2020 Thematic Brief: COVID-19 and Global Health Security

The COVID-19 pandemic has caused the deaths of hundreds of thousands of Americans and disrupted nearly all aspects of Americans’ lives.

While public health officials and experts continue to investigate the precise start of the COVID-19 virus in the United States, there is no debate that this pandemic has upended nearly all aspects of Americans’ lives. Hundreds of thousands of Americans have died and the economy, supply chains, education, travel, and more have been impacted.

The COVID-19 virus, which began in the Chinese city of Wuhan, was first reported to the WHO by the Chinese government in December 2019 (though it may have been spreading earlier than that).¹In January 2020, the WHO’s mission to China announced that there was evidence of human-to-human transmission of the virus; it was officially declared a pandemic in March.²Since then, the virus has spread rapidly in the United States, causing the death of almost 200,000 Americans at the time of writing and leaving even more severely ill.³Even worse, people of color are disproportionately impacted by COVID-19, including increased mortality rates, higher rates of infection, and reduced access to testing, all due to systemic racism.⁴

In addition to the devastating public health impacts of this virus, nearly every other aspect of Americans’ lives has been disrupted. Social distancing measures put in place by governors are estimated by one peer-reviewed study to have prevented up to 60 million more infections in the United States.⁵While these measures were critical, they came too late. Another study estimated that 700,000 infections and 36,000 deaths could have been prevented if broad social distancing measures had been put in place just one week earlier in March.⁶The National Bureau of Economic Research, a nonpartisan, nonprofit organization that tracks the history of US economic activity, officially declared the United States entered a recession in February. Record-breaking unemployment numbers and a sharp decline in economic activity have ended a 128-month-long expansion—the longest in our history.⁷Everything from critical supply chains (including those for medical equipment)⁸to travel⁹to education systems¹⁰has been affected.

Congressional Democrats are leading the fight to get rapid, badly needed resources out to the American people, businesses, and state, local, and tribal governments to help them recover. However, the president’s disastrous response to this pandemic from the beginning has fueled the crisis that we continue to experience.

The Trump Administration’s catastrophic mismanagement of the pandemic from the start turned the situation from bad to worse.

While China must answer for its handling of the COVID-19 virus, President Trump has tried to deflect blame on the Chinese government—and, by extension, on the WHO—for his Administration’s own failures. Since the start of this pandemic, the president has focused on distracting and blaming while peddling falsehoods and misinformation about the virus and its cures, instead of addressing pressing issues that could have saved lives.

Scientists and experts agree that the Chinese government put out misinformation about the COVID-19 virus and stifled accurate reporting about the crisis. Reporting indicates that the Chinese government silenced doctors and reporters who tried to sound alarm bells about the COVID-19 virus and its human-to-human transmission in the early stages of the outbreak in Wuhan. The Chinese government under President Xi Jinping continued to deny the virus’ spread between humans even after it was clear. Top Chinese epidemiology experts have acknowledged the government took too long to inform the public of human transmission. If this was done earlier, it may have saved many lives.¹¹

The Trump Administration is right to call the Chinese government out for its handling of this crisis, but the responsibility for the consistently mismanaged response from America’s federal government falls squarely on President Trump. The Chinese government confirmed in December 2019 that authorities were treating dozens of cases of the virus there,¹²and while it is unclear how early the virus was spreading in the United States, it is thought there were only a few cases in the country by mid-January 2020.¹³That gave the Trump Administration time to put in place measures to slow the spread of the virus in the United States and ensure the country’s health care system was well prepared. While the Administration focused its efforts on travel bans, the country faced dire shortages of personal protective equipment—which could have limited the exposure of health care providers to the virus—and ventilators needed to treat COVID-19 patients. President Trump failed to rapidly invoke the “Defense Production Act of 1950” (P.L. 81-774),¹⁴which could have ramped up private sector production of these badly needed supplies before the virus rapidly spread throughout the country.¹⁵Even in April 2020, the Administration failed to ramp up the necessary testing and contact tracing to identify and isolate cases. And it largely left governors to decide on stay-at-home orders and other social distancing measures that research tells us have saved lives in the places where they have been implemented.¹⁶

Rather than listening to the diverse experts who have offered proposals to address these shortages and put in place the architecture necessary to protect people’s health while supporting an economic re-opening,¹⁷the president has eschewed listening to the experts and peddled his own dangerous falsehoods and misinformation about the virus. He has promoted unproven drug treatments for the virus, which his own Food and Drug Administration has warned may be unsafe and ineffective.¹⁸His suggestion that COVID-19 might be treated by ingesting disinfectant was widely condemned by the medical community and caused a spike in calls to state poison control hotlines.¹⁹²⁰Similarly, his claim that UV light could possibly be used inside the human body to treat the virus has been widely debunked.²¹

To make matters worse, the Trump Administration dismantled efforts that were in put in place by previous administrations to ensure America was working to detect, prevent, and, if needed, respond to this type of pandemic. The Trump Administration largely disbanded the White House’s National Security Council Directorate for Global Health Security and Biodefense, which was put in place by the Obama Administration to coordinate America’s pandemic preparedness.²²While some members were reassigned, experts have criticized this move, saying it leaves the United States unprepared for this type of crisis.²³The Administration has moved to shutter the US Agency for International Development’s (USAID) PREDICT project, which focuses on detecting infectious diseases like COVID-19 around the globe.²⁴ Republicans have also falsely claimed the Obama Administration did not leave any sort of plan for the Trump Administration to deal with a possible pandemic. However, a 69-page pandemic preparedness playbook developed by the Obama Administration and left for the Trump Administration has been widely reported on. It was the Trump Administration’s decision to scrap it.²⁵

Additionally, while federal funding for pandemic preparedness has been largely shifted to countering terrorism, the Trump Administration’s cuts or attempted cuts to the budgets of critical global health and infectious disease programs could have made a bad situation even worse. For example, in FY2020, the Trump Administration proposed over $100 million in cuts to Centers for Disease Control and Prevention (CDC) programs that protect Americans and people around the globe from emerging and zoonotic infectious diseases. Fortunately, Congress did not move forward with these proposed cuts.²⁶The Administration has also pushed for cuts to vital global development programs that would help bolster the health care systems of particular countries of concern to ensure they are more rapidly able to respond to a pandemic.²⁷Nobel laureates and experts have also criticized the Trump Administration for ending funding to a program that supports American research on bat coronaviruses, like COVID-19 is suspected to be, in China.²⁸The Trump Administration also reportedly ended work at the Department of Homeland Security on pandemic planning.²⁹

Instead of addressing these missteps, President Trump has tried to deflect from his catastrophic handling of this crisis by shifting the blame to China and the WHO. His decision to terminate America’s relationship with the global health entity will only serve to hurt the country’s efforts to slow the spread of the COVID-19 virus and strengthen China’s influence. In July 2020, the Trump Administration notified the UN Secretary-General that the United States was officially withdrawing effective July 6, 2021.³⁰President Trump has accused the WHO of helping China cover up the virus in its early stages and has made several claims about the organization’s response to the pandemic that have been widely disputed by news organizations and scientists.³¹The WHO, created in 1948, has been critical in providing guidance on testing tools for COVID-19, accelerating research and development on vaccines and treatments, advising global health care personnel, and providing recommendations to governments on how to reduce the spread of the virus and prevent deaths. In many countries, the WHO’s deployed experts are playing a leading role in responding to the pandemic, which will ultimately impact America’s own ability to do the same domestically.³² The United States was the top donor to the WHO and provided the organization with over $400 million in 2019.³³Now that President Trump has announced the United States is terminating its relationship with the WHO, China has pledged $2 billion over two years to fill this funding gap. This will give China even more leverage in the organization and further diminish US leadership in the midst of the biggest global health crisis the world has seen in over a century.³⁴This tragic global response by this Administration stands in stark comparison to the leading role the Obama Administration played in directing the response to contain and eradicate the Ebola epidemic.³⁵

The United States has also notably refused to join international efforts to fund the Coalition for Epidemic Preparedness Innovations (CEPI). CEPI provides funding for promising vaccines in exchange for equitable distribution of that vaccine around the world.³⁶Failing to join international efforts to develop the vaccine could leave the United States out of the distribution if another country discovers the vaccine first.

As President of the United States, America’s response to the COVID-19 pandemic falls squarely on Donald Trump. And in the face of this crisis, he has failed every step of the way. He is trying to pass the buck with moves that will only help strengthen China’s hand while more Americans die from this devastating virus and the economy lies in ruins.

Congress can take steps to reverse President Trump’s mismanagement and ensure America is prepared to fight this and other pandemics.

In addition to the tremendous number of actions Congress must take to address the health³⁷and economic needs³⁸of Americans during the COVID-19 pandemic, there are a number of steps to ensure the United States is better prepared to fight this and other pandemics in the future. Global health security is a vital component of America’s national security, and this crisis has demonstrated that America needs robust tools in its arsenal to prevent and respond to these types of threats.

First, Congress must protect and restore all funding to pandemic prevention and detection programs cut by the Trump Administration and evaluate key programs and initiatives that require increased support. The Trump Administration has targeted critical programs that would have helped the United States better detect, prepare for, and respond to the COVID-19 pandemic at a wide spectrum of federal department and agencies, including the CDC, National Institutes of Health, Department of Homeland Security, USAID, and others. Congress must protect and restore funding to these vital programs to ensure the United States is prepared to fight this and other pandemics in the future. Congress should also take steps to ensure that no president is able to dismantle global health security leadership at the White House again.

Second, Congress should work to rebalance US government security spending to ensure we can protect the American public from the things that can cause the most damage, especially pandemics and other natural disasters. Federal spending for global health security has declined for many years since the 9/11 attacks, as resources were shifted to counterterrorism priorities. But the COVID-19 pandemic demonstrates that there are many security threats where the United States has been underinvesting, and others where it is still overinvesting. In particular, this crisis calls for a serious reevaluation of America’s military infrastructure and defense spending. In FY2021 alone, the Trump Administration has requested over $700 billion for the Department of Defense, while continuing to propose cuts to pandemic preparedness programs. Congress must take steps to ensure the United States is investing in the tools we need to keep Americans protected from 21^st century threats—from pandemics to cybercrime to climate change—and rebalance US security spending to reflect that.

Finally, Congress must step in and try to reverse the Administration’s decision to withdraw from the WHO and restore all funding that has been halted. Should a new president be in power in 2021, that individual could retract the Trump Administration’s official notification of withdrawal from the WHO. In the meantime, Congress must work to ensure the United States meets its required financial commitment to the WHO. In approving US membership in the WHO in 1948, Congress required the US government to give a one-year notice to the organization, which the Trump Administration has just done, and pay all dues owed to it in full.³⁹It is unclear if the Trump Administration will abide by this funding commitment; Congress must take steps to ensure these dues are paid in full. Without this vital support, the organization will be hindered in its effort to stem the spread of the COVID-19 virus and other global diseases, which will hurt America’s efforts to do the same domestically. And ultimately it is China that will benefit from diminished US leadership in the organization.  

Conclusion

The COVID-19 outbreak has caused the tragic death of thousands of Americans and upended every aspect of American life. President Trump’s disastrous handling of this crisis has taken a bad situation and made it astronomically worse. And while China’s government must answer for its handling at the start of this pandemic, President Trump who must answer for his own catastrophic mismanagement of this crisis. No amount of effort on his part to shift the blame to China and the WHO can take away from his Administration’s failures. But there are steps that Congress can take now to ensure the United States is better prepared and able to fight this and other pandemics in the future. Restoring funding for pandemic prevention and detection programs, rebalancing US government security spending to increase resources for these efforts, and doing what it can to ensure the United States continues to support the WHO in its vital work are important steps Congress can take to make sure a global health crisis of this magnitude never happens again.