President Trump knew in January that the coronavirus was highly lethal, airborne, and could make young people sick. “Deadly stuff” is how the president put it in an interview with Washington Post journalist Bob Woodward that’s in Woodward’s new book,“Rage.” It has ignited the latest political firestorm around this pandemic.
The political impact of this disclosure is yet to be measured, but the public health impact is dismally clear. Given what the president knew and when he knew it, if he and the federal government had acted on that knowledge, a majority of the more than 194,000 confirmed deaths could have been prevented — a fact that Woodward may not have considered in his decision to withhold his interviews until now. Given this disclosure, as a nation we must take action on basic public health measures to save tens of thousands of lives moving forward.
The politicization of the US response to the pandemic has crippled our public health capacity by provoking conflict and undermining confidence around the key facts of the outbreak. For much of the last six months, there has been a battle between scientists — who have called for more testing, more protective equipment, more social distancing, and wearing of masks — and those who have sought to sow discord and confusion by undermining the basic facts. Their arguments, advanced by the president, included the notion that this virus is no worse than the flu, that it largely spares the young, and that testing makes it appear worse. This politicization has made it far more difficult to control the pandemic.
Here is the key issue: When there is no agreement on a basic book of facts, it is impossible to mount a coordinated and effective response. Most of us in public health have been battling this pandemic on two fronts: the virus itself, and the misinformation that has often come from our political leaders, including (and especially) from Trump and his supporters. In a nation confused by basic facts, including whether the virus is deadly (it is), if it can be harmful to young people (it can), and whether it spreads easily (it does), it’s difficult to persuade people to wear masks, avoid indoor gatherings, and stay isolated when they have symptoms or are infected.
It’s no surprise that many Americans overlook these basic public health practices. In their minds, if there is so much “controversy,” can the virus can really be that bad? This has meant packed nightclubs in Phoenix, Ariz., no mask-wearing at a motorcycle rally in Sturgis, S.D., and little effort to get testing rolled out in Jackson, Miss. The consequence is a tragic loss of life: We are approaching 200,000 Americans perishing from this disease.
From a public health perspective, then, the Woodward tapes represents an urgent opportunity to turn the corner. The president is now on the record acknowledging what epidemiologists and public health experts have been saying for months. We should no longer have to fight the pandemic on two fronts. While we can agonize over who knew what when, the public health imperative is to use what we know and take action now.
Trump suggested to Woodward that he chose to downplay the severity of the pandemic to avoid panic, but experience in previous outbreaks has shown that withholding information from the public almost always backfires. Word gets out. Confusion breeds mistrust. Mistrust precludes the very collective action necessary to minimize the impact of pathogens. The president — and, arguably, Woodward — should have shared with the world what Trump knew in January. But sharing the president’s words now will help us get back on track in defeating the virus — particularly in places where his views are valued most. Imagine public health ads using Trump’s own words: “You just breathe the air and that’s how it’s passed. …It’s also more deadly than even your strenuous flus. This is deadly stuff.” Such a statement would naturally lead to the recommendations to wear a mask, maintain social distance, practice good hand hygiene, and get tested if you might be sick or were exposed.
We can no longer afford to debate or discuss those strands of misinformation that have hampered our collective response. The past weeks have seen an avalanche of news about politics distorting and hobbling the work of public health. But it is possible that the words of the president, now in the public realm, can stem the ubiquitous tide of misinformation. There is no more effective countermeasure than for those who have propagated much of it to hear Trump’s own voice putting the facts in clear terms.
We are at a moment where we must accept and respond to the basic book of facts. We know this is an awful pandemic with a deadly virus that has killed too many people. An effective public health response, even starting now, can save lives. Many lives. With the president and the public health community finally on the same page about the virus and its severity, the focus needs to be on controlling the virus, using the science of public health. To paraphrase Charles de Gaulle: Public health is too important to be left to the politicians.
Dr. Ashish Jha is dean of the School of Public Health at Brown University in Providence.