Last month, after analyzing figures on epidemics since 1960, The Economist concluded that people die at a higher rate from such disease outbreaks in authoritarian countries than in democratic ones, even controlling for income levels.
This might seem counterintuitive. Autocratic societies have an easier time imposing strict behavioral limits than democratic ones; it’s hard to imagine Italy locking down Milan the way China closed off Wuhan. Without the messy deliberations of democracy, certain kinds of infrastructure can be scaled up much more quickly. “In Norway, one of the most democratic countries in the world, lawmakers have been debating the location of a new 200-bed hospital for seven years,” according to the article in The Economist. “In China, a new 1,000-bed hospital to treat coronavirus patients was recently built in just 10 days.”
But democratic countries are far better than authoritarian ones at fact-based policymaking and at sharing the truth with the public. “Nondemocratic societies often restrict the flow of information and persecute perceived critics,” The Economist piece noted. We’ve seen this in China. As Li Yuan wrote of coronavirus in The New York Times last month, “As the virus spread, officials in Wuhan and around the country withheld critical information, played down the threat and rebuked doctors who tried to raise the alarm.”
Unfortunately, you could substitute “Washington, D.C.” for “Wuhan” in that sentence and it would be equally true. So far, President Donald Trump’s response to coronavirus combines the worst features of autocracy and of democracy, mixing opacity and propaganda with leaderless inefficiency.
From the beginning, Trump minimized the scale of the crisis, portraying it as a purely foreign threat that could be addressed by closing borders. At a Feb. 26 news conference, he claimed there were 15 cases in America, omitting those diagnosed overseas. “The 15 within a couple of days is going to be down to close to zero,” he said. As of Friday morning, there have been more than 230 cases confirmed across the country and 14 deaths.
Trump dismissed Democratic complaints about his handling of the crisis as “their new hoax.” Last week Mick Mulvaney, Trump’s acting chief of staff, told the crowd at the Conservative Political Action Conference that the media is paying so much attention to coronavirus “because they think this is what’s going to be what brings down the president.” Speaking to Sean Hannity on Wednesday night, Trump seemed to imply that it was OK for people with coronavirus to go to work: “So if, you know, we have thousands or hundreds of thousands of people that get better, just by, you know, sitting around and even going to work — some of them go to work but they get better.” (He later wrote an angry tweet saying he’d never said sick people should go to work, but he certainly didn’t instruct them to follow the Centers for Disease Control and Prevention advice and stay home.)
Within the administration, there’s strong pressure not to contradict Trump’s line. In February, when Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases, warned that community spread of coronavirus in America was inevitable, the president was reportedly furious, and the director of the CDC said she misspoke. Pro-Trump media figures like Rush Limbaugh suggested that she was part of an anti-Trump conspiracy because her brother is former Justice Department official Rod Rosenstein, often derided on the right as part of the Deep State.
The New York Times reported that Defense Secretary Mark Esper has warned the military not to make decisions related to Coronavirus that might “run afoul of President Trump’s messaging,” even as leaders have to make quick judgments about protecting troops stationed in countries with outbreaks. A Pentagon spokesperson took issue with the Times story, calling it a “dishonest misrepresentation.” Still, it seems as if in the midst of this burgeoning crisis, we’re seeing a coordinated, whole-of-government campaign to protect the president from being contradicted.
Dr. Joshua Sharfstein, a vice dean at Johns Hopkins Bloomberg School of Public Health and author of “The Public Health Crisis Survival Guide,” told me that, reviewing the history of such crises, “One of the huge lessons is: Don’t politicize the communications. You really need credible communicators who people believe.” Trump is the opposite of that. At least half the country distrusts him, and he’s ensured that a good part of the other half distrusts actual experts.
But if this administration is incapable of the basic honesty one expects from officials in a democracy, it also can’t pull off autocratic, top-down coordination. It has utterly failed to ramp up sufficient testing capacity; on Thursday, Vice President Mike Pence admitted, “We don’t have enough tests today to meet what we anticipate will be the demand going forward.”
As I write this, the Grand Princess, a ship carrying thousands of people, is stuck off the coast of San Francisco after a former passenger who had disembarked died of COVID-19, the disease that this coronavirus causes. According to Gov. Gavin Newsom of California, 11 passengers and 10 crew members are showing signs of the illness, and Newsom said that number may “significantly understate” the severity of the outbreak onboard. This comes after last month’s disastrous attempt to quarantine people aboard another cruise ship owned by the same company, the Diamond Princess, off the coast of Japan. In the end, 705 people were infected on that boat.
Researchers concluded that if people had been quickly taken off the Diamond Princess, the infection rate would have been only one-eighth as high. Nevertheless, DHS official Ken Cuccinelli told a Senate committee on Thursday that the ship off California can’t be evacuated because U.S. health care facilities lack the capacity to quarantine its passengers. Therefore, at least for now, the Diamond Princess experiment is being run again.
Jeremy Konyndyk, a former director of the foreign disaster assistance program at USAID who helped manage the response to Ebola during Barack Obama’s presidency, said a competent administration would have had a contingency plan for a repeat of the Diamond Princess debacle. “It’s one thing to be the first one to make a mistake,” he told me. “It’s pretty different to be the second one to make the same mistake.” He added, “To say we’ve got no way to bring these people off the cruise ship is extraordinary to me.”
Extraordinary, but perhaps not surprising. “It’s like a Xerox copy of Puerto Rico,” Konyndyk said, comparing the administration’s coronavirus response to its mismanagement of Hurricane Maria’s aftermath. Trump’s presidency has caused manifold catastrophes, but so far, most Americans have not seen them up close. That might be about to change. Trump spent much of Thursday afternoon congratulating himself on Twitter for his coronavirus response. If things get really bad, maybe he’ll toss us a few rolls of paper towels.