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Trump in a Time of Pandemic: The Banality of Evil

The numbers of deaths in the US from covid-19 are vastly greater than they would have been with a "normal" president, i.e. any president in living memory except Donald Trump. Without Trump, the NSC Directorate for Global Health and Security and Bio-defense would have been in charge of planning to stop the pandemic. When asked in late February why the directorate had been disbanded, Trump replied "I'm a business person. I don't like having thousands of people around when you don't need them." The directorate had a 69-page Playbook for Early Response to High-Consequence Emerging Infectious Disease Threats and Biological Incidents, prepared by the Obama administration to codify lessons learned in combating the 2014-15 ebola epidemic. It has not been used. Instead, under Trump's buffoonery, rather than leadership, the US has no plan to control the epidemic.

The CDC, led by a Trump appointee, Dr. Robert Redfield, bears much of the blame for lack of action on testing and tracing. The Center for Science in the Public Interest opposed Dr. Redfield' s appointment in 2018 because of his lack of administrative experience and his having served on the board of an anti-gay evangelical organization that advocated only abstinence for HIV prevention.

Dr. Redfield recently said that there would be 30,000 to 100,000 workers trained for contact tracing in the field before the next wave of the epidemic hits in the fall, but this country is under a flood, not waves, of covid-19. CDC trained contact tracing personnel should have been in the field in February, when only dozens were needed, and at least 100,000 ought to be in the field now.

The first covid-19 cases in South Korea and Taiwan were reported within a day of the first reported US case, January 20. Through June 21, South Korea has had 280 covid-19 deaths, and Taiwan 7, while the US has suffered 119,719 deaths . Deaths per million population are 5.5 and 0.3 for South Korea and Taiwan, respectively, and 362 for the US. (Oxford University ourworldindata.org).

In South Korea and Taiwan, professionals took charge. They quickly produced and distributed enough kits to test contacts of all reported cases. They isolated all contacts found to be infected. Five months later, Taiwan and South Korea have mostly reopened for normal life and economic activity. The US still has only limited contact tracing and testing in some states, and suffers massive unemployment and economic paralysis.

It might be fairer to compare the US to European countries. Several European countries fared worse than the US in March and April, but average daily deaths in Italy and France have since declined to about one tenth of their peaks in April. Because of clear and decisive leadership, Germany and the Nordic countries, except Sweden, have fared much better. Germany has reported so far 106 deaths per million. If the United States merely had responded to the epidemic as well as Germany, it would have had 70% fewer deaths by June 21, i.e the death total would only have been about 35,900.

Now it is clear that the virus is not seasonal like influenza viruses. During the first three weeks of June, the daily number of covid-19 deaths in the US plateaued at an average of 759. Beginning June 17, however, average number of new cases, which had plateaued near 21,000, increased steeply, reaching 34,158 on June 21. The number of deaths also is likely to trend upward in coming days.

The disease is spread by human behavior, which depends largely on government policy. It is easy to see that, if policy and behavior stay as they are now and daily new cases continue near 30,000, average daily deaths will exceed 1000. There then would be more than 313,000 total deaths by year's end. The epidemic could continue indefinitely if an effective vaccine is not found. If states reverted to greater social distancing and required wearing of masks, and if they could ramp up testing and tracing and also isolate all new cases, the epidemic could be brought nearly to a halt, as it has been in most advanced countries. What is certain is that, with no change of administration, the federal government will not start doing what needs to be done to prevent more deaths.

President Trump's only concerns on any issue appear to be how it affects his chances for re-election and whether it corresponds with his childish, preposterous self-adulation. "Lack of empathy" hardly begins to take the measure of the inappropriateness of Trump's remarks, or of his decision to use the Defense Production Act for keeping meat processing plants open without requiring measures to control contagion, and not using it for producing personal protective equipment.

Other leaders in history have, in pursuit of their goals, showed no concern for how many people died: Hitler, Stalin, and Mao would head the list. Another was Adolf Eichmann, the Nazi organizer of the holocaust. Hannah Arendt used the phrase "banality of evil" to describe Eichmann , who expressed no more concern for the millions of lives he destroyed than for railway timetables . The phrase also fits Trump, whose only reaction to skyrocketing numbers of deaths on his watch is that too many people are being tested.

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Andy Silver, MA, MSPH, is a retired unAmerican epidemiologist. In 1965, horrified by reports of American atrocities in Vietnam and the overwhelming public support for them, he decided that he was living under enemy occupation and that (more...)

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