The United States Pandemic Response
In this paper I will take a short overview of all the epidemics and pandemics save a few in the history of the United States. Examination of the past outbreaks and the US government’s response is of vital importance to understanding how to properly implement plans to eliminate a health threat. The purpose of this is to highlight the delinquency in the 2016-2020 presidential administration’s responsibilities in regards to the current pandemic, Covid-19.
Epidemics and pandemics can occur in a number of ways. In modern times, in certain places lacking proper health care infrastructures, they are more common than elsewhere. Even then, first world countries with well funded health care services can be struck. One type of infection has been the scourge of humans for years, Influenza. Influenza pandemics take place when animals infected with an influenza that jumps from their species to humans. Humans, having never been infected with such an ailment, lack the immune response to fend off such disease.
The method in which these influenzas jump ship as it were is by two methods, genetic reassortment or mutation. Essentially, their genes change and we become susceptible to them. In order for it to be considered an epidemic, the Center for Disease control or CDC states an epidemic is a disease that affects a large number of people within a community, population, or region. What makes a pandemic is determined by the extent of the spread of the disease over multiple countries or continents. Many people believe it has to do with lethality of the disease, but that’s not the case. In fact, even if no deaths occur but there are widespread infections present, it will be deemed either an epidemic or pandemic.
Perhaps the best known pandemic of all time was the Bubonic plague. Better known as the Black Death. It ravaged Europe, parts of Asia, and Northern Africa for just about 4-6 years and claimed the lives of 75-200 million. Sources differ. There was no stopping the scourge. It struck down the poor and wealthy alike. Many believed at the time that it was the wrath of God. Today, we know better. We have a much greater understanding of viruses and bacteria.
From Washington to Obama, every single president before Trump who has had to deal with such hard times has had some kind of pandemic response agenda. In the year 1778, smallpox was working its way through Washington’s army. Washington has a plan. While in Valley Forge, in a matter of a single winter, he systematically inoculated his troops from smallpox.
He did this secretly as to not alert the British that his men were weakened by disease. His men emerged from their ‘unforgiving’ winter camp immune. Through his planning and management of the outbreak, his actions may have won the Revolutionary War.
In the year 1793 Yellow fever broke out in Philadelphia. They called it the American plague. Having no idea what caused it, many fled the city including much of the government. The officials urged others to do the same but sadly some could not. By the 26th of October a cold front had moved in doing away with much of the mosquito population. At the end of it all, 5,000 people lost their lives.
Cholera struck between the years of 1832 and 1866. It came in three waves. It’s believed to have began in India and spread through the trade routes. New York City was the first US city to be hit. It’s estimated 5-10% of people in the larger cities died from it. What put a stop to it was due in no small part to quarantine measures taken wherever possible.
Around the same time, 1858, scarlet fever struck and it too came in waves. While it is a bacterial infection, it had less impact than did cholera. Many studies suggest this is due to greater nutritional intake. However, modern research shows that due to cholera and other previous outbreaks, there had been systematic improvements in public health.
In the year 1889 a flu from Russia started to spread across Asia. Soon to be known as the Russian Influenza, not many Americans took it seriously. Nor did they seem to concern themselves with the fact that it infected as much as half the population of St. Petersburg in only a few months. This pandemic soon touched all corners of Eurasia. Still, Americans seemed unconcerned.
Virologists now view this Russian influenza as the first modern flu pandemic due to how it spread. It made its way down roads and railways and sailed oceans. The trade economy connected the world and the flu rode it as if cargo. And like cargo, it soon showed up on American shores.
As soon as it showed it’s face, it’s truth was denied and undermined. “It is not deadly, not even necessarily dangerous,” The Evening World, a newspaper in New York. “but it will afford a grand opportunity for the dealers to work off their surplus of bandanas.” However, the reality of the situation would come to light. As this pandemic spread across Eurasia it too would ride the rails to the whole of the Americas. It would seem the US was the end of the line though for this flu as it only took a mere 13 thousand out of the world’s total of 1 million lives lost.
In the years 1906 and 1907 typhoid fever broke out throughout New York City. A woman named Mary Mallon was perhaps the first asymptomatic carrier on record ever. Being asymptomatic means she is a carrier of the disease while not presenting any symptoms. She was active spreader of the disease without ever knowing it. She and her carrier qualities are still studied today.
She became known as ‘Typhoid Mary’. She worked as a cook spreading the disease as she went from job to job, house to house, and one hospital. It is believed she is responsible for anywhere from 53 to 122 infections. Out of those, it’s believed only 5 died. However, separate from Mary, the disease was still spreading and by 1907, a rough total of 25,800 people had died.
The year is 1918 and The Spanish Flu struck. Many people believe, due to its name, that this flu began in Spain. However, it did not. The flu actually started in the United States. WWI started in 1914 and ended late 1918, however Spain maintained a political stance of neutrality. Therefore Spain did enter the theater which also meant its news wasn’t censored. Which is important. The US, having entered the war, was censoring all its newspapers and other news outlets. Many historians point to this one of many possible reasons why the 1918 pandemic was so bad.
The date was March 4, 1918 and a one Private Albert Gitchell of the U.S. Army became ill. He was stationed at Fort Riley, Kansas which became ground zero. The US did not report the outbreak as it was knee deep in the war to end all wars. The US government thought that by announcing such news may make the enemy believe it a weakness and attack.
Instead, the US marines sent to Europe to fight ended up bringing with them a different weapon. One that would wage war on the entirety of the globe. The first country to report actual cases just so happened to be Spain. Thus it’s name, the Spanish Flu. This was the worst pandemic in modern times infecting an estimated 500 million and killing an estimated 50-100 million worldwide. Within the US, it’s estimated at 546,000 deaths. It’s also known by a different name, H1N1.
Between the years 1921-1925 the US had a diphtheria epidemic on its hands. Diphtheria has a death percentage rate of between 5% and 10% of cases. For young children and middle age to older adults, the death rate increases to as much as 20%. By 1925 a vaccine against the disease was developed. With the vaccine, cases dropped in the United States. It, however, is far from gone. 10’s of thousands have perished from this disease since 1990 to today.
In 1916 and in 1952 polio outbreaks spread across the world. In the US, regular outbreaks took place through the early 1950s. At its height, there were nearly 58 thousand reported cases. Though out of those cases, only 3,145 people lost their lives. Since 1979 the United States has been polio free.
In the year 1957, a mutated strain of the Spanish Flu emerged. The H2N2 virus became the second major flu outbreak. Worldwide, a total of 1.1 million lost their lives with a tenth being in the US. Due to a flu vaccine developed in 1942 and early detection, this is considered to be a mild pandemic. Virologists know this could have been far worse.
In the year 1968 arrived a new flu. The H3N2 virus also known as the 1968 pandemic. It made its appearance on the 13th of July in Hong Kong. By August it had spread to most of South Asia and in September it had reached Australia and California. Upon the new year it had engulfed the world. This was the third influenza pandemic in the twentieth century and this one lasted for 3 years. The estimated death toll was 1-4 million worldwide and about 100,000 in the US.
In the year 1976 an interesting event took place that had far reaching echoes. Late in the flu season of 76’ a new flu emerged. This virus was from swine in origin and became known as Swine Flu. It was a newly mutated strain of H1N1. US public health authorities reacted after an outbreak occurred on a military base at Fort Dix, New Jersey. The health officials feared a pandemic and took measures to stop it in its tracks.
The president at the time, Ford, gave an announcement. He set out to vaccinate everyone in the country. In just a matter of months his plan had seen over 40 million citizens vaccinated. In the large scale, it was by no means a grand success leaving some 160 million left unvaccinated. The issue was that the feared pandemic never came. In the eyes of many Americans, this was a blunder. So much so that the public health credibility suffered greatly.
The government response, while a blunder in the public’s belief, set precedent for how a real pandemic could be handled. Thus began efforts to create a coherent comprehensive response to future pandemics. It wouldn’t get its true start until the following year.
In 1977, two things took place. A another new strain of H1N1 broke out in Hong Kong, Russia, and China and this lead the US federal government, under CDC leadership, to start working on the first draft of a US pandemic plan. Upon its completion it was released in 1978 with recommendations for yearly flu shots for anyone at high risk, expanding infectious disease research, as well as established an outline for when such an event should happen.
1900-2019… a true plague, measles. During the United States Civil war, Union soldiers totaled 20,000 cases with a death toll of just 500. However, upon the turn of the century numbers skyrocketed. Hundreds of thousands of cases around the globe with tens of thousands dead. A vaccine wouldn’t come around until 1963. With the development of the measles vaccine cases and deaths began to decline. Doctors reported very low levels in the United States and everywhere the vaccine was licensed across the globe. Except in one realm, the unimmunized.
The year was 1978 when the CDC was eyeing measles for elimination. 20 years after the CDC started on this journey of elimination, there was a paper published defaming the intent and after effects of the vaccine. It was published 1998 in the U.K. and was quickly retracted as a falsehood. Later, in the year 2000, it was announced that measles was successfully eliminated in the US. In 2015 it was further eliminated from the entire continent. Now, elimination does not mean eradication. Outbreaks of measles continue in the US as well as in other countries for numerous reasons.
One of the causes for continued outbreaks is due to the spread of misinformation such as the 1998 paper. The claim is, at this point, quite old and has been debunked over and over again. The claim being is quoted here “you would not get consensus from all members of the group on this, but that is my feeling, that the, the risk of this particular syndrome (autism) developing is related to the combined vaccine, the MMR…”. It is due to this claim and the false claims made within the retracted paper that millions today do not get vaccinated.
Due to these anti-vaccinators, measles has once more spiked in the states. In 2010 reported cases were as low as 63. A few years later in 2014 the numbers jumped to 10 and a half times that of 2010 at 667. By 2019, even those numbers had nearly doubled to 1,282 reported cases.
In 1997 an avian influenza also known as H5N1 was detected in Hong Kong. It spread to surrounding areas only infecting 18 people. While that doesn’t sound all that bad in comparison to past cases, this was a rather deadly flu. Out of the 18 infected 6 cases were fatal. That scared a lot of people. So when H5N1 returned in 2003, it was taken extremely seriously. It struck in China and Vietnam with a total of 4 cases with a total of 4 deaths.
Every year since 2003 cases have been reported all the way until the year 2018. However, in 2019, the number of reported cases was 1 but the patient sadly didn’t survive. Though it has yet to reach the United States, there has been a single confirmed case in Canada. The World Health Organization and the Center for Disease Control watches and is taking notes.
In the year 2002, SARS broke out in south China. SARS is a respiratory illness caused by a coronavirus strain(SARS-CoV). There is speculative material that states the first case of SARS was in November 2002. Patient zero was a farmer in Foshan, China. He was brought to the local hospital where he died soon after. The cause for the speculation is that there was no definitive diagnosis upon death. While the Chinese government took steps to control the outbreak, measures ultimately failed.
Chinese officials reported to the World Health Organization in late February 2003 and in a very short time after it spread across the globe. Out of the many countries affected by SARS, 8,098 people became sick while 774 people died. In the United States, only eight people had confirmed cases none of which died. The truly alarming aspect of SARS is that is spreads fast and there is still no cure nor vaccine.
As of July 2003, SARS was contained and since then health officials have declared SARS eradicated in humans but it remains in animals. The CDC and WHO warn that an outbreak could take place once more. For that reason the world preparedness for such an event is of the upmost importance. The CDC and WHO has urged all countries to update their epidemic/pandemic response plans.
In the year 2005, President Bush Jr. demanded the government make a more updated pandemic response plan.
In the year 2009 H1N1 made its return. This was a relative of the Spanish Flu but more closely related to the ‘76 outbreak. It had mutated into a new strain of swine flu. During the first week of March, possibly earlier, a yet unidentified disease struck Mexico. One estimate says 60% of La Gloria, Veracruz, Mexico fell ill with a respiratory infection. The 17th of March saw the first case later diagnosed a new strain of H1N1. During this time, the US CDC was doing its yearly FluView check up and their findings was that the seasonal flu was starting to decline. That trend would not last.
During this time and the weeks before, the Mexican government made contact with the US government to alert them of the state of things. The first known onset within the States was on the 28th of March in Imperial County, California. It was a nine year old girl. She was confirmed the following day to have the novel H1N1 virus.
From April 1st to the 12th, the novel H1N1 virus was completely sequenced. The European Union began monitoring reports of an outbreak in Mexico. Mexico’s Public health authorities begin investigating 400 cases of flu-like symptoms. A United States based biosurvellance firm reports a respiratory outbreak in Mexico. Mexico’s General of Epidemiology sent reports of the outbreak to PAHO. (Pan American Health Organization).
Shortly after, in accordance with the U.S. International Health Regulations Program, the CDC and WHO were informed the following day. By April 21st a vaccine was in the works. The process however was in dire need of funding if it was to make any headway.
On the 24th of April the CDC issues on outbreak notice. Shortly after, the Obama administration’s director of health and human services declared a public health emergency on April 26, 2009. At the time the US had 20 confirmed cases. By the 28th, the Obama administration made a request to Congress for funding and was okayed $7.65 billion. This money was used to aid in production of a vaccine and other measures such as protection equipment for medical professionals. On the very next day WHO raised the pandemic alert to a level 5.
A mere month and a half later, June 11th, WHO raised the alert level once more to 6, a worldwide pandemic. By late October President Obama declared the outbreak a national emergency. By December over 100 million vaccines were publicly available. Just a few months later the crisis was over. It was due to such swift actions that lead the US out of the dark. In the US there were 60.8 million cases with 12,469 deaths. Worldwide, the CDC estimates that between 150,000 to 575,000 people died from swine flu.
In the year 2014, President Obama gave a speech about how we need an updated response plan just like Bush did in 2005 but stressed the need for preparedness. Not just in the US but globally. They put together an entire set of hypothetical scenarios and how to deal with them. One was very specific about a flu-like outbreak.
When Trump won the presidency, Obama’s team handed over their pandemic response information. Seven days before he took office he was briefed by Obama’s health officials. This is what they said/did…the year is 2016… “Health officials warn that this could become the worst influenza pandemic since 1918,” Trump’s aides were told. “Soon, they heard cases were popping up in California and Texas.”. This of course never happened, it was a scenario to aid in creating plans if the worst should happen. This is how policies and agencies are formed.
In May of 2018, the Trump administration made the choice to disband the White House Pandemic Response Team. In July of 2019, the Centers for Disease Control epidemiologist working in China’s branch of disease control agency left. The Trump administration chose to not fill the position but rather to eliminate that job. In October of 2019, one month before the first case of covid-19 struck the city of Wuhan in Hubei province, China(the 17th of November 2019), Trump is quoted in saying…”Currently, there are insufficient funding sources designated for the federal government to use in response to a severe influenza pandemic.” I imagine that’s because he reallocated the funds for the wall Trump said Mexico was supposed to pay for.
It’s 2020 and the worst is spreading. Trump has had three years to prepare. As news made headlines of an outbreak in China, Trump was briefed back in November 2019. In January, the first cases emerged in the US and Trump was once more briefed. On January 22nd, Trump is quoted in saying “(The coronavirus is) totally under control. It’s one person coming in from China, and we have it under control. It’s going to be just fine.”
He set up what he called a ‘travel ban’ on the 31st of January. In reality it only restricted travel from or to China for some people. Others, like US citizens or their spouses in China at the time, were free to travel back to the states. Upon arrival, there was no quarantine or any health precautions. Beyond the restriction, the Trump administration did next to nothing to stop the spread for nearly two and a half months.
Nearly a month later on February 24th the Dow Jones fell 1,000 points. Trump had this to say… “The Coronavirus is very much under control in the USA… Stock Market starting to look very good to me!” To give a sense of the level of public denial being pushed by the White House… Between February 10th through the 27th, Trump is quoted in saying …“I think the virus is going to be—it’s going to be fine.”
“Looks like by April, you know in theory when it gets a little warmer, it miraculously goes away.”
“CDC and my Administration are doing a GREAT job of handling Coronavirus.”
“I think that’s a problem that’s going to go away… They have studied it. They know very much. In fact, we’re very close to a vaccine.”
“The 15 (cases in the US) within a couple of days is going to be down to close to zero.”
“Well, we’re testing everybody that we need to test. And we’re finding very little problem. Very little problem.”
“This is a flu. This is like a flu.”
“It’s going to disappear. One day, it’s like a miracle, it will disappear.”
It’s around this time that certain news outlets start to parrot what the Trump Administration is saying. And at this point we are now in an exact parallel to the 1889 Russian Influenza propaganda. “It is not deadly, not even necessarily dangerous,” Taken directly from The Evening World. A newspaper from the time.
From early January 2020 to this day, there are people saying that this ‘flu’ is China’s problem.
There are even some politicians downplaying the severity as well. Anti Chinese propaganda was rampant. One particular politician went as far as to call the coronavirus the ‘Kung Flu’. This only fueled a lack of public concern.
Trump not only spent this time underpinning the reality but he also undermined the health official’s authority. So blatant was the misinformation he fed the public that while in an interview with Bob Woodward he admitted to it. He is quoted on tape during this interview saying he downplayed it knowing full well the danger. “It’s also more deadly than even your strenuous flu… This is deadly stuff”. This took place on February 7th but only became public knowledge September 9th.
During a press conference Trump did far worse than spread misinformation, he presented those who listen to his every word extremely dangerous advice. “… I see the disinfectant where it knocks it out in a minute. One minute. And is there a way we can do something like that, by injection inside or almost a cleaning”
Due to this, the center for poison control for states Michigan, Illinois, California, Maryland, New York City, and Tennessee had a record number of calls. Once again, his Press team spun his words as sarcastic. When asked if Trump as president took any responsibility about what actions his words inspire or just the general state of things, Trump said no. He doesn’t take any responsibility.
To get a clearer sense as to the level of mismanagement, I’m going to compare other countries and their management vs the US. On the very same day the US had its first case of coronavirus, so did South Korea. The date was January 20th, 2020. News recorded on the date July 28, 2020 stated that South Korea has been virus free for just about three months. On October 11th, the South Korean disease control released news of 97 newly confirmed cases. This brought their total to 24,703, including 433 deaths.
Many have said that our case load and death count is due to our population size. The United States has a population of 331.7 million with a case total of 11.06 million with a death count of 249,977 people. India has a population of 1.385 billion yet its total cases is 8.7 million with a total of 129,225 deaths. China, where coronavirus originated, has a population of 1.439 billion. Its total case load is a staggering 86,087 with a death count of 4,634. To put it simply, the US has the highest total cases and death count of every single other country on the planet.
On November 3rd 2020, Trump made the claimed that his administration has beaten covid. As he said this crowds of adoring fans cheered him on. On that exact same day there was a total of over 1,000 deaths. Today, there is 100k new cases and once more over 1,000 deaths daily.
Regardless of Trump’s claims, the sad fact is this pandemic, Covid-19, isn’t going anywhere yet. Currently, there isn’t a coronavirus vaccine available. The US is still in the thick of it. We have currently a case total of 10.2 million with a rough total of 239 thousand dead. European countries are currently being hit with a second wave and virologists say its even more deadly this time around. On top of this, a new study released speaks of a new mutation that may cause it to spread even faster as well.
So much for a plan. The reason is because the US listened to a man not fit for such high office. He ignored his predecessors, his own health officials, and literally the rest of the world. As a result, the United States makes up nearly a fifth of the worlds dead! As of November 9th, a vaccine for coronavirus is entering clinical trials. If all goes well, this vaccine will be public ready before the new year.
In conclusion, the Trump administration showed an absolute flagrant disregard for the US history of pandemic response planning. There are a number of methods to handling any outbreak. Acknowledgment, preparedness, coordination, communication, and respect. Combine these with early detection methods and we as a people have a much greater chance of seeing tomorrow. All of these methods were in place when Trump took office.
We need to remember boarders are just lines on a map. Viruses have no respect for such concepts. We are all in this together and only by working together do we stand a chance. Also, I can’t stress this enough, listen to the experts not the politicians. Petty divisions serve no one but those who seek to build walls. In times such as these, we require bridges.
Organizations such as WHO and the CDC need funding to combat our current predicament and to further the research for future generations. So, for the sake of your children’s children, stay home until this current pandemic has past. If you have to venture out, wear a mask and maintain social distancing practices. Stay safe. Get vaccinated.