Basics Belie the Birx Betrayal

This weekend saw several members of former President Trump’s response team let fly with accusations that the President mismanaged the COVID-19 pandemic:

In interviews broadcast on CNN Sunday night, former President Donald J. Trump’s pandemic officials confirmed in stark and no uncertain terms what was already an open secret in Washington: The administration’s pandemic response was riddled with dysfunction, and the discord, untruths and infighting most likely cost many lives.

Dr. Deborah L. Birx, Mr. Trump’s coronavirus response coordinator, suggested that hundreds of thousands of Americans may have died needlessly, and Adm. Brett P. Giroir, the testing czar, said the administration had lied to the public about the availability of testing.

…

Dr. Robert R. Redfield, the former director of the Centers for Disease Control and Prevention, accused Mr. Trump’s health secretary, Alex M. Azar III, and the secretary’s leadership team of pressuring him to revise scientific reports. “Now he may deny that, but it’s true,” Dr. Redfield said in an interview with Dr. Sanjay Gupta, CNN’s chief medical correspondent. Mr. Azar, in a statement, denied it.

Birx’s comments, in particular, have drawn considerable attention. She alleges that the first wave of deaths was inevitable. But the subsequent waves — now at 450,000 dead and counting — could have been prevented had the Administration acted more aggressively.

There are several things to unpack here. First of all, I don’t think any of this is a surprise to anyone. The Trump Administration’s response to COVID-19 was haphazard at best. All of the statements we have heard from the former officials confirms what we knew or suspected: that they downplayed the danger, that they botched the testing rollout, that they couldn’t stay consistent in their messaging.

However, the idea that a more consistent message from the White House would have saved 450,000 lives crosses me absurdly optimistic. The reason it crosses me as optimistic is that we have seen countries that stayed on message have outbreaks too. France’s deaths per capita have been only 14% lower than ours. They also experienced a second wave in the fall and a surge in the winter. Germany has gotten well-deserved praise for their management of the pandemic. But they’ve still had about half our per-capita deaths, experienced a surge in the fall and are currently seeing caseloads rise as the new variant spreads. The only countries that have really managed this disease well are either islands (New Zealand, Australia, Taiwan, South Korea effectively) or Pacific Rim nations where cultural factors and past experience have created a much more robust response from individual citizens.

That last factor is critical. Because ultimately, politicians can pass all the rules and say all the right things. But unless they are literally welding people into their homes, the spread of the virus depends on billions of decisions made by millions of people. The Trump Administration could have been absolutely perfect in its messaging; a lot of people would have still ignored them.

And that brings me to my final point. After Birx’s interview, the internet erupted with people saying she had blood on her hands for not doing something when it was clear that Trump was botching the response. I think that had Trump stayed consistent and realistic, we would have cut the number of cases and deaths. Maybe not to Germany levels — our nation is too big and too federalized and our people too individualistic for that. But yes, we probably would have done significantly better.

But that’s if Trump has stayed on message. The idea that Deborah Birx — a person who most people did not even know — could have prevented hundreds of thousands of deaths by going rogue is a bit ridiculous. What would it have changed? What has it changed? If, last week, you thought that Trump bungled the COVID-19 response, you still think that today. If, last week, you thought he did a good job under difficult circumstances, you still think that too. Had Birx or Redfield or anyone else called a press conference and said, “This man is crazy; he has no idea what he’s doing.” it would have been on the news for a few days. The Republicans would have denounced them. The Democrats would have praised them. And then Trump would have tweeted something insane and we’d have been talking about that.

You may remember, Anthony Fauci tried to gainsay the Administration in various ways. And it made little difference other than a number of Right Wingers turning on him. If Fauci — who was far more famous than Birx — couldn’t get the train on the tracks, what hope did anyone else have? By late spring, it was obvious that Trump was buying into garbage models of the pandemic and listening to the likes of Scott Atlas. The entire COVID task force could have turned on him and it would not have changed his mind. Nor would it have changed the mind of any of the Republicans devoted to him.

From Day One of the Trump Presidency, I said that we needed good people to stick with him. We needed them to curb his worst instincts, to soften his dumbest policies, to keep him within the bounds of the law. I got a lot of flak for that; a lot of people felt no one should work with Trump because he was evil. But I feel vindicated by the course of his Administration. As time went on, the good people left. As time went on, he surrounded himself with people who indulged his worst instincts. And as time went on, his behavior got worse, culminating in the January 6 attack on the Capitol.

Had Birx left, it would have changed nothing. By staying in, she was able to talk to state and local officials to try to mitigate the poor federal response. Now if you want to argue that she should have quit and gone public with her concerns because it was the honorable and right thing to do, that’s fine. I think I would have made the same decision in her shoes — biting my tongue so that I could continue to do the actual work of coordinating the science, talking with public officials and managing the federal response. I would have known that leaving would just get me replaced by someone who didn’t care for those things and was happy letting the disease spread to achieve the “herd immunity”.

So, I can see the “resign with honor” argument. And criticizing public health officials — and the Trump Administration in general — is certainly warranted. But we seem to also be descending into silver bullet theory again. If only Trump had done better, this wouldn’t have happened. If only Birx had gone public, this wouldn’t have happened. If only people wore masks, this wouldn’t have happened.

But there is and never has been a silver bullet in this pandemic. Our containment of it has depended on many factors and our failure to do so has been a result of many factors, of which the Administration’s poor response is one. Unfortunately, the nature of a pandemic — that it spread exponentially — means that even small deficiencies in response can add up to huge differences in cases and deaths. Maybe Birx and her fellows refusing to gainsay the President was part of that. But if so, it was a tiny part. Other failures — from the Administration, from the government of China, from the WHO, from local government and from our own individual selves — loom much larger.