Crimson Contagion Exercise

· Existing statutory authorities tasking HHS to lead the federal government’s  response to an influenza pandemic are insufficient and often in conflict with one another. 

· Currently, there are insufficient funding sources designated for the federal government to use in response to a severe influenza pandemic. 

· It was unclear if and how states could repurpose HHS and the Centers for Disease Control and Prevention (CDC) grants, as well as other federal dollars to support to the response to an influenza epidemic. 

Excerpt from an October 2019 “Coordinating Draft” – “not to be disclosed” – from the US  Department of Health and Human Services after a January to August simulation exercise discovered by the New York Times. 

Simply put, the United States was and remains woefully underprepared for an outbreak of a pandemic flu. Clearly, both HHS and CDC knew they were incredibly underfunded for a bad case scenario, and COVID-10 is a worst-case scenario. But after that massive corporate tax cut – from a 35% to a 21% rate generating trillions of dollars to the deficit – the mandate from the Trump administration was to cut what budget busters considered expendable. 16% less for the CDC and the total elimination of their pandemic specialist group.

As of this writing there are over a quarter of a million confirmed cases of COVID-19 around the world. Italy has passed China in the number of fatalities, reflecting a pattern that appears to be mirrored here in the United States. We are short of everything, from life saving ventilators to protective gear for the medical professionals to test and treat patients. And despite the President’s invocation of the Defense Production Act – which would enable him to force even private industry to get on an accelerated manufacturing track to give medical professionals what they need (like WWII) – he has openly expressed reluctance to use those powers.

Noting an inflection point in the number of cases, still not clear since testing kits are skill incredibly in short supply despite federal insistence that there are enough, California Governor Gavin Newsom noted that as many as 25.5 million California residents (way over half the population of the state) could be infected within 8 weeks. He put the entire state on lockdown.

Trump immediately pointed to the possibility that anti-malarial drug chloroquine was showing remarkable promise in testing and was abundantly available. It sold out even before the FDA contradicted the President, saying there was no evidence that chloroquine was effective against COVID-19. Trump also insisted that implementation was up to state governors and that the federal government was not a “shipping clerk.” When massive centralized coordination and support was necessary, and unlike any modern major disaster, Trump pulled the rug out from under state authorities everywhere.

HHS suspected that the United States was not remotely prepared for a pandemic, but with their budget for such emergencies slashed, all they had money for was a computer simulation. Here’s how that simulation worked out: “The [simulated] outbreak of the respiratory virus began in China and was quickly spread around the world by air travelers, who ran high fevers. In the United States, it was first detected in Chicago, and 47 days later, the World Health Organization declared a pandemic. By then it was too late: 110 million Americans were expected to become ill, leading to 7.7 million hospitalized and 586,000 dead.

“That scenario, code-named ‘Crimson Contagion’ and imagining an influenza pandemic, was simulated by the Trump administration’s Department of Health and Human Services in a series of exercises that ran from last January to August…

“The draft report, marked ‘not to be disclosed,’ laid out in stark detail repeated cases of ‘confusion’ in the exercise. Federal agencies jockeyed over who was in charge. State officials and hospitals struggled to figure out what kind of equipment was stockpiled or available. Cities and states went their own ways on school closings.

“Many of the potentially deadly consequences of a failure to address the shortcomings are now playing out in all-too-real fashion across the country. And it was hardly the first warning for the nation’s leaders. Three times over the past four years the U.S. government, across two administrations, had grappled in depth with what a pandemic would look like, identifying likely shortcomings and in some cases recommending specific action.” New York Times, March 19th.

So, the Trump administration absolutely knew they were ill-prepared, and even as they watched the escalating spread of the disease worldwide, they could only advise Americans that it was not serious, would easily be contained and effectively did not begin to bolster supplies that would be needed as the situation worsened.

The stark reminder of our failings becomes more obvious when you look at other, successful, international efforts. “The World Health Organization, for weeks now, has been making an emphatic plea to countries around the world: Social distancing is crucial to stopping the spread of coronavirus, but it is only half of the equation. To suppress and control a pandemic of this magnitude, countries also must find and isolate every person infected with Covid-19 — including those with mild cases of the disease who don’t turn up in doctor’s offices or hospitals.

“For just as long, however, officials in the United States have said something very different: If you suspect you’re infected, stay home. Even those who live in close quarters with someone who faces a higher risk of becoming severely ill or dying from the infection, have been discouraged from seeking testing unless they are having difficulty breathing.

“There are valid if dismaying reasons for this guidance. A string of failures at the White House, the Centers for Disease Control and Prevention and the Food and Drug Administration have led to intractable delays in making diagnostic tests for coronavirus widely available in the United States. The same failures have sown confusion about where and how to get tests and have forced clinicians to make tough choices about how to ration the tests that are available.

“But there is no question that the W.H.O.’s approach works better. Every region that has managed to get a coronavirus outbreak under control has succeeded thanks to a combination of social distancing and aggressive efforts to test as many people as possible. South Korea, for example, has tested some 274,000 people since February. The United States has tested just 82,000, the vast majority of them in the past few weeks.” NY Times.

For Trump and the GOP, prevention and healing people have never been priorities in this outbreak; it is and was all about the economy, sensing that no matter the excuse, absent a robust restored economy by the November election, the Republicans faced devastating losses. Showing a profound lack of concern for the expected suffering, and even admitting that the well-connected would tap their way to top medical care well above and ahead of the rest, the GOP-led Senate and all Trump appointed agencies were much more concerned with making the business numbers look good, to reignite the stock market.

“The Trump administration is asking state labor officials to delay releasing the precise number of unemployment claims they are fielding, an indication of how uneasy policymakers are about further roiling a stock market already plunging in response to the coronavirus outbreak…

“The federal numbers released Thursday morning [3/19] were already alarming: 281,000 people nationwide applied for unemployment insurance last week, up from 211,000 the previous week. They were apparently only a grim preview of what is to come…

“Senate Republicans, racing to put their imprint on the crisis response, unveiled a package that would provide hundreds of billions of dollars in loans to big corporations and small businesses, large corporate tax cuts and checks of up to $1,200 for taxpayers. The plan would also place limits on a paid-leave program enacted this week to respond to the crisis… But the 247-page measure, the product of a feverish round of negotiations among Republicans, was all but certain to face opposition from Democrats who have pressed for more generous paid-leave benefits and targeting help to workers and families rather than large corporations.” NY Times

Put the overflow in empty cruise ships said the President, now knowing we do not remotely have enough hospital beds. This is what the biggest economy on earth has to offer its citizens? This is how a government elected by fundamentalists and big business owners voted in their populist choice. God will save some, and a fat wallet will provide the best medical care for the rich?

I’m Peter Dekom, and if the outbreak were reflected in a color, it has to be the red blush of shame!