COVID-19: The leadership failure

Unanticipated events with global consequences have always been a part of human history. During World War II, both Nazi Germany’s attack on the Soviet Union (Operation Barbarossa) and the Japanese attack on Pearl Harbor came as strategic surprises.

More recent unanticipated events include the (relatively) peaceful collapse of the Soviet Union, the terrorist attack of 9/11, as well as the economic crisis of 2007-2009. These events are often referred to as “black swans” due to the impossibility of predicting them. But I always said, there are no black swans, there’s poor analysis — and leadership failure.

However, the common thread that unites all of these events is bureaucratic sclerosis: The intelligence warnings and reports prior to the events were ignored or did not reach the right people. In the COVID-19 case, the national mobilization and “warfare” were too little too late.

And unlike with the above-mentioned strategic surprises, the knowledge of a possible viral pandemic has always been public. In fact, leading public health experts and epidemiologists have been warning about its dangers for years.

In 2007, a group of scientists in Hong Kong published a seminal article called “Severe Acute Respiratory Syndrome Coronavirus as an Agent of Emerging and Reemerging Infection” warning about the deadly respiratory virus (SARS) jumping from bats via exotic game food animals such as civets to humans and causing a pandemic.

In fact, we knew about what’s coming for 20 years. Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), Swine Flu, Bird Flu, and Ebola — all demonstrated the clear and present danger. In 2015, after the outbreak of Ebola, Bill Gates declared that the world’s greatest risk of global catastrophe does not look like a war but rather a highly infectious virus. The Gates Foundation produced the simulation showing that a flu pandemic is capable of killing more than 33 million people globally in just 250 days. Thank God, this is not that case.

Since the 1940s, we knew that the U.S., the USSR, China and other countries were working on biological warfare, and it stands to reason that nation-wide first response structures, labs and vital medicine and equipment stockpiles should have been put in place to protect the civilian populations.

In the U.S. they were not — until President Bill Clinton created the Strategic National Stockpile program in 1999 as biological attacks were becoming a global threat.

Since 2003 the stockpile has operated under the direction of the Office of the Assistant Secretary for Preparedness and Response of the Department of Health and Human Services (HHS) to store crucial medications and life-saving supplies, including respirators, as an adjunct to state stockpiles in the event of a widespread public health emergency. The stockpile is embodied in six warehouses strategically situated in undisclosed locations across the country and employs about 200 staff members. While the exact inventory of the stockpile is classified, it is estimated that it exceeds 1,000 categories of drugs and medical items and is worth about $7 billion.  

Over the last 20 years, the stockpile has been mobilized in response to 9/11, major hurricanes, and N1H1 pandemic in 2009-2010, when all 50 states were sent flu medication. The stockpile operates on an annual budget of about $600 million dollars and is supposed to be prepared for the next outbreak by maintaining a large supply of N95 masks, personal protective equipment, surgical gowns, and ventilators among other medical items. Unfortunately, U.S. administrations, including George W. Bush’s, Barack Obama’s and Donald Trump’s, persistently failed to upgrade and restock the Strategic Stockpile. One of the major challenges is the shelf life of these products, making maintenance an indefinite and costly process with uncertain returns.

The national stockpile is woefully inadequate — not just insufficient to handle the kind of bio warfare attacks the U.S.S.R could have unleashed in the last century, but now failing to handle a pandemic like COVID-19. On April 1, the Washington Post reported that the stockpile was almost depleted of personal protective equipment: the much needed N95 masks. 

The federal government failed to proactively prepare for the pandemic, despite multiple warnings inside the government. In 2019, the National Security Council conducted the exercise called “Crimson Contagion,” which modeled a massive respiratory epidemic hitting the U.S. and straining the system to the point of failure. The exercise exposed conflicts between the Federal Emergency Management Administration (FEMA) and HHS, which are supposed to work in tandem to manage a health disaster. Nothing was done. What’s more, the year before, in 2018, the National Security Council’s Senior Director Rear Adm. Timothy Ziemer, who championed pandemic preparedness, was ousted, and the Centers for Disease Control and Prevention (CDC) global pandemic budget was drastically cut.   

As the COVID-19 epidemic hit, the U.S. intelligence community warned that China was covering up the severity of the disease and projected a global impact. Between December 2019 and March 2020, the CDC and the Food and Drug Administration (FDA) engaged in an epic fail of bureaucratic back-and-forth, utterly unable to produce a government-developed coronavirus test. The FDA blocked academic labs and the private sector from producing and distributing one until March.

The federal government is not the sole culprit, however. In 2015, the New York State Task Force on Life and the Law noted that New York would need to purchase thousands of ventilators in the event of a major outbreak as well as train additional personnel in how to use them. Instead of following through on these potential lifesaving measures, Gov. Andrew Cuomo’s administration sought ways to cut healthcare spending, while endorsing the Task Force’s November 2015 Ventilator Allocation Guidelines — a 272-page report that not only acknowledges the severity of the possible outbreak, including lack of ventilators, drastic staffing shortages, and enormous burden on the health care system, but also discusses how to determine which patients will or will not receive respiratory assistance in a severe outbreak.

The cavalier attitude of the U.S. president, who downplayed the pandemic threat early on, the bureaucratic public health failure from Beijing to Washington, and the rather slow response of the World Health Organization, which finally declared COVID-19 a pandemic on March 11, 2020, have combined to cause a global medical and economic catastrophe of historic proportions.

In these turbulent times, the American public needs leadership, not partisan politics.

We need answers on what went wrong, who is responsible, and how to reform the global and national public health system to prevent the horrific loss of life that we are witnessing today. The demand for a forward-looking and responsive crisis prevention mechanism is not limited to public health only: We need an extensive round-the-clock monitoring of other hazards to counter potential catastrophes and to build resilience on both national and global scales.

This task needs the attention and requires fast and bold political leadership now.

Ariel Cohen, Ph.D., is a Senior Fellow at the Atlantic Council’s Eurasia Center and director of the Energy, Growth and Security Program at the International Trade and Investment Center.