the situation cannot be denied: The president himself did not want the disease talked of too widely, did not want knowledge of it to spread, and, above all, did not want the numbers of those infected to appear too high. He said so himself, while explaining why he didn’t want a cruise ship full of infected Americans to dock in California. “I like the numbers being where they are,” he said. “I don’t need to have the numbers double because of one ship that wasn’t our fault.”

Donald Trump, just like the officials in Wuhan, was concerned about the numbers—the optics of how a pandemic looks. And everybody around him knew it. There are some indications that Alex Azar, the former pharmaceutical-industry executive and lobbyist who heads the Department of Health and Human Services, was not keen on telling the president things he did not want to hear. Here is how Dan Diamond, a Politico reporter who writes about health policy, delicately described the problem in a radio interview: “My understanding is [that Azar] did not push to do aggressive additional testing in recent weeks, and that’s partly because more testing might have led to more cases being discovered of coronavirus outbreak, and the president had made clear—the lower the numbers on coronavirus, the better for the president, the better for his potential reelection this fall.”

Chu was not threatened by the government, like Li had been in Wuhan. But she was just as effectively silenced by a rule-bound bureaucracy that was insufficiently worried about the pandemic—and by officials at the Food and Drug Administration and the Centers for Disease Control and Prevention who may even have felt political pressure not to take this disease as seriously as they should.

For Chu was not alone. We all now know that COVID-19 diagnostic tests are in scarce supply. South Korea, which has had exactly the same amount of time as the U.S. to prepare, is capable of administering 10,000 tests every day. The United States, with a population more than six times larger, had only tested about 10,000 people in total as of Friday. Vietnam, a poor country, has tested more people than the United States. During congressional testimony on Thursday, Anthony Fauci, the most distinguished infectious-disease doctor in the nation, described the American testing system as “failing.” “The idea of anybody getting [tested] easily the way people in other countries are doing it? We’re not set up for that,” he said. “Do I think we should be? Yes, but we’re not.”

And why not? Once again, no officials from the Chinese Communist Party instructed anyone in the United States not to carry out testing. Nobody prevented American public officials from ordering the immediate production of a massive number of tests. Nevertheless, they did not. We don’t know all the details yet, but one element of the situation cannot be denied: The president himself did not want the disease talked of too widely, did not want knowledge of it to spread, and, above all, did not want the numbers of those infected to appear too high. He said so himself, while explaining why he didn’t want a cruise ship full of infected Americans to dock in California. “I like the numbers being where they are,” he said. “I don’t need to have the numbers double because of one ship that wasn’t our fault.”

Donald Trump, just like the officials in Wuhan, was concerned about the numbers—the optics of how a pandemic looks. And everybody around him knew it. There are some indications that Alex Azar, the former pharmaceutical-industry executive and lobbyist who heads the Department of Health and Human Services, was not keen on telling the president things he did not want to hear. Here is how Dan Diamond, a Politico reporter who writes about health policy, delicately described the problem in a radio interview: “My understanding is [that Azar] did not push to do aggressive additional testing in recent weeks, and that’s partly because more testing might have led to more cases being discovered of coronavirus outbreak, and the president had made clear—the lower the numbers on coronavirus, the better for the president, the better for his potential reelection this fall.”

These are only the most recent manifestations of an autocratic style that has been described, over and over again, by many people. And now we see why, exactly, that style is so dangerous, and why previous American presidents, of both political parties, have operated much differently. Within a loyalty cult, no one will tell the president that starting widespread emergency testing would be prudent, because anyone who does is at risk of losing the president’s favor, even of being fired. Not that it matters, because Trump has very few truth-tellers around him anymore. The kinds of people who would dare make the president angry have left the upper ranks of the Cabinet and the bureaucracy already.

But some of what we are seeing is unrelated to Trump. American dysfunction is also the result of our bifurcated health-care system, which is both the best in the world and the worst in the world, and is simply not geared up for any kind of collective national response. The present crisis is the result of decades of underinvestment in civil service, of undervaluing bureaucracy in public health and other areas, and, above all, of underrating the value of long-term planning.

Back from 2001 to 2003, I wrote multiple editorials for The Washington Post about biological warfare and pandemic preparedness—issues that were at the top of everyone’s agenda in the wake of 9/11 and the brief anthrax scare. At the time, some very big investments were made into precisely those issues, especially into scientific research. We will now benefit from them. But in recent years, the subjects fell out of the news. Senators, among them the vaunted Republican moderate Susan Collins of Maine, knocked “pandemic preparedness” out of spending bills. New flu epidemics didn’t scare people enough. More recently, Trump eliminated the officials responsible for international health from the National Security Council because this kind of subject didn’t interest him—or very many other people in Washington, really.

Juliette Kayyem: Trump is failing to prepare Americans for a disturbing new reality

As a nation, we are not good at long-term planning, and no wonder: Our political system insists that every president be allowed to appoint thousands of new officials, including the kinds of officials who think about pandemics. Why is that necessary? Why can’t expertise be allowed to accumulate at the highest levels of agencies such as the CDC? I’ve written before about the problem of discontinuity in foreign policy: New presidents arrive and think they can have a “reset” with other nations, as if other nations are going to forget everything that happened before their arrival—as if we can cheerfully start all relationships from scratch. But the same is true on health, the environment, and other policy issues. Of course there should be new Cabinet members every four or eight years. But should all their deputies change? And their deputies’ deputies? And their deputies’ deputies’ deputies? Because that’s often how it works right now.

All of this happens on top of all the other familiar pathologies: the profound polarization; the merger of politics and entertainment; the loss of faith in democratic institutions; the blind eyes turned to corruption, white-collar crime, and money laundering; the growth of inequality; the conversion of social media and a part of the news media into for-profit vectors of disinformation. These are all part of the deep background to this crisis too.

The question, of course, is whether this crisis will shock us enough to change our ways. The Japanese did eventually react to Commodore Perry’s squadron of ships with something more than fear. They stopped talking about themselves as the vertex of the Earth. They overhauled their education system. They adopted Western scientific methods, reorganized their state, and created a modern bureaucracy. This massive change, known as the Meiji Restoration, is what brought Japan, for better or for worse, into the modern world. Naturally, the old samurai-warrior class fought back against it, bitterly and angrily.

But by then the new threat was so obvious that enough people got it, enough people understood that a national mobilization was necessary, enough people understood that things could not go on that way indefinitely. Could it happen here, too?

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