On March 18th, researchers in France circulated a study about the promising experimental use of hydroxychloroquine, an anti-malaria drug, in combination with azithromycin, an antibiotic, as a treatment for the disease caused by the coronavirus. The study was neither randomized nor peer-reviewed, and other scientists soon criticized its methodology. But Tucker Carlson, on Fox News, highlighted the work. The next day, President Trump promoted hydroxychloroquine’s “very, very encouraging early results.” He added, mentioning another unproven therapy, “I think it could be, based on what I see, it could be a game changer.”
At a White House press briefing on March 20th, a reporter asked Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, whether hydroxychloroquine could be effective in treating covid-19. “The answer is no,” Fauci said, before yielding the microphone to Trump, who countered, “May work, may not. I feel good about it. That’s all it is, just a feeling, you know, smart guy.” A few days later, Tedros Adhanom Ghebreyesus, the director-general of the World Health Organization, said, “Using untested drugs without the right evidence could raise false hope and even do more harm than good.”
Trump’s quackery was at once eccentric and terrifying—a reminder, if one was needed, of his scorn for rigorous science, even amid the worst pandemic to strike the country in a century. Yet his conduct typified his leadership as the crisis has intensified: his dependency on Fox News for ideas and message amplification, his unshakable belief in his own genius, and his understandable concern that his reëlection may be in danger if he does not soon discover a way to vanquish COVID-19 and reverse its devastation of the economy.
New York City now faces a “troubling and astronomical” increase in cases, according to Governor Andrew Cuomo, and the emergency is overwhelming hospitals, straining drug and equipment supplies, and threatening to cause a shortage of ventilators. The grim course of events in the city is a “canary in the coal mine” for the rest of the country, Cuomo said, and leaders elsewhere must take decisive action lest they, too, become inundated. Trump, though, spent much of last week promoting a contrarian gambit that has been percolating in the right-wing media. He said that, to revitalize the economy, he would like to lift travel restrictions and reopen workplaces across the country within weeks, perhaps by Easter, which is on April 12th, because, as he put it repeatedly, “we can’t let the cure be worse than the problem.”
Public-health experts immediately warned against such a reversal of social-distancing rules. “The virus will surge, many will fall ill, and there will be more deaths,” William Schaffner, a specialist in preventive medicine at Vanderbilt University, told the Times. When a reporter asked the President whether any of the “doctors on your team” had advised him that a hasty reopening was “the right path to pursue,” he replied, “If it were up to the doctors, they may say, ‘Let’s keep it shut down . . . let’s keep it shut for a couple of years.’ ” Public-health specialists have said no such thing; they have spoken of a conditions-based approach (“You don’t make the timeline, the virus makes the timeline,” Fauci has said), while advising that, to save the most lives, local leaders must wait to lift restrictions in their areas until the data show that the virus has stopped spreading. Trump said that any loosening of rules he might seek around the country—he mentioned Nebraska and Idaho as possible sites—would be “based on hard facts and data,” but he also said that he chose Easter as a target date because he “just thought it was a beautiful time.”
It is true, as Trump also argued, that enormous job losses and an all but certain recession caused by the pandemic will harm many vulnerable Americans, and claim lives, as ill people without health insurance, for example, forgo care or struggle to get it at stressed clinics and hospitals. Yet, at least in the short term, over-all mortality rates fall during recessions; the reasons for this aren’t fully clear, but social scientists think they may include the public-health benefits of a decrease in pollution, as a result of the slowing economy. In any event, the case the President made for hurrying an economic revival against the advice of scientists was morally odious; it suggested that large numbers of otherwise avoidable deaths might have to be accepted as the price of job creation.
Public-health officials spoke frankly to the press about the catastrophic prospects of the President’s Easter folly. (“President Trump will have blood on his hands,” Keith Martin, the director of the Consortium of Universities for Global Health, told the Times.) Trump responded on Twitter by lashing out at the “LameStream Media” for reporting such forecasts, calling the press “the dominant force in trying to get me to keep our Country closed as long as possible in the hope that it will be detrimental to my election success.” Last Wednesday, after Mitt Romney, the only Republican who voted to convict the President, on a charge of abuse of power, during the Senate impeachment trial, announced that he had tested negative for COVID-19, Trump tweeted mockingly, “I’m so happy I can barely speak.” At the White House briefings, surrounded by the sorts of civil servants and experts he habitually disdains, Trump has adapted awkwardly to the role of solemn unifier. When he leaves the podium to tweet nonsense at his perceived enemies, he at least provides his opponents among the country’s homebound, screen-addled, and anxious citizenry with a galvanizing dose of his immutable obnoxiousness—a splash of the old new normal.
The journal Science asked Fauci why he doesn’t step in when the President makes false statements in the briefings. “I can’t jump in front of the microphone and push him down,” he said. America’s public-health system is fragmented and market-driven, conditions that only compound the challenge of quashing COVID-19. In the Trump era, however, decentralization has a benefit: the President is not solely in charge, and in the months ahead governors and mayors will continue to shape the odds of life or death for great numbers of Americans. Last week, Trump reviewed the possibilities for quarantine in New York City, his ravaged home town. He rambled about the stock exchange (“It’s incredible what they can do”), before going on to pledge, “If we open up, and when we open up . . . we’re giving the governors a lot of leeway” to decide how this should be done. We can only hope so. ♦