Throughout The Silent Invasion: The Untold Story of the Trump Administration, Covid-19 and Preventing the Next Pandemic Before It Was Too Late, Birks talks about her struggle to connect with an administration unprepared for the pandemic and President Trump, who she quickly cooled off her definite predictions about the damage the virus could cause.
“Every other president would like to know how bad things will get and what can be done to prevent the worst,” Birks wrote of his first days in the 2020 task force. president or any other White House. It was President Trump and the White House of Trump. I stood on ever-shifting sand, among political players I didn’t know, and a president who obviously liked his news, served well and optimistically, or not at all. “
Birx has also criticized the US Centers for Disease Control and Prevention for its initial response to the flu-like illness and the lack of a clear division of responsibilities between agencies. Birks attributes some of this to CDC Director Dr. Robert Redfield as “politically appointed” in the Trump administration.
“Human resources will question everything that comes from Bob and this White House,” she said of her difficulty in directing CDC staff to the board by acknowledging the widespread asymptomatic spread of the coronavirus.
And yet, as political messages drove public health messages, Birks writes, she and some of the doctors in Covid-19 responded by signing a pact: If anyone is fired, Redfield, director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci and US Commissioner for Food and Drug Administration Dr. Stephen Hahn agreed that they would all resign in protest.
“I did not hope to be fired, nor did I want to resign despite the release of others,” she wrote.
“I did not believe that leaving would change anything for the better. Accusing the Trump administration of negligence would not suddenly lead to a different response to the pandemic. ”
Optics to shoot her would be bad, she writes.
After Birks told CNN’s Dana Bash in August 2020 that the virus was “extremely widespread,” Birks wrote, Trump called her and asked for the name of the person who booked the interview, saying, “This is it! Do you understand me? Never again! the virus is under control. “
Although they made progress, she wrote: “The president was wrong. We didn’t have the virus under control. “
In addition to the “dysfunctional” White House, the United States has struggled to keep up with the fast-moving virus. Addressing the problems uncovered by the Covid-19 pandemic could help save the country from the next, she said.
Deal with inadequate data collection and analysis
“Data is all in a pandemic,” Birks wrote in the book. “The data shows your shortcomings; they show where communities have an effective response; they reveal the truth, where things get worse and where they get better. It allows you to stay focused on the laser and develop evidence-based policies. Without comprehensive data, you will not receive a comprehensive answer. “
Before joining Covid-19’s response, Birks wrote, she believed U.S. health officials were seeing data she didn’t have access to. But since she arrived in March 2020, Birks – who previously worked on the president’s emergency plan to alleviate AIDS – has found the country “dangerously behind the G8” in collecting data on the emerging coronavirus.
Birks described a meeting in March at which the working group received a single bilateral data page that “summarizes data on cases and deaths by country.”
In 2020, she writes, data in some states is often faxed and then transmitted to the CDC.
“How did this really happen? How in God’s name can we not have clear data at this time?” She wondered.
All the United States had, she said, was a static, partial realization of thirty thousand feet. I pressed my flat hands to my eyes and shook my head. I was expecting something very different, but now I could see not only that the reporting structures that took years to build in Africa are not present in the United States, but that we have days to do the same work here. “
Understand that a new virus can behave differently
Birks wrote that even before joining the White House team, she suspected that the asymptomatic spread was contributing to the rapid rise of Covid-19, although the evidence was slim.
“After years of trying to see asymptomatic, asymptomatic and mildly symptomatic cases that are ignored in tables, every time I read a number showing a confirmed case, I multiply that by a factor of three to ten,” she said.
At least initially, the focus was on those with symptoms, similar to the flu case.
But the virus that causes Covid-19 is very different.
This became clear when cases increased in New York, a dramatic increase that “cannot be explained by symptomatic spread alone.”
“If previously there was doubt about the extent to which asymptomatic prevalence had contributed significantly to the increase in the number of cases, New York data convinced the team that my estimate of at least 30-50 percent asymptomatic prevalence was probably accurate and probably even conservative. “Birks writes.” Although testing problems prevented us from having the necessary amount and type of data, mostly numerical evidence, the picture was crystal clear.
“For those of us in this small room, doubt has been replaced by a sense of common fear,” she told the task force.
Develop tests early
The contribution to the lack of clear, detailed data on Covid-19 and the misunderstanding of silent distribution was a significant need for testing in the United States. The early CDC test was flawed, leaving the country weeks behind for testing, Birks writes. Even then, public health laboratories were not equipped to move quickly and cope with the volume that the Covid-19 response would need.
Writing about a meeting with US manufacturers to test Covid-19 at the beginning of her term, Birks said learning that the White House had dragged on to meet with manufacturers, along with limited testing and slow test processing, was “the most bad script “
“In later conversations, I asked one of the manufacturers who is critical of the production of high-performance and field tests whether someone from the administration or the CDC called them in January and February 2020,” she wrote.
“Their response was that it was actually the opposite: manufacturers are the ones who call the CDC to find out what they are doing and how they can help. Manufacturers were kept at arm’s length “from the CDC, the Ministry of Health and Human Services, and its Assistant Secretary’s Office for Readiness and Response. “They were told their help was not needed,” Birks wrote.
Trump’s testing rhetoric later changed – he suggested that the United States has a large number of cases because so many people have been tested – but Birks said the task force is working quickly to expand it, spending billions on testing and supplies. and implementation of serial testing in nursing homes and universities.
“At no point did anyone tell us to stop this acceleration of tests. “The president was good at saying one thing to calm his base while his administration did another to support the fight against the virus,” she wrote.
Insist on solutions before there is a problem
Birks’ book concludes with a list of “critical issues” that need to be addressed in the United States about pandemic response and preparedness. It includes clarity on how responsibilities are shared between agencies, enhanced testing and diagnostics, improvements in CDC data collection and “comprehensive” improvements in public health coordination.
Some of these changes are still needed to manage the current pandemic.
“One of the most important things here is not to wait until the wave or the holidays,” she wrote. “We have learned that there is a lull in the epidemics. During these interruptions, we had to expand access to testing. We had to use that time to prepare for the next leap, getting as many Americans as possible involved in making the necessary critical changes in behavior to protect their vulnerable family members. “
Looking ahead, Birks wrote that solutions cannot be implemented only when there are emergencies.
“We do not need one set of standards and processes to improve the country’s public health and another to prepare for a pandemic – they must be integrated and used between pandemics to improve the nation’s health,” she wrote.
“We just need to stop looking at the problem and start dealing with the problem.”
CNN’s Jamie Gumbrecht contributed to this report.
Add Comment