Discourse

Top medical journal changes the goals for the Trump administration's handling of COVID, then blames him for not meeting them

The NEJM has forgotten that the original intention was not eradicating the disease from public life, but giving Americans the best chance of living with it.
Libby Emmons
Libby Emmons Brooklyn, NY

The New England Journal of Medicine published a scathing editorial condemning the Trump administration for mishandling the coronavirus and demanding that Americans vote him out of office. The editors state, correctly, that the US has the highest numbers of deaths. We have a little more than a million cases more than India, which is in the number two spot, and 100,000 more deaths. The NEJM claims that "in the United States, we have consistently behaved poorly."

The editors write, "We know that we could have done better." But the measures that they're touting as better for handling the virus, which honestly are still up for debate as to their efficacy, would not have been better for our democracy, not by a long shot.

China, the country that was incapable of containing the virus from spreading across the world to nearly 36.5 million cases and over one million deaths,  is held up by the editors as a shining example of what was done right. They write that China "chose strict quarantine and isolation after initial delay."

The US was never in a position to "choose" quarantine. Unlike China, which is a communist dictatorship, the American system of governance does not give the federal government the authority to lock everyone in their homes for an undisclosed period of time. In the US, every man's home is his castle, not his prison.

The editors hold up Singapore and South Korea, as well, as examples of what was done right as they implemented mandatory testing. We just don't have that, we don't have a system where each citizen must submit to the government for either medical tests or anything, basically, but taxes—and even then, we've got masses of infrastructure to enforce that, and it's not easy.

New Zealand is another glorious bastion of coronavirus contagion containment, where Prime Minister Jacinda Ardern imposed strict lockdown measures. Ardern implemented contact tracing, to which New Zealanders complied, creating a "digital diary of places you visit" so that contact tracers could track movements and reach out to anyone you may have been in contact with.

Americans simply will not submit to that, and there's nothing the federal government can do to change that. Frankly, we would rather not "defeat the virus," as Ardern touts her achievement, than be tracked, traced, and surveilled by our government. Ardern said that "You only need to see around the world to see the alternative to our approach her in New Zealand." And the WHO director-general Tedros Adhanom Ghebreyesus agreed.

Tedros also praised China's handling of the virus. China, it is notable, still claims to have had only 85,500 cases, and there's been no independent verification of that and their leadership is not transparent.

The editors write "We had ample warning, but when the disease first arrived, we were incapable of testing effectively and couldn’t provide even the most basic personal protective equipment to health care workers and the general public."

But they clearly were not paying attention. On March 29, the American Hospital Association reported on the Herculean efforts undertaken by leaders to get PPE exactly where it needed to go, under the auspices of the Federal Emergency Management Association. Called Project Air Bridge, this sped the PPE across borders and through supply lines to get it to essential workers and hospitals. FEMA did this so effectively that no one ever heard about PPE again, because the people who needed it had it, and media did not see any need to report on a job well done.

NJEM claims that we are behind the curve in testing, as well. However, to date, about 34 percent of the US population has been tested, and this has primarily been done by choice. In New York City, schools have begun making testing mandatory, which will both increase testing and increase the ability of government to enact broad restrictions to locales where cases increase. Private citizens have more concerns over this level of reach into people's personal lives and bodies than they feel comforted by the mandatory testing.

The editors claim that the US "instituted quarantine and isolation measures late and inconsistently, often without any effort to enforce them." Well, yeah. How, exactly, would the editors at The NEJM liked to see the federal government enforce the quarantining of healthy Americans? When the federal government moved to protect its property, in Portland and Seattle, for example, with use of federal agents, it was not a highly regarded move. Governors railed against the perceived federal overreach. How does The NEJM think they would have responded to federal officers forcing people to go inside?

The NEJM complained that US leaders didn't enforce face masks, either. But frankly, it's just not constitutional to do so. The people who don't wear masks don't not wear them because their leaders say it's okay not to, they don't mask because they don't want to, and no law can make them do it.

The NEJM also claims that the government is at fault for people not trusting the vaccine, and as they are using this article to tell people not to vote Trump, they neglect to point out that it is the rhetoric of the opposition, Democrat ticket, Senator Kamala Harris, is one of the most vocal critics of a vaccine. Harris has even said that she would not take it. Though the NEJM editors say that the vaccine process has been "politicized," they neglect to inform readers just who has been politicizing it. For many on the left, any mistrust of government, from any side of the aisle, is Trump's fault wholly and directly.

The editors note how great the American medical system and infrastructure are, and claim that the Trump administration ignored those experts. However, standing side by side with the president over these past eight months have been doctors and leaders in the government medical community. There have also been vying opinions and perspectives, and the research as to what is the best approach has not been a consensus, but rather there have been concerns on either side of the concept of locking down our society and economy.

"The response of our nation’s leaders has been consistently inadequate," they write. "The federal government has largely abandoned disease control to the states. Governors have varied in their responses, not so much by party as by competence. But whatever their competence, governors do not have the tools that Washington controls. Instead of using those tools, the federal government has undermined them."

But the federal government consistently provided what the states requested, as per our system of government where the federal branch does not routinely impose upon the states, but supports them and provides funding when legislated by Congress. When New York Governor Andrew Cuomo said he didn't have enough hospital beds, the administration sent a hospital ship. That ship was barely used. PPE and medical equipment, such as ventilators, flowed into the states. Federal troops did not—and perhaps that's what the NEJM wanted to see. Or maybe they just didn't like Trump's demeanour and tone of voice.

When the NEJM states that the administration "undercut trust in science and government," they are citing Maggie Haberman's New York Times article on the Bob Woodward "bombshell" that wasn't, wherein Woodward said that the president knew about the dangers of the illness prior to telling the public.

He told Woodward "This is deadly stuff," saying "you just breathe the air and that's how it's passed," and went on to say that "it's also more deadly than even your strenuous flus." The gotcha moment, for Haberman, Woodward, and the editors of the NEJM is that a few days later he said "we're in very good shape. We have 11 cases," and claimed to have it under control.

That is hardly a gotcha that shows Trump meant to "obscure the truth and facilitate the promulgation of outright lies."

But the editors aren't finished yet, because it's not just the handling of the virus that has them bent out of shape, but their perception that the virus has "disproportionately affected "disproportionately affected communities of color has exacerbated the tensions associated with inequality." So the virus and Trump are to blame for inequality.

"Many of our children are missing school at critical times in their social and intellectual development," they write. But this is the effect of lockdowns, which the editors seem to wish we had more of. In fact, a recent group of 6,000 health experts across the globe came out against lockdown restrictions, saying that the best course of action is to isolate the vulnerable, not the healthy.

The NEJM claims that is it the virus that is preventing businesses from reopening, but in fact, it is that the goals of state and local governments across the country has changed. In March, the population was told that we needed to flatten the curve, meaning that while many people were likely to contract the virus, the best course of action was for us to not all get sick at once and overwhelm the hospital infrastructure. Now, the new idea is that we should be free of coronavirus cases entirely. This is not a reasonable goal, nor one that is possible given the rights and freedoms that Americans demand.

In blaming the Trump administration for the deaths of over 200,000 Americans from the Chinese-born coronavirus, the NEJM has forgotten that original intention of not eradicating the disease from public life, but giving Americans the best chance of living with it and not destroying our health care system in the process. The NEJM editors are holding the government to an unrealistic standard of no deaths from or cases of coronavirus, and the way to get to that place, with overreaching surveillance, invasive and mandatory testing, and enforcing lockdowns, are not something that Americans can live with.

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