The Weekly Sift

This week the number of new Covid-19 infections spiked up to even higher levels than before the shutdown. Other governments have avoided this scenario, but ours has no plan for dealing with it.

What if we have a crisis? In one of the less-noticed parts of John Bolton’s new book, Chief of Staff John Kelly complains that he is frustrated to the point of quitting. “What if we have a real crisis like 9/11,” Kelly asks Bolton, “with the way he makes decisions?”

As Bolton — like so many other former Trump insiders before him — demonstrates with numerous examples, “the way he makes decisions” is to start from a place of complete ignorance. (Prior to his ill-fated Helsinki meeting with Putin, he asked aides whether Finland was part of Russia. He also seemed not to know that the United Kingdom has nuclear weapons.) Then he ignores the briefings that come from the intelligence community or other government experts, and doesn’t ask for any studies or position papers from people the government employs to do research like that. Instead, he spends hours each day talking to friends on the phone and listening to the pundits on Fox News. If he hears something he likes, maybe that becomes government policy immediately, or maybe it turns into a line he uses at rallies. If the rally-goers cheer, then that’s what the world’s greatest superpower will do.

If you think there ought to be a more rigorous process than that, you must be part of the Deep State.

This is how we got the border wall project. No one who studies border security for a living ever concluded that a wall between the US and Mexico was the most efficient way to accomplish some desirable goal. But Trump’s 2016 campaign advisers decided he needed a “mnemonic device” to get him to focus on immigration. Any realistic plan to deal with unwanted border-crossings is full of the kind of legal, diplomatic, environmental, and other details Trump hates, but “Build a Wall” was simple enough to hold in his head, and the crowds loved it — especially when he added the fantasy that Mexico would pay for it.

Those cheering crowds are why some adviser’s mnemonic device is turning into a physical wall that takes years to build, costs billions of dollars, and doesn’t solve any identifiable problems. We just lucked out that Trump wasn’t still holding rallies when the inject-yourself-with-bleach idea got into his head.

Own-goal crises. The reason Bolton and Kelly were having a what-if conversation rather than recalling an actual disaster is that until that point the United States had been having an extraordinary run of good luck. You may remember these last three-plus years as a high-wire state of constant national anxiety, but in fact the real world was unusually tame. Barack Obama had handed Trump a country in pretty good shape, particularly compared to the one Obama had received from George W. Bush. All the major economic trends were in the right direction, Obama’s light-footprint strategy to defeat the ISIS caliphate was working, and so on. Obama did leave behind a number of worrisome long-term challenges, like climate change, the ascension of China, nuclear proliferation, the decades-long decline of America’s middle class, and so on. But no one really expected Trump to make progress on any of that, and on any given day all those problems have been pretty easy to ignore.

Instead, what made the pre-Covid Trump years feel so tense were the crises Trump created himself: He ratcheted up his “fire and fury” rhetoric against North Korea to the point that war seemed inevitable, and then arranged a marvelous reality-show resolution when he “fell in love” with Kim Jong Un, a performance so compelling that Trump wanted a Nobel Peace Prize for it. Of course, nothing was actually accomplished by the whole up-and-down cycle (other than some great propaganda for the Kim regime), but didn’t it look grand on TV?

The low points in his approval rating were similarly self-inflicted: when he described the neo-Nazis marching in Charlottesville as “fine people” or sided with Putin against the US intelligence agencies or couldn’t let go of a spat with a military widow. His China trade war spooked the markets and slowed the economy, but that was also something he brought on himself, so he could create good news whenever he wanted by tweeting about “progress” in the negotiations or delaying some tariff he had threatened to impose unilaterally.

Since those were all holes he dug himself, he could just stop digging, divert the public’s attention elsewhere, and wait for it all to blow over. Easy-peasy.

And then there was the ever-rising budget deficit, which would have been framed as an existential crisis for Obama, but became acceptable once a Republican was in the White House.

Before Covid, Trump only had to face two truly external problems: impeachment and his complete botch of the federal response to the Puerto Rican hurricane. Impeachment was never a big worry for two reasons: First, no matter how guilty he was, the Republican Senate was never going to convict him. (In the end, they decided that the House’s evidence wasn’t good enough to remove a president chosen by 46% of the people, and that if there was better evidence, they didn’t want to see it.) And second, the underlying offense (the extortion of Ukraine) didn’t really matter to Trump’s base. As for the Puerto Rican hurricane, well, that mainly affected Spanish-speaking people of color that the Trump base also didn’t care about. (Yeah, thousands of them are dead, but it’s not like they were ever “real Americans”, right?)

The virus is real. But Covid is different. There’s a real virus out there killing people. It can’t be intimidated by tweets or derogatory nicknames like “Wuhan virus” or “kung flu”. Even though it has been killing people of color at a rate disproportionate to their numbers, it kills white people too. And now it’s even spreading in red states (Texas) or purple states (Florida) that Trump needs to carry if he wants to be re-elected.

Trump has no plan to defeat the virus, but that’s par for the course. He doesn’t have a plan to deal with any of America’s problems. For example, he’s still promising a “FAR BETTER AND MUCH LESS EXPENSIVE ALTERNATIVE” to ObamaCare, and to “ALWAYS PROTECT PEOPLE WITH PRE-EXISTING CONDITIONS, ALWAYS, ALWAYS,ALWAYS!!!” But in the five years since he came down the escalator, he has not produced so much as a back-of-the-envelope sketch of a program to deliver on such promises. I’m sure the words in those capitalized phrases sound good to him and his fans, but as soon as the sound waves fade out the air is empty again.

Like his bromance with the North Korean dictator, Trump’s coronavirus briefings also made good TV for a while, but eventually they became embarrassing and he got bored with them. So he applied his usual crisis-control tactic: He congratulated himself for defeating the virus, which is “dying out“; flattered or browbeat Republican governors to reopen their states too early; stopped talking about the whole crisis, even as additional thousands of Americans continued to die each week; tried to divert our attention elsewhere; and waited for it all to blow over.

But here’s the thing: Reality doesn’t blow over. Covid-19 isn’t a PR flap or a misstep he can back away from, it’s a pandemic. For a short time, he may be able to get large segments of the public to “ignore that pile of dead bodies over in the corner” (as Bill Gates put it), but people keep dying even when everyone’s looking the other way, and eventually we start to notice again.

Comparisons. Covid-19 started out in China in December, and from there spread around the world, taking different courses in different countries. Some small countries with good leadership and a strong public spirit — New Zealand, Iceland, and South Korea pop to mind — reacted quickly, got the epidemic under control, and continue to hold it in check through a combination of testing, contact tracing, quarantine, and public cooperation in preventive measures like mask-wearing, hand-washing, and social distancing.

A number of EU countries, beginning with Italy, had really bad outbreaks, but then shut down just about all activities other than food distribution and medical care, using their national wealth and strong social-welfare systems to keep individual and family budgets above water. After a month or two of extreme sacrifice, the number of new infections began to collapse, to the point that they can now make use of the tactics that the fast-reacting countries used.

And then there’s the United States, where Covid-19 became the kind of crisis Kelly had been worrying about. Here’s how our daily reported new infections compared with the EU and South Korea as of Saturday.

South Korea’s infections stayed down. The EU’s went up and came down. But in the United States infections went up, started to creep down a little, and then shot back up.

What did we do wrong? A lot of things. Thursday The New York Times presented an illuminating series of graphics describing about how the virus spread in the US.

At every crucial moment, American officials were weeks or months behind the reality of the outbreak. Those delays likely cost tens of thousands of lives.

A short list of early failings:

• The CDC’s initial set of test kits were faulty, and tests were not imported to fill the gap, resulting in what the NYT described as “the lost month“. This was both a CDC failure and a White House failure, because it’s the role of the White House to keep tabs on the workings of the government and intervene when something important is falling through the cracks in the system.
• As a result, the initial spread of the virus was grossly underestimated. The NYT article suggests that in mid-February, when the US had 15 known cases (that Trump said “within a couple of days is going to be down to close to zero“) there were actually around 2,000 cases spread across ten major cities.
• Unlike other countries, the US did not use its lead time to build its stockpile of masks and gowns for medical personnel, as detailed by HHS whistleblower Dr. Rick Bright.
• The federal government did not prepare the public for the sacrifices that would eventually be asked of it. Instead, officials from President Trump on down consistently reassured the public that the virus was “totally under control” and “the risk is low”.
• Trump began politicizing the virus response early, charging on March 9 that “The Fake News Media and their partner, the Democrat Party, is doing everything within its semi-considerable power (it used to be greater!) to inflame the CoronaVirus situation, far beyond what the facts would warrant.”

By mid-March, states began to respond, with Republican Governor Mike DeWine shutting down schools in Ohio, Democrat Andrew Cuomo closing businesses in New York, and local health officials in six San Francisco Bay counties issuing a shelter-in-place order. A national campaign to “flatten the curve” began. Even Trump got on board for a month or so, rewriting history to claim: “I’ve always known this is a real, this is a pandemic. I’ve felt it was a pandemic long before it was called a pandemic.”

Undermining the national will. The number of new cases reached an initial peak of 33,000-a-day in early-to-mid April and then began to slope downward. But unlike Europe, the United States lacked the national will to finish the job.

That failure came from the top. As soon as it was clear a peak had been reached, Trump began pressuring states to relax restrictions and reopen their economies without waiting to achieve the milestones listed in his administration’s own guidelines.

Trump encouraged armed demonstrators to intimidate state governments. When protesters with rifles came to the Michigan statehouse carrying signs saying “Tyrants get the rope”, Trump tweeted “LIBERATE MICHIGAN!”. He also encouraged “liberators” in Virginia and Minnesota. Without once calling for the protesters to disarm, he tweeted:

The Governor of Michigan should give a little, and put out the fire. These are very good people, but they are angry. They want their lives back again, safely! See them, talk to them, make a deal.

Michigan more-or-less held firm, but Republican governors in red states knew they could not survive a Trump tweet storm and could benefit from White House photo ops. Georgia, Florida, Texas, and Arizona began to open their economies without achieving the statistical milestones laid out by the CDC. When the Republican members of Wisconsin’s Supreme Court invalidated the Governor Ever’s stay-at-home order and plunged the state’s gradual-reopening plan into chaos, Trump was jubilant.

The Great State of Wisconsin, home to Tom Tiffany’s big Congressional Victory on Tuesday, was just given another win. Its Democrat Governor was forced by the courts to let the State Open. The people want to get on with their lives. The place is bustling!

Meanwhile, he was campaigning against wearing masks, which nearly all public health officials recommend when people are unable to maintain social distance. He mocked Joe Biden for wearing a mask in public, and for “cowering in the basement” rather than holding face-to-face events. Trump refused to wear a mask while touring a mask factory in Arizona, even as “Live and Let Die” played on the sound system.

Long after it had become clear that the reopenings were premature and cases were spiking, Trump pushed to hold dangerous large-crowd events in Tulsa and Phoenix. (Fortunately for the nation, the crowd in Tulsa was not nearly so large as he had expected.) In Tulsa, he discounted the rising case numbers, arguing (falsely) that they just reflect increased testing, and offering a 10-year-old with “sniffles” as an example of a case. He said he had asked his administration to “slow down the testing”, and later contradicted aides who tried to downplay that suggestion as a joke. “I don’t kid,” he told reporters.

This anti-social leadership has had its effect: Around the country outraged people, many sporting MAGA hats or Trump shirts, are refusing to abide by rules that mandate mask-wearing or social distancing. Michelle Goldberg summarizes:

This is what American exceptionalism looks like under Donald Trump. It’s not just that the United States has the highest number of coronavirus cases and deaths of any country in the world. Republican political dysfunction has made a coherent campaign to fight the pandemic impossible.

The viral resurgence. New infections have been rising sharply in precisely the southern and western states that have reopened quickly, refuting the theory (which Trump had long promoted) that the pandemic would fade in warm weather. Nationally, cases had flattened out at less than 20,000 per day in late May and early June. But they have been above 38,000 each of the last five days.

On the state level, the best measure for comparison is the 7-day-weighted-average of new cases per day per 100K people. Here are the most seriously affected states:

Arizona 44

Florida 30

South Carolina 25

Mississippi 23

Arkansas 20

Louisiana 20

Nevada 19

Texas 19

California also has an large number of cases, due partially to its size. Its daily-new-case-per-100K number is 12. New York, which was the center of the epidemic in April, is down to 3.

And as for Trump’s attempt to discount those numbers, 10-year-olds with “sniffles” don’t show up in the ICU. Hospitals are reportedly close to capacity in Arizona, Florida, and Texas, and perhaps other states getting less national attention.

The Washington Post assesses what went wrong in Arizona:

At critical junctures, blunders by top officials undermined faith in the data purportedly driving decision-making, according to experts monitoring Arizona’s response. And when forbearance was most required, as the state began to reopen despite continued community transmission, an abrupt and uniform approach — without transparent benchmarks or latitude for stricken areas to hold back — led large parts of the public to believe the pandemic was over.

And now, Arizona is facing more per capita cases than recorded by any country in Europe or even by hard-hit Brazil. Among states with at least 20 people hospitalized for covid-19, the disease caused by the coronavirus, no state has seen its rate of hospitalizations increase more rapidly since Memorial Day.

And Republican governors or not, Texas, Florida, and Arizona have all had to retreat on their reopening timetables.

Deaths haven’t turned back up yet, but they will. The one saving grace is that nationally, deaths are still declining. For weeks I’ve been commenting on the mystery of how the death rate could continue downward while the new-case rate flattened and then turned upward.

Med school Professor Florian Krammer points to the same three explanations I’ve given: more testing has raised the new-case rate (or more accurately, made it better match the actual spread of the infection); better care is keeping people alive; but most of all, that the age-distribution of the infected population is shifting to younger people who are more likely to survive.

But he then goes one step further: Something similar happened in Iran in May. The new-case curve had been dropping, but started going up again around May 1.

But deaths did not go up. People explained to me, that now mostly young people are getting infected so nothing bad would happen.

Deaths started going up May 25.

What happened? First, it takes time to die of COVID-19. Second, cases probably really built up in younger people. But they diffuse into older populations. And then the deaths rose.

Each state has its own version of the pandemic, and death rates might already have started upward in some of them, like Arkansas and Texas. (The curves are jittery enough that it’s hard to be sure.) But nationwide, the new-case curve started rising around June 10. That would suggest deaths will begin rising about July 4.

Similar ideas (with a similar timeline) show up on the COVID Tracking Project Blog.

New daily positive cases only began to exceed the plateau of the previous two weeks around June 18-19, which means that an increase in deaths as a result of the rise in new cases would not be expected to show up until July.

So where are we? In some ways, we’re back where we were in April, and in some ways we’re worse off. Except in the northeast, whatever we gained through the sacrifices of the shutdown has been frittered away by bad leadership.

So now John Kelly knows: What happens if we have a real crisis “with the way he makes decisions”? This.

What is needed at this point is another wave of restrictions, and every state that thinks it is about to reopen its bars or arenas needs to think again. The American people can’t be trusted in bars; that is now a proven fact, at least until we have a vaccine. But a second wave of stay-at-home orders is hard to feature given that most of the country has nothing to show for the first wave.

We also need the kind of public spirit we had in the early days of “flatten the curve”: We need to encourage each other to wear masks, avoid crowds, keep our distance, and in general use common sense. Unfortunately, this is very unlikely to happen now that flouting common sense is necessary to establish your identity as a Trump conservative.

As best I can tell, this hasn’t happened in any other country (except maybe Brazil, which is also in very bad shape). Things got bad in Italy and Spain, but taking stupid risks never became a political identity.

And that reminds me of another famous question, this one raised by Trump himself in the 2016 campaign. “What the hell do you have to lose?”

Now we know.