THE FIRST NOTE

04.01.2020

Scrabble, Virginia — The redbud trees are opening. Tulips, daffodils, and forsythia have been in full bloom for almost three weeks. The tree pollen has not peaked yet, but you can see it in the air when a beam of sun hits at the right angle. In short, its early Spring in Rappahannock County, Virginia, or as many of we locals call it, the Rapp. It may be too early to plant the basil or have dinner outdoors, but it is time to begin clearing garden beds and, as the showers increase in regularity, think about when the first grass cutting will be needed and what new trees might be planted.

This year I am privileged, and compelled by the plague, to spend more time in the Rapp than I might otherwise have done. Having lived here slightly more than fifteen years, I am still in the minds of locals a “come here,” not a “been here.” Yet, I think of it as home and have grown increasingly appreciative of it in these weeks of “lockdown.” What better place to be grounded? The population density is normally so low that social distancing is a routine condition. Even if government owned parks are closed in some places, there are miles of hiking trails available in the Rapp simply by walking from one neighbor’s farm to another. With hunting season over, the only risks in the fields come from the occasional unfriendly dogs and bulls. In a few weeks, the copperheads and black bears will stir, but for now the fauna are largely limited to timid deer, turkeys, and red fox.

Early Spring here also brings an increase in avian life. Today the first bright red cardinal of the season visited my garden, a sight which always cheers me. Yesterday, however, a feather intruder announced itself with a bang, or rather a sustained series of loud bangs. A large, red-headed wood-pecker decided to attack the eves near my bedroom, waking me from a pleasant morning slumber.

All of this activity in nature has served to distract me a little from the destructive and disruptive part of nature that is the pandemic. I need that distraction because when I think of the federal government’s response to this crisis an anger rises in me that disrupts and disturbs my life. I feel anger because for decades I was part of the federal government, a crisis manager, someone charged with anticipating risks and threats and providing warnings, someone often asked to direct crisis response. I know what we could have done, how this crisis could have been so much less damaging. It is not twenty-twenty hindsight. None of this is a surprise.

In the mid-1990s, the Administration identified emerging infectious diseases and bio-terrorism as threats likely to increase in importance and for which the US was badly prepared. For the first time, the White House adopted an all-of-government strategy for dealing with the emerging infectious disease problem. As part of that, the President requested a significant increase in funding for the Public Health Service’s (PHS) surveillance network, creating local testing laboratories and a national reporting system. A little known part of the PHS, the Epidemiological

Intelligence Service, was strengthened. Later, disease surveillance specialists were deployed overseas, including one in China.

A National Emergency Medical Stockpile was created and stashed in “undisclosed locations” around the country. In anonymous looking warehouses, we deposited personal protective equipment (masks, gloves), ventilators, body bags, and specialized medicines. Stocks were rotated out routinely and used just before hitting their expiration dates, with replacement materials procured and warehoused. The National Security Council staff was expanded to create a small office, headed by a PHS admiral, to monitor and respond to disease and bio-terrorism threats. Cabinet members were directed by the President to participate personally in crisis training exercises.

All of this preparedness and consciousness raising proved useful several times, most notably in 2014 when the Administration moved forcefully to contain an outbreak of Ebola by deploying US Army units into the disease hot zone in Africa. Had the US not acted as it did, the Ebola outbreak would certainly have spread out of west Africa and put at risk Europe and the United States. That “near miss” energized the outgoing administration to impress upon the incoming presidential team that they needed to be prepared for such a crisis. Indeed, the outgoing team held a crisis exercise for their replacements to familiarize them with the risks and the response plans and capabilities.

That attempt to pass on the importance of being prepared for an emerging disease pandemic failed. The incumbent administration eliminated the National Security Council office, withdrew disease surveillance officers from many nations around the world, including China. Funding for the Public Health Service and the Centers for Disease Control were slashed and hundreds of expert job positions left vacant or eliminated. Despite all of that, CIA was able in January to warn that a disease was loose in China that could result in a devastating pandemic in the US. That was the time to act, to increase production of equipment for the emergency stockpile, to plan for an effective nation-wide testing effort. None of that was done.

Precious time was lost, as the President acted as if in denial of the threat, or seemingly pouted that the disease would upset his agenda or reputation. Again, this is not Monday Morning Quarter-backing. The threat was known and planned for, a system had been put in place to deal with it. This administration dismantled much of that system and then ignored warnings. That is not a partisan claim, it is an undeniable set of facts. Moreover, the past is not irrelevant to the present. In the present, we must insure that this country is led by those who heed scientists and other experts, who prepare for predictable disasters, and who know how to use all the instruments of government to respond effectively and in time.

A few years ago my colleague RP Eddy and I wrote a book called WARNINGS, about why governments have failed to act on clear indications of impending disasters. In it, we examined a hand full of crisis in waiting, those that experts had predicted and which were being inadequately addressed, one of those was Emerging Infectious Diseases (Chapter 11). The threat was neither unanticipated, nor a secret. We were warned. Our government failed us, again.

In the coming weeks, as Spring spreads over the Rapp, I will explore this phenomenon of warnings and government failures, among other issues, in occasional missives from my lockdown site in the Rapp. Until next time, be attentive and be well.