Evan Vucci/AP Photo
President Trump's Commerce Secretary Wilbur Ross (center) thinks the coronavirus could push jobs back to North America. But the administration's cuts to public health and pandemic preparedness have only added vulnerability here.
With everything from impeachment to the Democratic primaries dominating national headlines, a pandemic that’s resulted in 45,000 known cases, 1,100 deaths, and active quarantines all over the world has managed to plunge below the fold. But as the coronavirus continues to spread, it threatens not only human lives, but the highly entangled supply chain of the global economy. Yesterday, the Mobile World Congress (MWC) in Barcelona, the world’s largest trade show for the mobile phone industry, was canceled, after several major corporations backed out of attending due to fears of the outbreak. Economists are now predicting that a virus-induced disruption could send shockwaves throughout the eurozone.
While the Chinese government has trained considerable resources on the outbreak, building entire hospitals around Shanghai in a matter of days and accelerating the development of medical devices, the response of the Trump administration has been largely to sit back and hope for the best. The president mused that the virus would subside in April because “the heat, generally speaking, kills this kind of virus.” Ghoulish Commerce Secretary Wilbur Ross saw an active opportunity in the tragedy, offering that the outbreak “will help accelerate the return of jobs to North America, some to the US, probably some to Mexico as well.” Cartoonish callousness aside, Ross neglected to mention that component parts from China are slowed as well, encumbering manufacturing everywhere.
The administration’s inaction has been abetted by an active, years-long campaign to whittle away what little state resources were once tasked with fighting public-health crises. Since settling in office, Trump has enacted a rash of deep funding cuts that have hollowed out our feeble national defenses against outbreaks, infectious diseases, and public-health challenges. Coronavirus is a potent reminder of the extreme limitations of the Republican vision in times of emergency. There is no small-government response to a pandemic.
Coronavirus is a potent reminder of the extreme limitations of the Republican vision in times of emergency.
In a recent piece in Foreign Policy, the writer Laurie Garrett chronicles all the ways in which the Trump administration has summarily gutted the public-health provisions we once had in place. Forget building a hospital a week—in 2018, the Trump administration fired the entire pandemic response chain of command, and dismissed the entire White House management infrastructure.
In spring of 2018, the Trump administration pushed Congress to cut funding for Obama-era disease security programs, pounding the table to eliminate $252 million in previously allocated funding for rebuilding fragile health systems in Liberia, Sierra Leone, and Guinea, all countries devastated by the 2014 Ebola outbreak. Meanwhile, Trump lopped off $15 billion in national health spending and zeroed out the global disease-fighting budgets of the CDC, NSC, DHS, and HHS. The White House also nixed the Complex Crises Fund to save $30 million.
Those measures marked a drastic break with the Obama administration, which funneled significant funding toward fighting Ebola, and established a number of bureaucratic entities to facilitate battling epidemics broadly. Under Obama, there was a permanent epidemic monitoring and command group established inside the National Security Council, and another in the Department of Homeland Security. Ronald Klain, a onetime vice-presidential staffer, was appointed as “Ebola czar.” But Trump, holding true to Republican orthodoxy, took a Weedwacker to those organizations, hollowing out staff and disappearing essential funding.
Those moves have exacerbated the weaknesses in an already beleaguered American public-health system. In 2017–2018, the flu season, an annual and well-understood event, overwhelmed hospital capacity in a number of states. At one point, beds were being set up in tents. That diminished capability is something that experts have warned could prove devastating, even in countries with far more robust provisions in place. “The results are alarming: All countries—at all income levels—have major gaps in their capabilities, and they aren’t sufficiently investing in biological preparedness,” said Ernest J. Moniz, CEO of the Nuclear Threat Initiative, in a press release.
Tedros Adhanom Ghebreyesus, the director general of the World Health Organization (WHO), who recently declared coronavirus an international public-health emergency, noted that he had never seen a mobilization effort as thorough as what the Chinese government is undertaking over coronavirus. “China is actually setting a new standard for outbreak response,” he said. No such praise could be heaped on the Trump vision.
Part of this, of course, is an artifact of an autocratic Chinese government structure that doesn’t make room for checks and balances; that makes building hospitals on a whim easier. But a democratic system need not sacrifice emergency preparedness. Two weeks ago, in the face of this looming threat, presidential candidate Elizabeth Warren released a set of proposals that would deal specifically with our diminished capacity for taking on outbreaks. Her recommendations included expanding funding for domestic programs like the Public Health Emergency Preparedness (PHEP), the Hospital Preparedness Program (HPP), as well as international cooperation on things like fully funding the Global Health Security Agenda (GHSA). Those proposals dovetail with other plans to combat the opioid crisis and climate change–related initiatives.
Perhaps most importantly, coronavirus may well make the most concise case for Medicare for All. It’s far better from a public-health perspective to have people go to the doctor and get treated rather than staying home and transmitting the virus because they’re afraid of the sticker shock of a hospital visit. It also makes an economic argument: It’s far cheaper to treat the problem up front with preventative measures and preparedness than it is to sit back idly and let the virus wreak havoc on the economy and the population.
Neither of the Medicare for All advocates left in the Democratic primary have seized on this on the stump. But coronavirus is not going away anytime soon, despite the Chinese’s best efforts, and our worst. As Democrats continue to pitch voters on the superiority of their vision for health care in America, they’d be wise to point out that the Republican response to epidemic is to just let it happen.
