Helio Fred Garcia

The first American case of COVID-19 was diagnosed on January 20, 2020. 

Exactly one year later Joe Biden will be sworn in as the 46th President of the United States.

What happened in the United States in between is different from what happened in other developed countries. 

Twenty million Americans contracted COVID-19 between the first case and the end of the year.

2020 was the single deadliest year in American history. The first U.S. COVID-19 fatality was on February 6. By year end another 351 thousand Americans had died from the virus. For context, that is more than all the U.S. combat fatalities in World War II and Vietnam combined, but in a single eleven-month period rather than in the 24 years of those wars. For several weeks in December we were seeing the equivalent of a 9/11 casualty rate every day, with total 2020 COVID-19 fatalities equal to 118 separate 9/11 attacks.

Much of this was avoidable. And yet, here we are. So the question is – why did this happen?

Everything Changed

It was a year that changed everything: what it means to be “at work” or “at school”; how we visit the doctor; how we greet each other; how we shop for groceries and other goods; how we say goodbye to loved ones as they take their final breath.

It was a year of great trauma: medical, emotional, spiritual, economic, social.

And it was a year that saw great sacrifice and some of the best of humanity: in the front-line medical workers, in the agility of many companies to re-imagine their business models and their product offerings, in the emergence of a new class of heroes – postal workers, delivery drivers, and grocery clerks, who risked infection to keep us supplied.

 

And it was a year that intensified much that had already been fraying in the fabric of American civic life: hyper-polarization in politics, mistrust of each other and of civic institutions, and the shattering of social and political norms.

In the time of the pandemic we saw the explicit elevation and endorsement of white supremacist and conspiracist groups, such as the Proud Boys and QAnon. But also the largest civil rights protest in American history, with more than 25 million Americans marching in support of Black Lives Matter – and this in the days and weeks following the first wave of reopening after two months of stay-at-home orders.

After decades of one party discrediting science – from refusing to accept the reality of evolution, to redefining when human life begins, to denying the reality of climate change – we saw millions of Americans deny what scientists, public health experts, and their own doctors told them: that the virus is real, that it is deadly, that you can transmit it even when asymptomatic; and that masking, distancing, and handwashing are keys to prevention. The American population seemed to divide into those who believe what science teaches and those who choose not to. But as a popular T-shirt and internet meme noted, Science Doesn’t Care What You Believe.

The pandemic coincided with one of the most bizarre and contentious presidential election campaigns in American history, in which despite no evidence of fraud the sitting president refused to acknowledge defeat and lost more than 50 lawsuits challenging the results. And who for the eight weeks between the election and the new year seemed to give up on being president. He stayed out of sight and silent on anything having to do with the pandemic, even as fatalities approached the 350 thousand mark and infections soared to 20 million, and as he rage-tweeted about the so-called “massive fraud” that had prevented his re-election.

But the hardships were real and were devastating. In the weeks before and after Christmas, hospitalization rates reached record highs, with whole regions, including southern California, reporting zero intensive care beds available. At least one Los Angeles hospital started treating patients in the gift shop; another in a cafeteria; yet another in its chapel. But the real shortage was of medical personnel to treat the record number of patients. Doctors began talking about the need to choose which patients to treat, and which to leave to die. 

The nation saw the infection rate grow by a million cases every few days. And despite pleas from public health officials and hospital front-line workers, Americans continued to travel for the holidays, risking what health workers called a surge on top of a surge. And some governors refused to require citizens to wear masks in public. Florida’s governor even forbade Florida cities and counties from requiring masks and social distancing in their jurisdictions. And the White House, the State Department, and other federal agencies held dozens of holiday parties indoors and without a masking requirement: yet more super-spreader events.

Incompetence

It did not need to be this way. 

Much of the suffering, the hardship, the sacrifice could have been avoided. It resulted from a lethal combination of incompetence, dishonesty, and neglect. 

The United States, alone in the world, intentionally refused to follow or mandate basic public health steps: a national masking, distancing, testing, and contact tracing policy. There was no whole of government response; at best there were fragments of government responses. And some parts of the government seemed to be at war against other parts. Indeed, some parts of government seemed to be at war against themselves, such as the White House Pandemic Task Force, where in a single press conference the politicians would contradict the public health experts, and vice versa. 

The president and other senior government officials modeled the opposite of the public health guidelines, remaining unmasked in public and holding super-spreader events where the crowd was unmasked and packed close together – in violation also of local masking and distancing ordinances. 

Dishonesty

 

A Cornell University Alliance for Science report named the president as the single largest source of misinformation about the virus. It noted, “[I]f people are misled by unscientific and unsubstantiated claims about the disease, they may attempt harmful cures or be less likely to observe official guidance and thus risk spreading the virus.”

Its conclusion:

“One major finding is that media mentions of President Trump within the context of different misinformation topics made up 37% of the overall ‘misinformation conversation,’ much more than any other single topic. The study concludes that Donald Trump was likely the largest driver of the COVID-19 misinformation ‘infodemic.’”

Neglect

On January 28, 2020, U.S. National Security Advisor Robert C. O’Brien had told Trump that COVID-19 would be, “the biggest national security threat you face in your presidency.”

Trump knew about the severity of the virus in February and March. In taped discussions Trump told Washington Post Associate Editor Bob Woodward what he knew about how dangerous COVID-19 is:

• It is spread in the air
• You catch it by breathing it
• Young people can get it
• It is far deadlier than the flu
• It’s easily transmissible
• If you’re the wrong person and it gets you, your life is pretty much over. 
• It rips you apart
• It moves rapidly and viciously.
• It is a plague

But he told the nation the opposite of what he knew. He told Woodward that his approach was to downplay the severity. 

In March, Woodward named COVID-19 the leadership test of a lifetime, but Trump disagreed. In August, when the death count was more than 168,000, Trump told Woodward about his leadership of the COVID-19 response, “But nothing more could have been done. Nothing more could have been done.” 

 

And he has been AWOL on COVID ever since. 

Just before election day the White House science office announced that among Trump’s accomplishments are “ending the pandemic.” Cases doubled in the two months afterward.

In the third week in October 2020 Columbia University’s National Center for Disaster Preparedness published a report in which it compared the United States’ response to COVID to six other high-income nations and several low-and-middle income countries such as Thailand, Pakistan, and Honduras.

Its conclusion: 

“The abject failures of U.S. government policies and crisis messaging persist. U.S. fatalities have remained disproportionately high throughout the pandemic when compared to even other high-mortality countries.”

At the time of the report, more than 217,000 American lives had already been lost to COVID-19. It noted that with “a proportional mortality rate twice that of neighboring Canada and more than 50 times that of Japan — a country with a much older population than the U.S. — The United States has turned a global crisis into a devastating tragedy.”

 

The report concluded, “We estimate that at least 130,000 deaths and perhaps as many as 210,000 could have been avoided with earlier policy interventions and more robust federal coordination and leadership.”

Here’s an interesting point of comparison: On same day that the U.S. had its first confirmed COVID-19 diagnosis on January 20, the first case was confirmed in the Republic of Korea. Unlike the U.S., Korea took it seriously.

Columbia’s National Center for Disaster Preparedness report contrasted the U.S. response with Korea’s:

“South Korea was able to institute an aggressive diagnostic testing strategy and isolate infected patients, leading to a proportional mortality rate today that is 78 times smaller than that of the United States.”

The report noted that as of mid-October 2020, Korea had experienced 0.85 deaths per 100,000 of population, the lowest rate among six high-income countries, including Germany and France. The U.S. had the highest rate among peer countries, at 66.33 deaths per 100,000 of population.

Here’s another way to understand this: Between January 20 and December 31, more than one in every one thousand Americans died of COVID-19.

Leadership matters. Leaders are judged by how they deal with their biggest challenges. In the hundreds of thousands of avoidable deaths, in the millions of avoidable infections, and in the avoidable social, economic, and personal pain that followed, we see the tangible human consequence of leadership failure.

The tone is set at the top. And there are still three weeks to go before the new administration inherits this tragedy. At the start of a new year, here’s to the next leadership team, and hoping that they approach the pandemic with competence, honesty, and urgency.  

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About the Author: Helio Fred Garcia is the president of Logos Consulting Group and teaches crisis management, ethics, leadership, and communication at New York University and Columbia University. His next book, in progress, is The Trump Contagion: How Incompetence, Dishonesty, and Neglect Led to the Worst Handled Crisis in American History.