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How The United States Failed To See The Coronavirus Crisis Coming


Let me ask you to take yourself back to New Year's Eve. Just think for a moment where you were, who you were with, what you imagined for yourself in 2020. Safe to say none of us could have imagined the world we're living in today. There are now more than 1 million cases of coronavirus worldwide. The United States leads the official tally by far - more than 260,000 confirmed cases and COVID-19 has claimed the lives of more than 7,000 people here in America. We're going to spend some time today on how we got to this point and ask some hard questions. How did we miss what was coming? Why were we, the American public, so slow to take the coronavirus seriously, to grasp that it could wreck the economy, our health care system, our daily lives?

So let's walk back through what we knew and when and what officials were telling us, starting with New Year's Eve, December 31, 2019. That is the day China reported to the World Health Organization a cluster of pneumonia cases in the city of Wuhan. The following week, Chinese authorities identified the virus behind it.


UNIDENTIFIED REPORTER #1: A cluster of mysterious illnesses in central China may involve a new strain of virus that includes SARS.

KELLY: By then, dozens of people were sick. Here in the U.S., the Centers for Disease Control and Prevention issued an alert, told health care providers be on the lookout for respiratory symptoms in patients who had recently been to Wuhan. The CDC also began work on a test for the virus. And then on January 17, the CDC's Marty Cetron made this announcement.


MARTY CETRON: To further protect the health of American public during the emergence of this new coronavirus, beginning today, the CDC will be screening passengers on direct and connecting flights from Wuhan.

KELLY: At three airports - Los Angeles, San Francisco and New York's JFK - screeners began looking for signs of illness. Two days later, January 19, a 35-year-old man walked into an urgent care clinic in Snohomish County, Wash., with a persistent dry cough. He'd recently been in China, so he was given a test for the new coronavirus. Results came back the next day - positive.


UNIDENTIFIED REPORTER #2: Tonight, the CDC says the infected passenger passed through a busy Sea-Tac Airport in Seattle, the first confirmed U.S. case of the contagious coronavirus now in Washington state.

KELLY: OK. So only one confirmed case in the whole United States. But by now, there were also confirmed cases in Japan, Thailand, South Korea, and in China, the number of infected was climbing fast. On January 24, the U.S. announced a second confirmed case, this time a Chicago woman in her 60s who had been to Wuhan. At a press conference, Illinois Governor J.B. Pritzker sought to reassure the public.


J B PRITZKER: The number of people that she came in contact with since returning to the United States is small.

KELLY: Small but not zero because soon came troubling news. The woman's husband, who had not been to China, was also infected - an important development because the U.S. now had its first known case of person-to-person transmission. CDC Director Robert Redfield addressed the news in a telebriefing at the end of January.


ROBERT REDFIELD: We understand that this may be concerning, but based on what we know now, our assessment remains that the immediate risk to the American public is low.

KELLY: What goes through your head when you hear that message now? Was that the wrong message?

MARC LIPSITCH: I think it was an incomplete message.

KELLY: This is Marc Lipsitch, professor of epidemiology at Harvard School of Public Health. I called him this week, and he said, yeah, back at the end of January, the risk in America of getting infected was low. Besides the Chicago couple, there were only four other known cases in the U.S. But...

LIPSITCH: Repeating the raw, uninterpreted data is not a very good way to communicate with the public.

KELLY: This gets to the delicate balancing act that officials were trying to navigate, says Margaret Hamburg, a doctor I also reached out to this week because she has worn many public health hats over the decades in the Clinton and Obama administrations and as health commissioner for New York City.

MARGARET HAMBURG: You don't want to overly panic the public, but I think you also want to be honest about what can happen. And it's a time to start to mobilize, even if there are uncertainties.

KELLY: Especially if there are uncertainties, argues Marc Lipsitch.

LIPSITCH: So public health's job is to state the facts and then also to act like firefighters. You respond to the alarm. You treat it as if it's real, whether or not it's real. And if you're doing your job, you're going to respond to a number of false alarms. And if you're really doing your job well, you're going to turn what could have been a really big fire into a small fire by putting it out. That's the dilemma of public health is the more it does its job, the more it seems like it's overreacted.

KELLY: I mean, there were some early actions taken to try to stop the spread of the virus, to try to keep it out of the U.S. starting in January - the first airport screenings people coming off planes from Wuhan and then a ban on foreigners who had spent time in China. And that expanded to a ban on people coming from Europe. Did measures like that help? Did they create a sense that if only we can keep the virus out of the U.S. that'll stop it when, in fact, it was already here?

LIPSITCH: Yeah. I was one of the few people among my friends and colleagues that I respect who thought that those measures were a good idea. I thought they were a good idea not because I thought they would be perfectly effective but because I thought they would help to buy us time that we could use to make ourselves more prepared.

KELLY: And did they?

LIPSITCH: Well, the problem is those measures became the centerpiece rather than a minor aspect of the response. So we wasted a lot of time not getting prepared in those weeks of late January, early February and much of February, in fact.

KELLY: OK. So now we are in February. What was the U.S. doing? One move that blows your mind in hindsight came February 7, when the State Department announced that the U.S. had sent nearly 18 tons of medical supplies, including masks and gowns, to Hubei Province, China. That's right. The U.S. shipped medical masks out of the country. What the U.S. was not doing in those weeks was building the capacity to test for the virus or actually testing people. By mid-February, only 400-some people had been tested. And so the official number of infections remained low. On February 10, President Trump offered a rosy prediction at a rally in New Hampshire the day before the state's primary.


PRESIDENT DONALD TRUMP: Looks like by April, you know, in theory, when it gets a little warmer, it miraculously goes away - hope that's true.

KELLY: Obviously, that was not true. In New Hampshire, the president also said this.


TRUMP: Rough stuff, I tell you, rough, rough stuff, but I think it's going to work out good.


TRUMP: We only have 11 cases, and they're all getting better.

KELLY: That still-low number of confirmed cases, Margaret Hamburg says it gave Americans a false sense of security.

HAMBURG: If you don't test, you don't know. And we certainly were unaware of the magnitude of the problem until there had been considerable spread in communities, and the burden of disease was much, much greater than had been recognized.

KELLY: Meanwhile at Harvard, Marc Lipsitch was telling reporters he believed the coronavirus was spreading fast, that there already could be 1- or 200 cases in the U.S. His colleagues told him he might be undercalling it, and now he thinks he probably was.

LIPSITCH: If you see a little bit when you look a little bit, then there's probably a lot if you would just look a lot.

KELLY: But from the CDC came a different message. Here's Nancy Messonnier of the CDC in a telebriefing February 21.


NANCY MESSONNIER: I want to be clear that we're not seeing community spread here in the United States yet. But it's very possible, even likely, that it may eventually happen.

KELLY: Four days later, Messonnier spoke again - a more urgent alarm. She said community spread here wasn't a question of if but when. And she asked Americans to prepare. It could be bad. Later that day, we're now at February 25, Anthony Fauci, the top infectious disease doctor at the National Institutes of Health, addressed her comments on Fox News.


ANTHONY FAUCI: You don't need to do anything different today than you did yesterday. Really, nothing has changed except outside, the outside world, the other countries are getting into more difficulty, which may actually ultimately impact us.

KELLY: That same day, White House economic adviser Larry Kudlow all but brushed off the warning in an interview with CNBC.


LARRY KUDLOW: We have contained this. I won't say airtight but pretty close to airtight. The business side and the economics side - I don't think it's going to be an economic tragedy at all.

HAMBURG: I really don't want to be a Monday morning quarterback.

KELLY: Again, Margaret Hamburg.

HAMBURG: But I think it was really unfortunate that we didn't have more testing and disease surveillance so that we could really know the contours of this unfolding epidemic in our country. It meant that we really didn't have the tools that we needed to assess what steps had to be taken and, with that, what to tell the American people.

KELLY: That brings us to the start of March. By then, more than 90,000 people around the globe were infected with coronavirus. Americans were still shaking hands, going to work, going to school, going out to dinner. "Hamilton" was sold out on Broadway. The NBA season was in full swing.


UNIDENTIFIED ANNOUNCER: Just over five minutes in, 10-9 is the Utah lead. There's Gobert in the paint again (ph).

KELLY: President Trump continued to downplay the threat in a Fox News town hall on March 5.


TRUMP: It's going to all work out. Everybody has to be calm. It's all going to work out.

KELLY: And then eight days later...


TRUMP: I am officially declaring a national emergency - two very big words.

KELLY: That was Friday, March 13, nearly eight weeks after the U.S. confirmed its first case of coronavirus. The following Monday, President Trump announced 15 days of social distancing to stop the spread. Avoid travel. Avoid groups. No more hanging out at bars or restaurants. This week, Trump extended those guidelines through the end of April. Harvard's Marc Lipsitch says social distancing is showing signs of working in some parts of the country. But he is clear on this - walk back restrictions too soon and the virus will rebound.

LIPSITCH: We've grabbed a life raft, and we need to climb out of the water and catch our breath and start making plans for how we're going to solve the problem. But how to get to dry land is really unclear at this point.

KELLY: Tens of thousands of new infections are being confirmed here in the United States every day. At the White House, flanked by his top scientific advisers, President Trump acknowledged this week just how high the death toll could go - 100,000 to 240,000. That is with stay-at-home measures in place and if people follow them. In other words, 100,000 to 240,000 Americans dead - the White House says that is the best-case scenario. Transcript provided by NPR, Copyright NPR.

Mary Louise Kelly is a co-host of All Things Considered, NPR's award-winning afternoon newsmagazine.
Andrea Hsu is NPR's labor and workplace correspondent.
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