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The Pandemic Response That A Public Health Expert Wants, And The One He Got


When a president speaks from the Oval Office about a disaster, the aim is to soothe the nation.


PRESIDENT DONALD TRUMP: My fellow Americans, tonight I want to speak with you about our nation's unprecedented response to the coronavirus outbreak.

SHAPIRO: One person listening last night was Jeremy Konyndyk. He is a public health expert with the Center for Global Development, and part of his job has been mapping out how to stop diseases from spreading. Yesterday, he tweeted about what he hoped to hear from the president to help quiet the noise around this issue for the average American, and He's here in the studio with us now. Welcome.


SHAPIRO: You said on Twitter that if you were delivering an Oval Office address at this moment, you would suspend all gatherings of more than 50 people in every part of the country; the president did not suggest that. Explain why you think that is appropriate everywhere, even communities where the disease has not been detected.

KONYNDYK: Well, there's a few reasons. First, the nature of an outbreak is that you're never seeing what's actually happening; you're seeing an echo from the past. So right now we know that this disease has an incubation period of about a week, and you can spread it before you know you have it. So that means that the numbers we're seeing today is actually the transmission dynamics from a week ago. And so we need to assume, until we have good testing, that it could be anywhere and take precautions accordingly.

SHAPIRO: Do you think the Trump administration has done enough to encourage social distancing?

KONYNDYK: I don't think the Trump administration has done nearly enough on really any of the priorities that we need to be on top of to tackle this pandemic. I think there are three major things that we need to be doing in this country. The first is protecting our health system. When we saw what was happening in Wuhan in mid-January to the hospitals there, the way they were overwhelmed by a surge of cases, that was the warning sign of what could happen, and we're seeing it now play out in northern Italy. We may be only a week or two from that beginning to play out in U.S. cities.

SHAPIRO: So you said there are three main things we need to do - protect the hospitals and what else?

KONYNDYK: So the other two relate to relieving that burden on the hospitals. So the first is focusing like a laser on protecting the high-risk populations in this country. We know that this disease is most severe among the elderly and people with medical complications. It's not an accident that one of the worst outbreaks that we've seen in this country was at a nursing home in Kirkland, Wash. That is a warning to the rest of the country. We need to be on top of that everywhere else and making sure that nursing homes have the infection control that they need and the sanitation support that they need so that diseases don't spread there.

SHAPIRO: OK, so prepare the hospitals, protect the vulnerable populations - and No. 3?

KONYNDYK: And then the third is social distancing, and this is where the gatherings comes in. Things like shutting down the NBA, playing the NCAA tournament without spectators...

SHAPIRO: Shutting down Broadway.

KONYNDYK: ...Shutting down Broadway - all of those at this point are no-brainers.

SHAPIRO: What about limiting travel from Europe? Which is one of the things President Trump did announce last night. Does that have any potential to help?

KONYNDYK: It's actually worse than useless at this point because what it does - it doesn't really afford us any protection. Once the disease is here, once the disease is spreading in our country, that is the greatest threat. Banning travel anywhere in the world at this point is a bit like locking the door after the killer is already in the house. The reason it's actually worse than just useless is that it's a distraction. The people who need to be enforcing and monitoring that travel ban are the kind of public health officials that we would want to be protecting nursing homes, supporting hospitals to get ready. We don't have an infinite supply of those people; we need to prioritize them where they do the most good.

SHAPIRO: President Trump did not talk much last night about testing. Where is the availability of testing today as compared to where it needs to be?

KONYNDYK: We are still nowhere close to where we need to be on testing. We have, cumulatively at this point, tested roughly as many people as South Korea is testing in a day. So we really don't have an accurate picture of where this virus is in the country, how far it has spread in the country, and that makes it really hard to fight.

SHAPIRO: Is it clear to you who is calling the shots on coronavirus policy at the federal level? Do you have a sense of who is in charge?

KONYNDYK: To be honest, it doesn't really appear that anyone's in charge. There is an overall lack of leadership. And ultimately, the president has to lead in a response like this. The vice president can't lead. A White House coordinator can't lead. They don't have the stature and the platform that the president has, and they don't have the ability to whip the whole federal government into shape.

SHAPIRO: If the White House is not providing the kind of leadership you would hope to see, can the CDC or somebody else step in?

KONYNDYK: I think what we have repeatedly seen since the middle of January is a White House that is inclined to downplay the seriousness of the risk, and that makes it very, very hard for the rest of the federal government to contradict that. I think it's very hard - and I say this as a former federal official - it's very, very hard to get out in front of the president. And if the president has made clear to you what he does and doesn't want to hear, it's difficult to get out of line with that.

SHAPIRO: Jeremy Konyndyk is a senior policy fellow at the Center for Global Development, and he was director of the Office of U.S. Foreign Disaster Assistance during the Obama administration. Thank you for coming in today.

KONYNDYK: My pleasure. Thank you, Ari. Transcript provided by NPR, Copyright NPR.