This is, sadly enough, not a news story. Instead, it’s a tale of speculative fiction. However, it’s not “high fantasy.” There are no elves or dragons to be found, and the setting isn’t in some mythical land. Neither is it science fiction, because it doesn’t call for any technology or discovery not all in evidence. It’s more a story out of alternative history—alternative present, really—with a focus on what could have been.
This is a grand “what if” of a United States that isn’t trailing the globe in its response to the COVID-19 crisis. A United States that hasn’t racked up a disproportionate, and still growing, portion of the world’s deaths. A United States that hasn’t treated a pandemic as an “opportunity” to punish states that elected Democratic governors, and Black communities, and immigrants. A United States that hasn’t come to live with scorn for science, medicine, expertise of all types, and plain old common sense. It’s an image of what could have been. With images.
Back in mid-May, The New York Times looked at the success of women leaders in dealing with the COVID-19 crisis. Whether it was Angela Merkel in Germany running up a far lower death rate than neighbors in France or Italy; 34-year-old Prime Minster Sanna Marin in Finland whose all-women-led coalition came up with a plan leading to just 6% of the deaths in Sweden; President Tsai Ing-wen leading Taiwan through a plan so successful that the total number of deaths for the whole event to date is 7; or all-star Prime Minister Jacinda Ardern of New Zealand, who was proclaimed the most effective leader on Earth in uniting her country to completely eradicate the disease there. Women: They got the job done.
As of Monday, New Zealand had 23 cases of COVID-19, all of them being carefully monitored in isolation. The United States had 1,620,520, and states were waving the white flag on even attempting to conduct contact tracing or case management. While these women-led nations show the world that dedicated leadership on testing, contact tracing, case management, social distancing, and protective measures can successfully reduce the death rate and contain the disease, the United States has become the poster child for how to do every possible thing absolutely wrong.
How might things have been different? Well …
On December 31, 2019, the Wuhan Municipal Health Commission in Hubei Province, China, informed the World Health Organization (WHO) that there was a suspicious cluster of pneumonia cases in the area. This information was immediately passed on to WHO members, and in the United States it was brought to the attention of the Global Health Security and Biodefense unit under Navy Rear Admiral R. Timothy Ziemer. On New Year’s Day, Ziemer briefed Clinton, who authorized a U.S. team to join the WHO Incident Management Support Team as they evaluated this new disease. Two weeks later, the virus has been sequenced, WHO has issued technical guidance warning of potential for spread, and the first case has appeared in Taiwan. Public health experts are in place in airports in New York City, San Francisco, and Los Angeles to screen incoming passengers from China. (Believe it or not, almost all of this happened under … that other guy, other than the biodefense team, because they no longer exist.)
It’s what happens next that really changes things. Because when the first case appears in the United States, Clinton is ready with thousands of test kits obtained from overseas in advance of Centers for Disease Control and Prevention (CDC) kits becoming available. As recommended by numerous exercises, she has already created a central authority for dispatching personal protective equipment (PPE) to states. In fact, almost half of the available PPE and ventilators have already been sent to states before that first case is confirmed, and more equipment has already been ordered to restock the national supply.
With that first case, testing sites are set up and Clinton announces a national effort to distribute tests, provide rules for isolation and quarantine, and ensure prompt results.
Even as these test stations are being established, it’s clear that the freshly named COVID-19 has spread further and faster than expected. Cases have appeared on both coasts. But with tests available and a team focused on delivering them to the sites of identified cases, initial outbreaks are much more contained. A national program of sampling begins, with random tests looking out for community spread in unexpected areas.
New York emerges as a hot spot but never runs out of hospital space thanks to focused efforts to get tests where they’re needed and conduct early regional quarantines. By the first week of March, Clinton announces that both the Internal Revenue Service (IRS) and the Census Bureau have been given a new assignment, with their normal functions placed on hold. These massive number-crunching agencies are enlisted in contact tracing and case management. Working with state and local officials, it’s their task to see that every identified case of COVID-19 is being handled through proper isolation and receiving follow-up testing. In addition, they direct a growing number of mobile testing teams to track down potential contacts and enforce a 14-day quarantine period. Over the objection of Republicans in the Senate, Clinton calls for a nationwide stay-at-home order while working with Congress to secure protective gear and bonus payments for essential workers and Emergency Basic Income for the remainder of the nation.
By the end of April, the U.S. passes a sad milestone with 90,000 confirmed cases and over 9,000 Americans dead. However, widespread testing is in place across the country, case counts are dropping, and the percentage of tests coming back positive is below 1%. By mid-May, the storm has passed. Clinton announces that fewer than 100 positive tests have been determined in the last week. The nation begins to reopen on a regional basis, with clear guidelines and strict enforcement of rules for distancing and crowd-size.
Meanwhile, Sen. Mitch McConnell announces that Republicans in the Senate are launching a series of investigations into “the largest disaster in American history.” Ted Cruz calls it “Benghazi times 3,000” and Fox News declares that every warning they gave about Clinton is absolutely right. Frequent guest Donald Trump appears to explain how if he had been president, everything would have been so much better. In a national speech, Clinton thanks the citizens of the nation for their unity and fortitude, and ends by saying: “I accept full responsibility.”
The purpose of this extended sigh is simply this: Trump wants to declare a “win” by comparing the current results of the pandemic against simply allowing the virus to run wild. But that’s not the right measure. The measure is competent leadership. Could anyone have really held the numbers in the United States this low? All the evidence says yes. A rapid response on testing, a coordinated national effort, and a system that ran on evidence rather than spite could have identified the areas where COVID-19 was circulating in the community before emergency rooms filled up. South Korea’s response limited the cases there to just 12,000 and kept deaths down to 285.
Of course, none of this is going to be easy for Joe Biden, who isn’t starting from scratch, but has to deal with a nation where Trump has simply walked away from any responsibility. But at least Biden has a plan that’s more real than a fairy tale … unlike everything Trump has done.
And it’s possible I lied about the whole “no dragons” thing.