A group of public health and national security experts who sent some of the earliest and most dire warnings to officials across the Trump administration about the gathering coronavirus crisis is now offering a searing assessment of how the federal government blundered through the critical first months of a lethal outbreak.
Members of the group, whose lengthy string of emails now read like a chilling foreshadowing of the unfolding deadly pandemic, came to be known by the chain’s dark-humored subject line, “Red Dawn Rising,” a reference to the campy 1984 cold war movie about a gritty band of Americans who fend off foreign invaders. Now several have broken their silence about the early warnings in interviews with ABC News to describe their lingering distress about the missed chances to spare lives.
“We did not step up and meet the challenge that we needed to meet,” said Dr. Jeffrey Duchin, Seattle-King County Public Health Officer, and a contributor to the email chain. “We didn't act quickly enough to do the things that we needed to do early enough. And we still are not doing the things we need to do to get this outbreak under control.”
Tune in to ABC on Tuesday at 9 p.m. ET for the "20/20" special report "American Catastrophe: How Did We Get Here?"
The chain, which was first published in April by the New York Times, has at various times looped in 25 different federal officials involved in the pandemic response, including top medical advisors in the departments of Defense, Homeland Security, Veterans Affairs, and Health and Human Services. The emails gave them access to unvarnished analysis from an informal collection of scientific and medical experts, a number of whom had a first-hand role in developing a robust national pandemic response plan in the mid-2000s.
The Red Dawn emailers have tried to maintain a low profile, but six of them agreed to speak with ABC News, most for the first time publicly. The detailed accounts paint a picture of a frantic, race-against-the-clock effort to raise alarms in hopes of prodding a faster, stronger federal response to COVID-19.
Dr. David Marcozzi, who was the White House National Security Council director of medical preparedness policy in disasters during the Bush and Obama administrations, said the participants were driven by a single agenda.
“We were generally concerned that this was going to be a threat to our nation,” Marcozzi, now a senior official at the University of Maryland’s medical school, told ABC News.
The emailers, along with other public health experts, describe how the federal government missed opportunities to mount a more muscular defense and failed to brace the nation for the tidal wave of illness that was coming.
“The president began to say [in March] that nobody could imagine that something like this could actually occur,” said Dr. Dan Hanfling, a biosecurity and disaster response expert from Virginia. “The truth is that there was a group of us that had been trying to raise the alarm.”
Hanfling said it was unclear how much of the information from the chain filtered up to top policymakers. Senior officials including Dr. Anthony Fauci, Centers for Disease Control and Prevention Director Robert Redfield, and Surgeon General Jerome Adams, were copied into the chain at least once. Fauci told ABC News he “didn't pay that much attention” to the emails.
“As an informal group of experts looking at this information, how much of that was penetrating to upper echelons of government?” Hanfling said. “It's hard to say.”
Admiral Brett Giroir, an assistant health secretary who has helped run the pandemic response and who was occasionally copied on the Red Dawn email chain, said he believes the Trump administration has tried its best to be transparent, honest, and give the public the best information they know.
“Because I think that's the most important thing is to have public confidence that you may not always be right, but you're always transparent,” Giroir told ABC News. “You're going give the American people the best information."
Red Dawn Rising
Email excerpt, Mar. 12:
From: Richard Hunt [Senior Medical Advisor, U.S. Department of Health and Human Services]
As my 24 y/o told me, "the nation needs to go to war against this virus.”
One early correspondent on the Red Dawn chain was Dr. James Lawler, a Navy veteran who served in the administrations of Presidents George W. Bush and Barrack Obama and is now the director of clinical and biodefense research at the federally-supported National Strategic Research Institute in Nebraska.
Lawler said he still remembers the first alert he received on New Year’s Eve describing a pattern of "unexplained pneumonias" in China, and his initial outreach to what he called the “pandemic preparedness community.”
“We're a small, odd bunch and these are the things that we talk about,” he said.
The pace of the emails picked up quickly, Lawler said. And the list grew.
Hanfling, the biosecurity and disaster response expert, said he was added to the group in February, as the emails began tracking potential coronavirus cases as they started to appear on American soil.
“I've heard our group referred to as the Wolverines,” Hanfling said -- a reference to the nickname of the freedom fighters who emerged heroic in Red Dawn.
Others in the group eventually included former White House health and security advisers like Dr. Richard Hatchett, who also served under both Republican and Democratic administrations and who now heads an global partnership formed to respond to outbreaks called the Coalition for Epidemic Preparedness Innovations, and Dr. Herbert O. Wolfe, now a Penn State professor who also serves as executive director of the Office of the Chief Medical Officer at the U.S. Department of Homeland Security.
“It was a serious group,” Lawler said. “Many folks who had thought for a long time about pandemics. And so, I think, a pretty good kitchen cabinet, if you want to call it that.”
For those joining the Red Dawn chain, the initial hope was to offer a steady diet of thoughtful analysis for federal officials who wanted what Lawler called, “unvarnished opinion.”
“There were no filters,” he said. “It was raw and straight.”
Some government officials encouraged the input. In mid-February, Duane Caneva, who was appointed by Trump in 2018 to serve as the chief medical officer at the Department of Homeland Security, sent an email expanding the group of recipients.
Caneva wrote that the expanded "Red Dawn String" would give the participants the “opportunity to provide thoughts, concerns, raise issues, share information across various colleagues responding to COVID-19."
In some cases, government officials appeared to be learning about developments for first time from the Red Dawn emails. In one exchange, Eva Lee, the director of the Center for Operations Research in Medicine and Healthcare at Georgia Tech, flagged a study showing a 20-year-old woman left Wuhan with no symptoms and had infected five family members.
Dr. Robert Kadlec, the Trump administration’s Assistant Secretary for Preparedness and Response, appeared surprised. “Eva is this true?!” Kadlec replied. “If so, we have a huge [hole] on our screening and quarantine effort.”
Lawler said initially, that sort of reaction took him aback.
“Too often, we were finding that our group … [was] providing information to leaders who were hearing it for the first time from these informal channels,” he said. “And that was surprising and disappointing, to be honest.”
Kadlec did not respond to a request for an interview through his office.
An early, queasy feeling in 2020
Email excerpt, Jan. 28:
From: Carter Mecher [Department of Veterans Affairs physician]
Anyway you cut it, this is going to be bad.
Among the first Americans to get a bad feeling about the news out of China in early January was Helen Branswell, the infectious disease reporter for the Boston-based health news website Stat News.
Branswell, who was not among the Red Dawn emailers, said it was just hours into the new year that she started to feel a queasiness in her stomach. On Jan. 2, she tweeted: “Not liking the look of this.”
She described seeing images on social media of Chinese authorities in hazmat suits spraying down the wet market in Wuhan, the original epicenter of the outbreak, and hearing early reports of widespread shutdowns in the city.
“It rapidly grabbed my attention and held it,” Branswell told ABC News.
Lawler said after he started seeing alerts about the mystery illness in China the Red Dawn members began to "look at these things [and] were giving each other the play by play on what we were hearing and what we were seeing,” he recalled. “And it was obvious very early on, in January, that this had the potential to be a serious global event.”
At the time, the administration was still struggling to interpret the signs from China, said Tom Bossert, an ABC News contributor who was on the Red Dawn email chain and who served as a top Homeland Security Advisor to President Trump.
Bossert, who left the Trump administration in 2018, said government officials were so focused on containing the virus – keeping it from crossing the ocean – they were missing signs that people with no symptoms were capable of circulating it. Trump would announce a ban on most travel from China at the end of January.
“To contain this in China or in Wuhan, that's a really noble objective,” Bossert said. But that strategy, he said, “didn't seem to recognize or understand the notion that you can have a lot of sick people, infectious people walking around in any community.”
In those initial weeks, Lawler said the group was just starting their efforts to persuade leaders to look beyond efforts to block the virus from entering the U.S., and in the direction of bracing the public for potentially dramatic lifestyle changes that could slow down the spread.
“These signs were out there pretty early -- good indications that asymptomatic infections were occurring and that those people were then able to transmit to others,” Lawler said.
Hundreds of thousands could die. “People were stunned."
Email excerpt, Jan. 28:
From: James Lawler [Former Bush and Obama White House official]
Great Understatements in History:
Napoleon' s retreat from Moscow - “just a little stroll gone bad"
Pompeii - "a bit of a dust storm"
Hiroshima - "summer heat wave"
AND
Wuhan - "just a bad flu season"
By February, members of the Red Dawn chain were solidifying their view that what started as a mystery illness in China was poised to become an epidemic of historic proportions.
Lawler shared his early projections during a speaking engagement at a reception for the American Hospital Association. When he began to rattle off the numbers, he recalled, the room grew uncomfortably silent. Without a clear and aggressive response, he said he expected 96 million Americans to contract COVID-19, and as many as 480,000 would die.
“People were stunned,” he said.
Not only were the health care executives taken aback, he said. When he shared the figures with members of Congress and officials within the executive branch, he said he saw a similar reaction.
“They had not heard these types of projections before,” Lawler said. “The fact that folks were hearing these numbers for the first time from me was concerning.”
Currently, approximately six months into the outbreak, more than 4 million positive cases of coronavirus have been reported in the U.S. and more than 140,000 Americans have died, according to a count by Johns Hopkins University, despite many parts of the country taking on drastic lockdown measures.
Around the time of Lawler’s presentation, Fauci was appearing in Washington at an Aspen Institute panel discussing the outbreak.
Branswell, the Stat News reporter, was moderating. At one point, Fauci was asked to explain why the U.S. government was still so focused on keeping the virus from entering the population, instead of turning more attention to preparing for it to spread.
“That’s the message that is very fine-line sensitive,” Fauci responded. “To let the American people know that, at present, given everything that is going on the risk is really relatively low.”
Branswell told ABC News she remembered being puzzled. And it showed. “Explain to me why the risk is low, somebody?” she responded. “I can’t see why – there’s no force field around China.”
Fauci said his caution stemmed from the fact that, by this point in mid-February, the U.S. had only 13 confirmed cases of coronavirus. But he acknowledged this view could be wrong.
“Is there a risk that this is going to turn into a global pandemic. Absolutely yes,” he said. “There is. There is.”
In an interview with ABC News, Fauci said that, even looking back now, he believes it was “reasonable” to make the assumption that the risk of spread was low, because, at that moment, so few cases had made it across the ocean.
“As a scientist, the thing you must always do is to be humble enough to know that when you get additional information, even information that might conflict what was felt earlier on, you then change your viewpoint and you change your recommendations based on the data that you have at that time,” he said.
“Science is a learning process,” he said. “To think that we knew everything right at the first day that we knew that there was a new virus, I think is just unrealistic.”
Many of those interacting with federal officials through the Red Dawn chain said they understood that none of the decisions in the midst of a crisis are easy.
“We recognized the incredible challenges and really fraught decisions,” Hanfling said.
A “slowness” in revving up a response
Email excerpt, Feb. 29:
From: Eva Lee [Medical research expert, Georgia Tech]
We need actions, actions, actions and more actions. We are going to have pockets of epicenters across this country, West coast, East coast and the South. Our policy leaders must act now. Please make it happen!
Inside the Trump Administration, officials have had mixed views about the early steps taken to respond to those waving red flags about the burgeoning crisis.
Giroir, the four-star admiral in the U.S. Public Health Service Commissioned Corps, said he believes the administration took early, aggressive action. Beginning January 9, he said, the health service began a deployment of officers to nursing homes, field hospitals and Native American reservations that would eventually number more than 5,000.
“On February 3, I issued an order that everybody in the corps was on alert,” Giroir said. “For the first time in our history… everybody needed to be ready to go.”
By Feb. 15 he said the health corps had seven strike teams assembled to help monitor travelers arriving in several key U.S. airports. But until his team started seeing the virus blazing through the community, he said no one was sure what to expect.
“This may be fine and may go away, or it may be the big deal that we've all been training for and planning for our whole careers," Giroir said.
Perhaps the biggest challenge confronting federal leaders during a pandemic, Lawler said, is knowing when to acknowledge that it is occurring.
In one of the Red Dawn email exchanges, Lawler chided the assertions by President Trump that the spreading virus would be no worse than a “bad flu.”
Dr. Matthew Hepburn, a U.S. Army infectious disease expert, replied with his advice: “Team, am dealing with a very similar scenario, in terms of not trying to overreact and damage credibility. My argument is that we should treat this as the next pandemic for now, and we can always scale back if the outbreak dissipates, or is not as severe.”
Redfield, the CDC director, described the phenomenon as he experienced it, acknowledging he may have been “lulled” into a false sense of confidence that the virus would be more easily contained.
The CDC responded quickly, he said, to the first person in the U.S. was identified with coronavirus on Jan. 21. That person, Redfield said, had made 50 to 60 contacts before being isolated, and his agency worked hard to evaluate all of them.
“None of them were infected,” he said.
After the CDC had identified 12 more cases involving people traveling into the U.S. from Wuhan, they traced some 850 more people who had been in contact with those travelers.
“We only found two individuals that were infected, and both of them were intimate spouses,” he said. “So initially it didn't seem like this was infectious-infectious-infectious.”
Elizabeth Neumann, who served until April as the Assistant Homeland Security Secretary for Threat Prevention and Security Policy and who was not on the Red Dawn emails, told ABC News she initially saw an urgency to the government’s response – with preparations getting underway exactly as they were laid out in all the operational plans.
Neumann said to this day she is not sure why, given all that early activity, the response wound up looking so inadequate. Ultimately, she told ABC News she believes the urgency that some felt in headquarters was just not reaching all the people who needed to carry out the response.
“I will say that if you go line by line, the administration has done many of the things called for in those plans,” Neumann said. “There seems to have been just a slowness in getting to the point of actually turning on the engines.”
Signs of invisible spread
Email excerpt, March 1:
From: Duchin, Jeff [Seattle health official]
We are having a very serious challenge related to hospital exposures and impact on the healthcare system. Would be great to have a call to discuss.
At the end of February, Redfield said he could tell the virus was more aggressive and troublesome than it first appeared in the U.S. He recalled receiving reports of two California patients who had tested positive for the virus – even though they had no known connection to someone traveling from Wuhan.
“I think when those first two community cases happened, where I didn't know where they came from, that's when I knew that we were going to have trouble,” Redfield said.
By this point, concerns about invisible spread of the virus had been a chief concern raised by the Red Dawn email group. Their correspondence suggests they believed the virus had already been seeded in America, and could be silently spreading.
Lee, the Georgia Tech mathematician, was one of several of the experts who tried to flag the significance of the unfolding outbreak on a cruise ship docked in Yokohama, Japan -- the Diamond Princess.
An 80-year-old passenger who became sick while the ship was at sea, had disembarked on Jan. 25. His coronavirus diagnosis was confirmed as the ship sailed on for Yokohama. Soon after it arrived on Feb. 3., health officials found 10 more passengers were infected, and the passengers were asked to quarantine on board.
“It was, in a perverse way, a bit of a natural experiment,” Lawler said. “And so, being able to put the pandemic under a microscope and really look at the details of what happens in an enclosed community where you know there's nobody coming and going.”
To the experts on the email chain, the outcomes were deeply concerning.
In contrast to Redfield's observations of the first U.S. cases, which appeared to have indicated a slow-moving virus, on the ship it was spreading with stealthy speed. Even passengers who had been confined in their cabins – with virtually no contact with others – were catching it. In a little more than two weeks, the virus had spread to 691 passengers.
“That really brought home to us the potentially explosive transmission that could occur, particularly in that type of enclosed community,” said Lawler, who was dispatched to the ship to help rescue Americans trapped on board and fly with them to be treated.
Those on the Red Dawn email chain tried to signal to federal officials that the cruise ship was a troubling omen for what was to come. Hanfling noted that the data offered a crucial bit of evidence for U.S. officials about the stealthy way the virus was moving. He said a significant percentage of the passengers had tested positive for the virus, even through they had no symptoms.
“I think was the big red flag that the government missed,” Hanfling told ABC News.
Confusion about the potential for people without symptoms to carry and spread the disease was not a U.S. government trademark alone. Well into the outbreak, the World Health Organization and European health officials also issued conflicting statements about the potential.
But the Red Dawn group seized on the issue as critical.
Dr. Carter Mecher, a Department of Veterans Affairs physician who was a frequent contributor to the email chain, wrote on Feb. 28 that he was “worried what happened on the cruise ship is a preview of what will happen when this virus makes its way to the U.S. health care system.”
“I think this data is close enough to convince people that this is going to be bad,” he wrote. “All that's left is when.”
The answer came just over a week after he sent that email to the group. At the Life Care Center in Kirkland, Wash., a suburb of Seattle, the first two patients at the nursing care center had died and more were struggling with a strange respiratory infection.
Washington State resident Pat Herrick remembers that week -- calling her mother Elaine, 89, a resident of Kirkland, to tell her she planned to stop by. “Oh, you can't come in,” she says her mother told her. The facility had locked down.
“And I said, ‘Well, what's that about?'” Herrick told ABC News. “And she said, 'Well, I guess some people have the flu.'"
Duchin, the health official in Seattle, had been following the Red Dawn email chain and now was seeing signs of the virus. He worried that as it was spreading, the health care workers needed to care for patients were themselves getting sick.
“I wrote to the Red Dawn group expressing my concern,” he told ABC News. “Alarm bells are starting to ring because we were having newly reported cases each day."
Initially, the vast majority of cases were linked to the long-term care facility outbreak. But over the first week of March, Duchin said it became clear that there were also cases reported that had no links to Kirkland.
“That meant that we were having unrecognized community transmission, which was the absolute indicator that the containment strategy was not going to work,” he said. “We needed to rapidly move towards mitigation.”
'The virus travels faster than the plane.'
Email excerpt, Feb. 28:
From: Carter Mecher
Italy has emerged as a major exporter of COVID. Above the surface, nothing much was happening in Italy until Feb 21 before that just a few cases reported [...] Over the past week things exploded and Italy has exported cases around the world.
It would still be three weeks before the California and New York would be among the first to impose truly stringent mitigation efforts – with orders for residents to shelter in place. At this point, the most dramatic move the federal government had taken was President Trump’s China travel ban. Experts on the Red Dawn chain appeared distressed.
Equally worrisome, Redfield said, was that the follow-up decision to halt flights to Europe did not follow for two precious weeks.
“The president's decisive decisions to shut off air travel on the 31st of January …I think that had a huge impact,” Redfield told ABC News. But by the time they realized Europe posed a threat and shut down travel from that direction, Redfield said he had estimated there had already been “two or three weeks of 60,000 people coming back every day.”
“And that's where the large seeding came in the United States,” Redfield said.
More mitigation measures would come from the states, but not the White House. On March 20, President Trump said of a national lockdown, “I don't think we'll ever find that necessary.”
At times, Lawler said, the experts on the email chain found the response hard to watch.
“There have been cycles of frustration and despair at the fact that we've not been able to mount a national response in a way that comprehensively addresses the threat and the problem,” he said.
'The biggest tool was missing'
Email excerpt, Feb. 10:
From: Eva Lee
Strategic testing is a must -- if we truly want to get a good sense of what' s happening to the infection in the community level and have an ability to prepare the citizens, the community, and the hospitals...
Over the course of the pandemic, the Red Dawn group identified a host of problems in the federal response and tried to steer officials towards solutions.
Duchin said he considered the delays in producing and scaling up a screening test for the coronavirus to be “the Achilles' heel of our outbreak response nationally and locally, from the get-go.”
Ron Klain, the Obama White House official who oversaw the response to the Ebola outbreak in 2014, described the tests as a crucial tool in fighting an epidemic.
“You can't fight it if you don't know where it is,” said Klain, a longtime key adviser to former Vice President Joe Biden. “If you don't know how much of it is, if you don't know who has it, if you don't know where it's located, then you can't deploy all the other tools of disease fighting.”
It was in early February that Scott Becker, CEO of the Association of Public Health Laboratories, began hearing from public labs that the first diagnostic tests designed by the CDC were not delivering reliable results.
“These tests were undergoing verification at public health labs, and they spotted a problem almost immediately,” Becker said.
The ensuing delay left the health care system without a reliable test to spot the virus.
“The biggest tool in our toolbox was missing at this point,” Becker said. “We knew that the virus had to be here... And that's when the sense of dread really came into play. Because we weren't able to do the job that we were sent out to do.”
Both Fauci and Redfield acknowledged in interviews that they encountered delays in developing a reliable screening test. Giroir, who took over the job of procuring tests in mid-March, said the administration has worked tirelessly to increase availability even as he admitted that the nation’s testing program is not up to where it should be.
“We need to do better, and we're going to do that,” Giroir said. “But you can't go from zero to having everything you want in an historic pandemic of unprecedented scale. And I want to be clear that no one, since March 12, has let their foot off the gas. I mean we're pushing as hard as we can.”
In search of a Hollywood ending
Email excerpt, March 2:
From: Carter Mecher
6 deaths in Seattle
Seattle missed the window...
On Monday, March 1, Pat Herrick spoke with her mother Elaine Herrick for the last time. The call was brief. From her room inside at the Life Care Center in Kirkland, Washington, her mother was upset that one of her roommates was crying, and the other would not stop coughing.
For the next three days, Pat Herrick told ABC News, she tried to get her mother on the phone. Then the call came. She had passed away, one of 37 to be claimed in the first of scores of deadly nursing home outbreaks in the U.S. caused by the coronavirus.
“I think the thing for me was that, we've got to look at a big picture here,” Herrick said. “And we've got to look at how do we stop this here. How do we prevent this from going forward? We can't keep reinventing the wheel.”
Duchin, the Seattle health official who was part of the Red Dawn email chain, said he believes some of the solutions were sitting in plain view.
He recalled a report had just recently been released, in October 2019, by the the Nuclear Threat Initiative, a D.C.-based nonprofit organization, and the Johns Hopkins Center for Health Security, that ranked U.S. readiness for a pandemic as one of the best in the world.
“We may have taken false reassurance in that,” Duchin said.
“I think it was clear to us early on that this outbreak was going to be very difficult to manage,” he said. “And that, regardless of how we compare to other nations in surveys and international assessments, we were still not prepared enough to optimally meet this challenge.”
Lawler said the Red Dawn email chain continues, and still reflects the emotional highs and lows of the ongoing battle against the virus. But he remains hopeful that, much like the movie, the Red Dawn heroes will prevail and the nation will be saved.
“I do think that after all of these twists and turns, we can arrive at that Hollywood ending,” Lawler said, “that has us acting in concert together as communities to interrupt transmission, to implement aggressive but manageable social-distancing measures. And then, you know, we ride off into the sunset.”
ABC News' Chris Francescani, Ali Dukakis, Katherine Faulders, Evan Simon, Alex Hosenball, Halley Freger, Megan Christie, Brian Epstein, John Palacio, Jinsol Jung, Josh Gaynor, Jaz Garner, Audrey Gruber, Ashlee Romain, Dylan Goetz, Ely Brown, Tonya Simpson, Emily Ruchalski, Kate Holland, Alyssa Briddes, Ava Anderson, Lauren Dimundo, Oliver Agger, Joe Rhee, Emily Wynn, Alex Myers, Heather Guzman, Cindy Galli, and Melia Patria contributed to this report.
The Link LonkJuly 28, 2020 at 03:07PM
https://abcnews.go.com/Health/coronavirus-threatened-invasion-red-dawn-team-save-america/story?id=72000727
As coronavirus threatened invasion, a new 'Red Dawn' team tried to save America - ABC News
https://news.google.com/search?q=Red&hl=en-US&gl=US&ceid=US:en
No comments:
Post a Comment