Covering Coronavirus: Warnings to the White HouseListen
COVERING CORONAVIRUS: WARNINGS TO THE WHITE HOUSE
MARTIN SMITH: You've spent a lot of time thinking about the possibility, the inevitability really of some kind of pandemic hitting us all. What was going through your mind when you saw the news out of Wuhan?
STEPHEN MORRISON: Well, my first reaction was that this looked like the option that we feared the most. A fast moving respiratory pathogen that we had never seen before that was moderately lethal. And then as we began to learn more about its transmissibility, I began to realize that this was a truly extraordinary threat that we faced.
RANEY ARONSON: That’s Stephen Morrison, author of a study that warned last year of a pandemic like the coronavirus spreading to the U.S. He's talking with FRONTLINE correspondent and producer Martin Smith.
SMITH: As you watch the numbers rise, the number of cases, the number of deaths, and you see these horrendous scenes of frontline hospital workers giving their lives, shortages of equipment. How do you feel?
MORRISON: I feel like everyone else. I feel anguished. There will be thousands upon thousands of people in America who will die needlessly. They will experience preventable deaths. And there will be thousands of health workers whose lives will be imperiled and many of them will become sick and some of them will die because of our lack of preparedness.
ARONSON: For years, Marty's reporting for FRONTLINE has held leaders in government finance, the military accountable. Over the past several days, he's been talking with leading experts and insiders about early warnings and missteps related to the coronavirus outbreak. I'm Raney Aronson, Executive Producer of FRONTLINE, and this is The FRONTLINE Dispatch.
FUNDER: The FRONTLINE Dispatch is made possible by the Abrams Foundation, committed to excellence in journalism, and by the WGBH Catalyst Fund.
SMITH: Okay, so I'm recording on my end.
ARONSON: Great. Okay, Marty, it's great you could jump on the phone with me, where am I talking to you from?
SMITH: I'm sitting in the Catskill Mountains two hours and change from north of New York City.
ARONSON: Marty, you're the kind of reporter who is known for all the infield reporting work that you do. You usually go to places regardless of how dangerous they are even. How is it working remotely right now for you?
SMITH: You know, I was nervous about it because I'm used to talking to people in a room I walk in, I sit down, sit down across from one another. So there's in person contact. And so I was quite nervous before I began doing these interviews as to what kind of connection I would feel and how they would feel about doing these interviews. But you know, in the last week, I've spoken with people from China, from South Korea, from Hong Kong, from London, from Iran, from Italy and of course the United States.
ARONSON: So Marty, I know that you've been doing so many interviews lately, as you mentioned, but the other day one really got your attention. Stephen Morrison, why was that?
SMITH: You know, Stephen Morrison is a global health policy expert. He is with the Center for Strategic and International Studies, C.S.I.S., which is a well-respected, nonpartisan think tank in Washington. And last year, he headed up a project to put together a report and his report on the inevitability of a pandemic striking the planet. And the U.S., of course, was quite prescient and in our conversation, I was struck by the recommendations that he made and how much foresight there was in the report that he finished and published in late November of 2019.
ARONSON: So that gets published and what kind of response does he get at the time?
SMITH: Well, he talks about a pre-brief that took place with administration officials. And he said he was met with silence.
MORRISON: I think silence speaks for itself. I think that, you know, they didn't want to get into an argument where they couldn't very easily win. And so we just sort of cordially agreed to move on.
SMITH: They just didn't take seriously the recommendations that we were making, he told me. In hindsight, that's quite alarming. The cost of preparedness is minuscule compared to the cost that we're now facing.
SMITH: So immediately you felt that this is what you feared the most.
MORRISON: And I was not alone. I was not alone. This was being voiced by many of the experts who were watching this closely, including those at C.D.C. that I was in touch with.
SMITH: So you were, it's fair to say, very worried at this point.
MORRISON: Yes, I was quite worried, and watching very carefully to figure out the true gravity of this and figure out how quickly were we going to see a test developed because the Chinese, they made their declaration to W.H.O. December 31, began to share the genetic details, data around January 10, developing vaccines, developing antivirals and developing tests. So the race was on.
ARONSON: When Morrison was talking to you about those moments in January, when he was starting to see how the administration was handling the coronavirus, what was going through his head and his colleague’s head about what the U.S. government should be doing?
SMITH: Well, he thought that somebody should be in charge. Somebody should be taking control of this situation and somebody should be ringing alarm bells, and he just wasn't, he wasn't seeing that.
MORRISON: At the level of the White House, you didn't have a directorate, you didn't have a senior personality with gravitas dedicated to leading on this issue, who could have pulled the parties together and gotten the president's attention more readily. There were multiple problems across our government in the system of government structurally, in which you had the alarm bells going off, but you did not have concerted action happening with speed and coherence connecting to the president in a way that it should.
SMITH: That just wasn't anybody at home. You know, it wasn't until late January that the White House Task Force was formed to take this on, but by this time, the virus was everywhere. I talked to another official who sat down with a bunch of administration officials for a dinner, and he was raising these questions in January and all they were talking about was closing the border with China. And he was saying, ‘Look, guys, we got to do a lot more than closing the border. This is already here.’ By contrast, in South Korea, they had four confirmed cases of COVID-19, and they called an emergency meeting, gathered all private sector and public sector people together and declared an emergency, called for massive testing. And they had the ability to do that. And they had people trained as to how to administer these tests. They had all of that in place.
ARONSON: So I know that Morrison identified a really particular moment: the disbanding of the pandemic office. Can you talk a bit about that?
SMITH: Yeah, in May of 2018, the National Security Adviser in the White House, John Bolton, decided that he wanted to reorganize the office and how things were run. And so he decided to move this office out of the White House, disband it really, and dismiss its director, Admiral Ziemer, Tim Ziemer. He was dismissed and other people that were involved in that office were dispersed to other places. And it was basically thought that it would be better to put this kind of capacity into the Health and Human Services Department and that really was in his view and what he says, I mean, the first recommendation of the report is that that office needed to be restored. And they published this report last November. But of course, it wasn't restored.
MORRISON: This was a serious mistake and we raised it in the report that we put out and we raised it in many other fora. And the argument that I think was most powerful was to say this is an area of exceptional vulnerability. We live in an era in which we're seeing increasing rapidity and increasing velocity and increasing impacts of these new pathogens coming at us, and the idea that you would disband your capacity willfully at the White House, aware of the developments of the last two decades which were convincingly that we needed to be prepared and far better prepared on a consistent and sustained and coherent basis. We were not alone in voicing discontent and alarm that such a step would be taken.
MARTIN: And the importance of that is that when something strikes, you need somebody in the White House who had, who's close to the president, and who has the ability to coordinate all the different agencies within the government to respond and that just was missing. So you had this sort of, you know, bifurcated response with the C.D.C., the F.D.A., H.H.S., everybody doing things separately, but with nobody in charge coordinating the response.
ARONSON: Right, so the pandemic office is closed, it's recommended to open, nothing happens. And so then there is a critical breakdown in communication in early January that Morrison was pointing out to you can you can tell us a bit more about that crucial moment in January.
MARTIN: Well, in January, this virus is spreading in China. And this information had gotten to the Secretary of Health and Human Services. Secretary Alex Azar. And this was, you know, around the very beginning of January, he can't get a meeting with the president. Finally he gets an appointment almost three weeks later. And this is the story that Morrison tells.
MORRISON: The president was not reached by Secretary Azar until January 18. So there was quite the long delay. Secretary Azar was the designated lead under the national biodefense strategy on this matter. And so he took it up and he began pressing to get in to see the president. But it wasn't until January 18th, that he did that--
SMITH: And in the end Azar never even got a meeting, it was just a phone call.
MORRISON: --and the president's first concern at that time was to talk about e-cigarettes.
SMITH: The president is concerned about vaping and wants to talk about that.
MORRISON: The impeachment process was the overwhelming distraction and preoccupation in this period and Secretary Azar was having a hard time conveying the gravity of the situation to the president.
SMITH: And when he gets to talking about the coronavirus, you know, he doesn't really feel like he's getting the full attention of the president.
ARONSON: Marty, tell me a little bit more about Azar and what his response has been in general.
SMITH: Raney, I’m not sure we know yet exactly. There are those in Washington who say, ‘He could have done a lot more than he did.’ And of course that’s an accusation that’s being leveled at a lot of people in Washington across a number of agencies. Some have suggested that if Azar really wanted to get to the president sooner, he could have done that. So it’s unclear. And that’s what we’re looking at in our report: who is responsible, who is accountable for the kinds of fiascos on testing and supplies among the agencies?
ARONSON: Marty, I’m trying to understand from Morrison's point of view, what is this miscommunication or lack of communication actually in early January? What kind of consequence could that have had?
SMITH: I mean, Morrison believes that that had huge consequence. That had there been a coordinated response from the White House, where someone would have been in charge of coordinating all the responses at every level of government, it would have saved hundreds or if not thousands of lives.
SMITH: What's the highest level official that's called you after the outbreak of coronavirus and said, ‘Steve, you were right,’?
MORRISON: No, no. And I'm not surprised.
ARONSON: You know, one thing that really fascinated me that you told me a bit about is the role of media that's been playing out. And I know Morrison told you about what he calls ‘an infodemic.’ What does that mean exactly?
SMITH: Yeah, he used that word. And it was in the report and in the executive summary. I think there are like seven main points that they came up with and, and one of those points was something that they didn't expect to put into the report when they started. It was sort of outside of their purview. But this was the degradation of belief in science and the amount of misinformation that is coming at us all the time on the internet.
JEANINE PIRRO: All the talk about coronavirus being so much more deadly doesn’t reflect reality.
MAYOR BILL DE BLASIO: Go about your lives, go about your business. But this is not so far something that you get through casual contact…
GA GOV. BRIAN KEMP: Those individuals could have been infecting people before they ever felt bad. Well, we didn't know that until the last 24 hours…
MUSTAFA ALI: Many people who say and with conspiracy theories that if you're black, you can't catch coronavirus…
DREW PINSKY: It is a press-induced panic, I am angry about it. It is the flu. Professionals need to take it seriously, the government needs to do its job, the rest of us need to go about our business.
SMITH: So it's a major impediment to people respecting experts. And that has, of course, a really serious effect on how we respond to this. So on the one hand, you have that but on the other hand, you had a president who was susceptible to a lot of misinformation and was dishing it out.
PRESIDENT TRUMP: Now the democrats are politicizing the coronavirus and this is their new hoax…
REPORTER: Have you been briefed by the C.D.C.? Are there worries about a pandemic at this point?
TRUMP: No, not at all. And we're, we have it totally under control.
TRUMP: You know, a lot of people think that goes away in April with the heat… because of all we've done the risk to the American people remains very low… It’s going to disappear one day, it's like a miracle it will disappear.
SMITH: The consequences of the delay and the amount of misinformation that was out there is just astounding.
ARONSON: So the other day you spoke with Nick and Britta Jewell. And I know they've been tracking this since the very beginning. Can you talk to me about their take on how it's been handled?
SMITH: She’s a statistician and he works in infectious diseases and they're very dispirited in how it's been handled. And what they impressed upon me was what exponential growth really means. You know, most people think in terms of arithmetic growth, you know, two, four, six, eight, 10, 12. But this is, you know, two, four, eight, 16, 32, 64 and on and on. And so in a matter of days, you're into hundreds and then thousands, and they impressed upon me, you know, that not enough people can get their heads around that. So what they felt was that, in the beginning, the numbers were relatively low. So you had four cases you had 13 cases or whatever number you had in Seattle. In Seattle, they took action very quickly. Understanding that this was going to grow exponentially, but in other places, and in the White House, they didn't seem to get their heads around the consequences of exponential growth. Nick Jewell explained it better than I can.
NICK JEWELL: If I tell you there's 30 cases in the United States, that's not going to scare you. That's not going to cause you to shut down your cities. If I tell you there’s 60 cases in the United States, you still feel very comfortable, 120, 240, and so on. You don't feel the power of exponential growth until it's absolutely stunning. So when you say, ‘Oh, if there are 10,000 cases in the United States, then we ought to pay attention.’ The trouble is, in two or three days now, it's 20,000. So the month or two that it took a government and individuals and community members to become concerned enough to take steps, within a few days that whole month and a half of growth has been repeated again. And in two or three days, it's now four times what it was when you start to get concerned. Within another two or three days, it's 16 times. It takes a long time to ramp up. But once it gets your attention, it's stunning in its speed and and you're really then caught not being able to keep up with the spread at all, which is what I think New York experienced and has been repeated what Italy experienced, what many countries and regions have experienced firsthand, in maybe a way they never have before.
SMITH: Another point that Britta made was that if you avert one infection early on as opposed to averting that infection, let's say, in a week from now, the effect on the overall population is huge. And that's again, something that a mathematician can demonstrate with graphs and charts. But it's not something that people easily grasp that if you just keep somebody from being infected now, it has a tremendous leverage on what you're going to see down the road.
BRITTA JEWELL: If you took the number of cases that were in the U.S. I think on March 12 and if you just removed one of the infections that would happen tomorrow, and monitored how many infections, assuming it just continued to grow at a 30% rate every single day for a month, how many infections you would end up with at the end of the month, and then what would happen if you didn't avert that one infection tomorrow, but instead waited a week to avert the one infection. And what you see at the end of the month is that you've averted about four times as many infections by averting it a week earlier. So if you really want to have the biggest effect, you have to do it sooner rather than later. You know, if any of these countries had worked to shut down transmission when there were only a handful of cases, we would never have seen this exponential growth. But therein lies kind of the catch-22 because if you intervene and shut down the entire economy when there's 50 cases in your country, that seems almost politically infeasible, but you would have seen a much greater effect in terms of the number of potential infections that had been averted.
ARONSON: That makes a lot of sense. So I know that the Jewells and Stephen Morrison they've been working to prevent something like this and, you know, beyond their specific analysis of the missteps, what's their mood right now? Are they angry? Are they anguished? What's going on with them?
SMITH: You know, I don't think they take any joy in having been right. I think they're quite, I mean, they're upset. I mean, Stephen Morrison told me he knows someone who's died. His 87-year-old mother has now moved in with him. He's making masks at home out of material that he bought in Sierra Leone during the Ebola epidemic. The Jewells, they take no pride in having been right about this. And when I asked her about the, first it was Fauci and then it was the president saying there could be as many as 200 or 240,000 deaths. I asked the Jewells, Nick and Britta, what they thought of those numbers.
BRITTA JEWELL: I mean, I'm gonna go out on a limb and say, I think that's optimistic to see that level of death. I think that's if we do things right, we'll end up there.
SMITH: 200,000 deaths you think is optimistic?
BRITTA JEWELL: Yes, I know that the modeling that people have done, I was not involved in this, but people at Imperial College where I work, forecasted 2.2 million deaths if you do nothing, obviously, we're not doing nothing so I wouldn't expect to see it reach anywhere near that level. But it doesn't seem like this is a virus where you have a lot of room to play. If you don't do things right, if you don't do things early, it gets out of control very quickly. Part of the issue in the U.S. is it’s such a big space, and each state is essentially going to have its own epidemic and as of right now, there isn’t any formal limitation on transit between states. So my guess right now is you’re going to see epidemics taking off at different points in time.
SMITH: It's extremely sobering. And, you know, he also, Nick said, ‘Look, the next month is going to be a really rough time, a really tough time for all of us.’
ARONSON: Marty, you know, you've covered so many big stories for FRONTLINE over the years. I mean, just to name a few: 9/11, the wars in Iraq, Afghanistan, Hurricane Katrina, the financial crisis. And you've always looked at it from an accountability perspective. And I'm wondering what stands out about this story regarding the government's response to this crisis compared to the others?
SMITH: Well, look, there's a lot of finger pointing going on right now. And what I'm discovering is that there's a lot of unknowns as to who dropped the ball and when. It's clear that at the top, and I mean by that the president, the wrong messages were being given. And so he is accountable in that sense. As far as the agencies, we're still trying to figure out and this is going to go on for some months.
ARONSON: Marty, when you're thinking about all the interviews you've had, especially with the Jewells and Morrison, what are they concerned about next?
SMITH: You know, perhaps the most sobering comment that I heard in amongst the interviews was when Britta Jewell said to us, ‘This is not the big one.’ I said, ‘Really, what do you mean?’ And she says, ‘Look, this is, there's gonna be more of this and the way we live now the microbial universe that we exist in the fact that we there are more of us on the planet and we live closer and have more exchanges with animals and zoonotic transferences of viruses can be more common. This is not likely to be the big one and it's just a matter of time before that happens.’
ARONSON: When you heard that, I'm sure you followed up to say, ‘How prepared do you think we are for the big one?’
SMITH: I asked Britta Jewell, I said, ‘So this isn't the big one. How prepared are we for the big one?’ And she's said, ‘We weren't prepared for this one.’ So I mean, do the calculation. We are not prepared. And, you know, Morrison makes the point in his report. In fact, it's in the title. It's the cycle of crisis and complacency that we go through these things and we're all alarmed. And you know, it's like, you buy insurance after you've after your house has burned down. You know, we’ve got to take this as a lesson and heed it. We spent all sorts of billions and billions of dollars on weapons for the Pentagon so that we can take over countries, we can conquer enemies. But we don't think of healthcare in the same fashion and it's a much more insidious and dangerous enemy that we're facing. But we don't take it as seriously as we need to.
ARONSON: What's next for you now? What are you going to be doing next?
SMITH: We are going to be doing more interviews and trying to get to the meat of the matter in terms of where we failed, because that's important that we understand how to fix the situation. How do we fix our government to be better prepared for this? So we want to drill down on that. And as we continue our reporting, we'll get deeper into just who was responsible and who dropped the ball or where there were weaknesses in our system, we're making progress on that front.
ARONSON: Marty, thanks for joining us on the Dispatch and we'll be keeping tabs on you and talk to you again soon.
SMITH: Raney. Thank you. It's a privilege to be able to do this reporting for FRONTLINE.
We're going to be bringing you more dispatches like this one as the pandemic unfolds.
You can find more of our reporting on the coronavirus and its impact, including transcripts of Marty's interviews with experts online at FRONTLINE dot org.
This podcast was produced by Max Green and James Edwards.
Our production assistant is Lucie Sullivan.
Katherine Griwert is our editorial coordinating producer.
Pam Johnston is FRONTLINE’s senior director of strategy and audience.
Lauren Ezell is senior story editor.
Sarah Childress is our senior editor.
Frank Koughan is senior producer.
Andrew Metz is our managing editor.
I’m Raney Aronson, executive producer of FRONTLINE.
Music by Stellwagen Symphonette.
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