What Trump’s Covid malfeasance warns us about the next epidemics
One barely noticed pledge by Donald Trump during the 2024 campaign in a May Time magazine interview offers an especially ominous warning about Trump 2.0. If he won a new term, Trump said, he would “probably” disband the Office of Pandemic Preparedness and Response policy established by Congress in 2022.
Fast forward to his next term nominees, especially anti-vax conspiracy theorist Robert F. Kennedy Jr. as Secretary of Health and Human Services who has said he would pause National Institute of Health infectious disease and drug development research for eight years. As the saying goes, we might have a problem.
With confirmation hearings soon to begin for Kennedy and other health care department heads with similar views about to begin, the threat of future pandemics in an administration with a disastrous track record is another reason to urge their defeat.
Why does this history matter? Consider the latest New York Times report on Kennedy: Just six months into the Covid vaccine rollout in May 2021 Kennedy filed a petition with the Federal Drug Administration “demanding that officials rescind authorization for the shots and refrain from approving any Covid vaccine in the future.”
The 2022 law was prompted by the worst pandemic in a century, that has killed over 1.2 million Americans and counting. The law’s roots were in a pandemic global health security office President Obama set in the National Security Council. It followed Obama’s experiences with the H1N1 swine flu pandemic in 2009 that killed up to 575,000 people globally, including more than 12,000 in the U.S., and the 2014 Ebola outbreak that claimed thousands of lives in West Africa and provoked a major scare in the U.S.
Trump eliminated the office in 2018, suggesting, the Associated Press reported, “that he did not see the threat of pandemics in the same way that many experts in the field did.” In March, 2020, as the U.S. was grappling with the next pandemic, former pandemic office director Beth Cameron, wrote she was “mystified” by the unit’s shutdown “leaving the country less prepared for pandemics … all with the goal of avoiding a six-alarm blaze.” Trump officials insisted they were fully prepared. Facts on the ground tell a different story.
In December 2019 the first reports emerged of patients in China’s Hubei Province suffering symptoms of an unknown pneumonia-like illness, drawing reminders of the Severe Acute Respiratory Syndrome Coronavirus, SARS Cov-1. By early January 2020, the World Health Organization (WHO) began referring to the outbreak as a 2019 Novel Coronavirus, soon to be renamed Covid-19.
With infections spreading in Asia, the U.S. Centers for Disease Control and Prevention (CDC) in late January reported the first U.S. cases in Washington, Illinois, Arizona, and California. The first U.S. deaths occurred in January 2000. By mid-March, when Cameron’s op ed appeared, the WHO confirmed more than 118,000 Covid cases and 4,291 deaths.
Australia, which had a similar profile of libertarian individualism and a rightwing prime minister in 2020, created a bi-partisan response with opposition Labor Party and state leaders, and medical officers out front. They quickly subsidized production and distribution of masks, prioritized testing and contact tracing, and understood some shutdowns were necessary. If the U.S. had the same death rate as Australia, the New York Times later reported, about 900,000 American lives would have been saved.
Trump: ‘It’s going to be fine’
The first year of Covid was critical to establishing the protocols and public health protections to confront the crisis and reduce the deaths and suffering. But, due to widespread government failures, the infections spread like wildfires.
Yet the Trump administration was glacially slow to react. In his first public statement on January 22, 2020, Trump declared, “We have it totally under control. It’s one person coming in from China. It’s going to be just fine.”
In multiple public comments tracked by Rep. Lloyd Doggett, Trump downplayed the danger. In February 2020: “Looks like by April…when it gets a little warmer, it miraculously goes away,” …“CDC and my Administration are doing a GREAT job of handling Coronavirus,” …“We’re going very substantially down, not up,” and, “ One day, it’s like a miracle, it will disappear.”
Due to Trump’s malfeasance, promotion of misinformation, including false miracle cures, and actively discouraging government and community safety measures to slow the spread, Covid exploded.
Embracing the sluggish signals from Washington, hospitals stalled on adopting critical safety protocols and were ill-prepared for the flood of desperately ill patients that led to cascading deaths, and bodies piling up in makeshift morgues or refrigerated trucks outside hospital doors. It was made worse by inadequate isolation of patients believed to be infected, shortages of ventilators, and failure to provide proper personal protective equipment for overwhelmed nurses and other health care workers who paid a horrific price with thousands of deaths and many leaving due to unwillingness to work in unsafe conditions.
Trump’s failures continued for months. At a White House press conference on April 3, Trump eroded a new voluntary CDC guidance on wearing masks, as other countries were now requiring, proven to reduce transmission of the virus, but emphasizing he would not do so.
That position, New York University sociologist Eric Klinenberg recalled, “undermined it,” suggesting “to anyone in his world that wears a mask, it’s cowardly, weak, feminine, so no one’s going to wear masks. (It) becomes clear to everyone in the Republican establishment that bearing your face is the way to show solidarity and support to the president,” said Klinenberg, reinforcing a partisan political divide on not just masks but soon all public health measures.
In April 2020, as the U.S. death toll passed 60,000, Trump said, “this is going away.” In May, amid 80,000 deaths, Trump said, “we have met the moment, and we have prevailed.” In June, with 110,000 dead Americans, Trump said “it is dying out, it’s going to fade away.”
On August 31, with the death count passing 180,000, Trump said, “we’ve done a great job in Covid, but we don’t get the credit” blaming a “fake news media conspiracy.” For months, Trump demanded an end to steps some states were implementing to limit infections. As Trump’s term ended on January 20, 2021, the U.S. recorded 25 million cases, and over 400,000 deaths.
National Nurses United, one of the first to respond to prior pandemics during H1N1 in 2009 and Ebola in 2014 had gained valuable experience. By early January, 2020, “before most people in the U.S. had even heard of Covid-19,” as the New York Times put it, NNU began mobilizing and aggressively pushing employers, government elected officials, health and regulatory agencies to implement decisive safety actions. In contrast to public bodies, NNU quickly understood the virus was being spread through airborne transmission, and the need for appropriate safety protocols and protections.
NNU launched multiple public endeavors from rallies to marches, vigils, pickets, and other collective action, including strikes, to demand optimal protections for nurses, other healthcare workers, patients and the broader public.
Employers took their lead from Trump and federal agencies he influenced including the CDC and Occupational Safety and Health Administration (OSHA) that continually eroded safety guidelines and workplace regulations. Hospitals, observed NNU Executive Director Bonnie Castillo, RN, “took a gamble relative to how much to have and how much to be prepared. And the CDC came out with guidelines shifting, commensurate to what the hospitals are complaining of. The lower standard is cheaper. So they just kept lowering and lowering, all the way down to bandannas. They’re looking at us like fodder.”
The racist legacy of Trump’s Covid malfeasance
Trump’s abysmal mismanagement of the pandemic and indifference to who was most harmed proved especially catastrophic for communities of color, including a large percentage who were essential workers, in transit, food processing, service industries and health care.
Early in the pandemic, Trump sought to shift blame from his administration to China, repeatedly referring to Covid as “the China virus,” though by April the U.S. with 4 percent of the world’s population accounted for 17 percent of global Covid deaths. Trump’s scapegoating ignited a sharp rise in anti-Asian hate speech and physical assaults.
His future HHS nominee Kennedy was among those adding fuel to the fire. In a 2023 New York press event Kennedy claimed “there is an argument that it is ethnically targeted. COVID-19 attacks certain races disproportionately... The people who are most immune are Ashkenazi Jews and Chinese.” His unfounded remarks also contributed to a climb in antisemitism under Trump.
Asian American/Pacific Islander (AAPI) healthcare workers subsequently reported a rise in racist incidents, both in hospital settings and in their daily lives. Twice as many verbal and physical assaults were directed at women. “We must unite to challenge anti-Asian violence, harassment, and racism,” said University of California San Diego RN Dahlia Tayag at a statewide California Nurses Association protest against ongoing anti-Asian hate crimes.
The disproportionate racial impact was evident in Covid’s devastating toll on Filipino health care workers. Kansas City RN Celia Yap Banago, one of many RNs who had pressed her hospital, HCA’s Regional Medical Center, to fix inadequate protections, was one of the first RNs to die in April 2020. “We were being told we’re not allowed to wear masks because it’s going to scare our patients,” said Jenn Caldwell, RN. “We recommend the hospital should prepare now,” NNU had written January 24, 2000 to HCA Midwest Health. “My mom put everyone before herself, all the time,” said Cecelia’s son Jhulan Banago. “If my mother’s death can result in more protection for all nurses everywhere, that will be very meaningful to our family.”
By August 2023 when the government stopped reporting healthcare worker Covid date, 5,753 health care workers, including 501 RNs, had died of Covid. Zenei Triunfo-Cortez, RN, CNA/NNOC’s first Filipina president, commenting on the lack of personal protective equipment made available to scores of RNs and other health care workers, said, “we love our jobs, but we love our families too.” In a June interview, she added, nurses call for help from Trump and Congress “fell on deaf ears…Our employers are banking on (CDC) guidelines, which have been watered down… We’re being treated like we don’t matter and we’re dispensable.”
The racial disparity of infections and death
Centuries of structural racism accelerate the disproportionate impact of any crisis, including pandemics. As Trump was continuing to downplay the tsunami of infections and deaths, and discouraging safety procedures, the racial impact escalated. Black Chicagoans, 30 percent of city residents, comprised 72 percent of the Covid deaths. Black Michigan residents, under 15 percent of the population, accounted for 40 percent of the deaths. Milwaukee African Americans, 26 percent of the population, totaled 70 percent of Covid deaths, the same percentage as in Louisiana where Black residents were 32 percent of the population. Similar rates were evident across the country, from states with large Black populations like North and South Carolina, to those with smaller percentages, Nevada and Connecticut.
Latinos were 80 percent of the first people admitted for care at San Francisco’s large public hospital and in Latino San Jose neighborhoods. Native Hawaiians and Pacific Islander infection and death rates were also higher in California. In March 2020, New Mexico Gov. Michelle Lujan Grisham cited “incredible spikes” in Navajo Nation. Two months later, Navajo Nation still had higher Covid infection cases per capita than much more publicized, hard hit New York City.
Columnist Jamelle Bouie linked the disparities to “longstanding structural inequities.” Systemic racism in health care had a long history, evident in less access to medical institutions and caregivers, provider treatment biases, lower rates of costly health coverage, housing segregation and higher concentration in polluted neighborhoods. Hospitals in Black neighborhoods were far more likely to close than in mostly white areas, a National Institutes of Health study found.
“Even if we had a perfect healthcare system in which anyone could access a doctor, we would still see significant health disparities because of food deserts and lack of walkable streets,” said Chicago Public Health Commissioner Dr. Allison Arwady. “The issue of preexisting conditions doesn’t just happen. There’s a whole political economy that’s made Blacks more vulnerable to having preexisting conditions,” Ohio State University professor Darrick Hamilton told journalist Stephen Greenhouse.
Black and Latino workers were also far more likely to hold “essential” jobs. Many were concentrated in lower paid jobs often forced to keep working due to economic need or employer pressure, including in food services, grocery and drug stores, poultry and other meat processing plants. The Guardian reported alarmingly high transit worker death rates among bus and subway drivers, mechanics and maintenance workers in New York, Boston, Chicago, St. Louis, Detroit, Washington DC, and other major cities.
In September 2020, the CDC drew condemnation for reportedly soft peddling safety precautions due to political interference at a South Dakota meatpacking plant. All these factors resulted in workers of color having less economic ability or opportunity to shelter or work from home, and less access to safety measures, from masks to social distancing on the job where they risked constant exposure.
It also reinforced a class chasm with “a lot of professional and more affluent people who could afford to make the kind of sacrifices this public emergency called for who were able to protect themselves, able to sustain a level of comfort that other people in America were not,” said sociologist Klinenberg.
“It wasn’t like when we called them essential, we said, because you’re essential we’re going to honor you, we’re giving you masks, you get the best access to health care in the world, and here’s a bonus from all of us and our forever gratitude,” Klinenberg added. What it meant to be an essential worker was to be deemed expendable. And it wasn’t just you, you got exposed to the virus, then you were more likely to go back home to your family who also got exposed to the virus. So you’ve got these neighborhoods throughout the country where there’s a lot of working class people who are getting exposed and they have higher mortality.”
“Covid was kind of a search light that showed us everyone, everywhere we had studiously looked away from,” writer/activist Naomi Klein observed. “Suddenly we’re forced to think about the way in which our culture produces disposable people, whether they are working in elder care facilities when there’s suddenly Covid outbreaks, or the poultry plants (that) were Covid hotspots. Places where you never see a camera because we’re not supposed to think about, (like) what’s going on in prisons.”
Klein cited “the myth of neoliberalism, like we are just individual people and families, and we don’t owe anything to each other. Covid said that wasn’t the case because you can’t just treat individuals, you have to treat a body of enmeshed individuals.”
Workers and unions had to fight with their employers and public agencies under Trump to protect their members and the public. Union pressure, Castillo told the New York Times, moved some hospitals to act. In the first six months alone, wrote Rikha Sharma Rani a “furious” NNU “staged more than 350 socially distanced protests, including two vigils in front of the White House for the nurses who died from the virus.”
Though Trump’s first term ended with the rollout of a Covid vaccine, lasting damage had been done with his encouragement of opposition to critical community protections from masking to social isolation to needed closures to reduce the spread of the virus, and his sympathy for an escalating anti-vax movement. NNU early in 2021 characterized the Trump administration’s response as “one of denial and abandonment.”
With Trump nominating people with similar views opposing the critical importance of a robust approach to public health, including full preparedness and action on sure to come future epidemics, there is ample cause for concern. A new avian flu’s first U.S. death has already occurred. Measles, polio and other illnesses could mushroom especially with health officials hostile to vaccines in charge of health agencies with vaccination rates already declining.
As confirmation hearings approached, the New York Times this week reported the alarming vaccination drop “creating new pockets of students no longer protected by herd immunity (and) … now an estimated 280,000 kindergartners without documented vaccination against measles, an increase of some 100,000 children from before the pandemic.” Resurgence of polio, once virtually eradicated, is also a threat.
Covid death rates among unvaccinated people were 14 times the rates of those who had received a Covid booster shot. Researchers also estimated that from May 2021 — the point at which Kennedy petitioned the FDA to rescind authorization for the vaccine — through September 2022, more than 230,000 deaths could have been prevented among people who declined initial Covid inoculations.
Rising temperatures from climate change mean that bacteria not only grow faster but are also associated with increased antibiotic resistance, facilitating the rise of new deadly pandemics. Factor in expected cuts in federal agencies, and reduced enforcement of workplace and community protections by an administration more friendly to corporate demands for cuts in regulations.
Our vigilance and mass action will be critical to protecting public health.
