The Washington Post published just the latest in a growing genre, short-term retrospectives on how the Trump administration horrendously mismanaged the coronavirus pandemic. (See earlier examples here in Vox and here in the New York Times) While no country was able to cruise through the pandemic, and some arguably have done as badly or worse as the United States, our country seemed uniquely positioned to fight a pandemic and lead the world in doing so. We were the richest, spent the most on health care, and had an enviable record - at least prior to the Trump administration - pandemic preparedness.
However, so far we have failed, badly, fatally, and shamefully.
We Warned You
We cannot claim any ability to predict pandemics. We never predicted this one. However, on Health Care Renewal we published warning starting in early 2016 that were Donald J Trump to be elected president of the US, he would prove to be uniquely badly qualified to lead on health care and public health.
No Health Policy, No Health Policy Advisers, Word Salads in Response to Health Care Questions
In February, 2016 we posted that while Trump was then a leading candidate, he had "no health plan" and "no health care policy advisers."
His one major health care proposal at the time was to somehow reduce the cost of drugs by $300 billion. He did not seem to then realize that $300 billion was the then estimated total cost of drug spending. When asked about the mandate provided by the Affordable Care Act his response appeared to be a "word salad." When asked about health policy during a debate, "Mr Trump only seems to have repeated the notion of selling health insurance across state lines to increase competition, interrupted by non sequiturs insulting Senator Rubio and insurance executives. The Minnesota Post writer and I could find absolutely no other content."
My conclusion at the time was:
We live in perilous times when a candidate with such reckless approaches to critical problems continues to attract adulation.
Given this, should it be a surprise that President Trump had no real public health policy, and undermined standard public health approaches to pandemic prevention?
Per the Vox timeline above, as early as on January 22, 2020, Trump said to CNBC
We have it totally under control. It's one person coming in from China, and we have it under control. It's - going to be just fine.
A History of Promoting Health Care Related Scams
In March, 2016, we posted about the Trump Network, a scam that involved the selling of apparently worthless nutritional supplements using equally worthless diagnostic tests.
The basis of the scam was a "network-marketing" (or allegedly "pyramid marketing") scheme in which individuals got monetary incentives not just for selling vitamins and tests, but for recruiting new marketers. In this case, the company sold "nutritional supplements" supposedly custom-designed for each customer based on results of a proprietary urine test. However,
there appeared to be no publicly available data on how the tests worked, what they actually tested, or how accurate they were. Then there was no data about how the test results could rationally be used to suggest particular mixes of vitamin supplements. Also, there was apparently no public data about what vitamins were in the potions sent to consumers, their purity, their strength, etc.
Worse, there was no evidence that any of this provided any benefits to the people who ended up taking the vitamins.
Trump bought the company that initially innovated this scheme and rebranded it the Trump Network in 2009. He then enthusiastically marketed its products, and careers marketing them. Marketing videos that include Mr Trump are still readily available online,
In the video, Mr Trump said "Americans need a new plan. They need a new dream. The Trump Network means to give millions of people a new hope."
Nonetheless, by 2011 the Trump Network was finished.
My conclusions then were:
What damage could such a leader do to health care? And what other damage could a man who so cavalierly fleeced the little people with his dubious nutritional product marketing scheme do, especially to the little people who now so unconditionally support him?
Is there a better example showing why we as a society need to completely rethink who gets to become our leaders? My only hope is we can do that rethinking in time to prevent a disaster.
How did that work out for you?
Based on this, is it any surprise that President Trump promoted unproved "cures" for COVID-19 such as hydroxychloroquine; hired "experts" who promoted herd immunity in lieu of a vaccine, which would likely result in millions of deaths were it to be implemented; and even suggested that people should ingest bleach to prevent infection?
According to the Vox timeline, as early as on March 19, 2020, "Trump incorrectly claims that the Food and Drug Administration approved the antimalarial drug hydroxychloroquine for treating Covid-19."
Denying Asbestos-Related Disease, PTSD and Chronic Traumatic Encephalopathy, Asserting Vaccines Cause Autism and Pornography is a Major Public Health Hazard
In November, 2016, just before the election, we posted a catalog of medical/ health care/ public health nonsense that Donald Trump had disseminated.
These included denying that asbestos is an important health hazard; that post-traumatic stress disorder is a manifestation of weakness, not a mental health problem; that chronic traumatic encephalopathy is "a little ding on the head," not a potentially severe neurological condition; and that vaccines cause autism. In addition, the 2016 Republican Party platform that Trump endorsed asserted that pornography is a major public health hazard.
My conclusion at the time was:
It is disturbing when one candidate for the most powerful political office in the US repeatedly disregards the best clinical and public health evidence, and offers ill considered opinions about public health that could potentially harm patients.
Based on this, is it surprising that during a pandemic, President Trump seemed to declare war on biomedical, clinical and public health science, and on professionals who try to implement scientifically based health care and public health?
According to the Vox timeline, as early as on April 17, 2020, "Trump calls on his supporters ... to 'liberate' Michigan, Minnesota, and Virginia...." Those supporters later threatened health care professionals advocated a more scientific approach.
The history was there. We were warned. We paid a tremendous price. Will we be smarter next time? Will we survive next time?