Washington Week with The Atlantic

YAMICHE ALCINDOR

Welcome to the Washington Week Extra. I'm Yamiche Alcindor. Joining us tonight as part of Washington Week Bookshelf series, Yasmeen Abutaleb, national health policy reporter for The Washington Post; and Damian Paletta, economics editor and also for The Washington Post. Yasmeen and Damian are authors of the new book

Nightmare Scenario

Inside the Trump Administration's Response to the Pandemic That Changed History. Thank you so much, both of you, to being there - for being here. In your book you talked to former White House officials who regretted how infighting became more important than addressing the pandemic. They told you, quote, "no one in

the White House was asking

What's the right thing to do for patients? What's the right thing to do for America?" Yasmeen, I want to start with you. Why did internal infighting end up overshadowing what was best for Americans?

YASMEEN ABUTALEB

I think that's so much the story of the Trump administration, and Damian and I talked a lot about this. It just played out in such a devastating way when it came to the pandemic. It was one thing if you were having policy disagreements or, you know, petty infighting, but when it came to the pandemic what the country really needed was for the government to rally together, to send a unified message to people, and to put all their effort into beating back the virus and doing whatever was needed to beat the virus and not fighting each other. But instead - these rivalries predated the pandemic. It wasn't - and then they were exacerbated by the amount of stress and pressure the government was under, and because there was so much concern - you know, Damian and I document a number of times where Mark Meadows, the chief of staff to Trump last year, threatens to fire people with a kind of regularity and people are worried about being in and out of favor and the president's mood that day and wanting to be the one to announce good news. It just ended up overriding what they actually needed to do for an effective response.

ALCINDOR

And Damian, in this book you talk about former President Trump becoming somewhat obsessed with keeping case counts of the coronavirus low. How did that impact his decision-making and ultimately the virus spreading around the country?

DAMIAN PALETTA

Yeah, it's a great question. I mean, we know the president's obsessed with numbers, whether it's his golf score or the stock market, and you know, early last - in 2020 when they were - when TV networks were showing on the bottom right of the screen the case counts, you know, it was like four cases and then it goes up to eight cases, then 14 cases, so he's watching that number go up and he knows that Americans are seeing it too, so he wanted to do everything he could to keep that number low. No matter what the real number was he wanted the number on the screen low, so you know, Yasmeen and I wrote about an incident when there was all these cruise ships with sick Americans on them. The president did not want these people stepping foot back on U.S. soil even though they were sick and needed health care because he didn't want the case numbers to go up, so at one point he told aides that he wanted to send these sick passengers to Guantanamo Bay, Cuba, and have them quarantine there until they were better so that the numbers wouldn't go up. This is - this is the kind of thinking that his aides were kind of being, you know, attacked with all the time, and while they were focusing on whether to execute these directives or not thousands and thousands of planes were landing each day and each week bringing tens of thousands of passengers, many of whom were sick, from Asia or from Europe and all other parts of the world. So they were so focused on, you know, trying to keeping the numbers down in ways that didn't actually help keep the numbers down, and by the time they had figured out that they had made mistakes it was just too late and the virus was all over the country.

ALCINDOR

And Yasmeen, I want to go to you. What was the president hearing early on about the pandemic and how did his view, his attitude of the pandemic change over time?

ABUTALEB

Well, the president's early warnings about the pandemic were that the virus was serious and something that could seriously upend his presidency. He received a briefing from his national security advisers on January 28th where they told him this could be the biggest crisis of your presidency, and then we also know that his first chief of staff at the start of last year, Mick Mulvaney, told him you think you're running on the economy and you're not, so - and then we of course know because of Bob Woodward's reporting that he knew that it was much deadlier than the flu and how dangerous it was because of how transmissible it was. So he seemed to appreciate the threat that the virus posed, but there were sort of two Trumps that Damian and I tried to explore in the book. There's the one who is a germophobe and frets about his own vulnerability, but then he also has so many close calls with the virus that he dodges, of course, until he gets sick in October, and I think that made him think it just wasn't as big a deal as people made it seem like it was because he was repeatedly escaping it, and he also of course didn't want the shutdowns, he didn't want the consequences that came with the measures you had to take to try to control the virus.

ALCINDOR

And you have some great reporting about when he got sick and I'm going to get to that in a minute, but I want to ask you a bit more about the decision-making here. There are some decisions, it seems, that could have been the difference between life and death for so many people. Yasmeen, when you think about the decisions that were made, what are the ones that stick out to you that were between life and death?

ABUTALEB

I think Damian and I were struck by the number of opportunities there were to turn things around that would have saved thousands of lives. So I think the most obvious one is this debate on masks, and there was a plan from HHS in March and they had already had a lot of it underway where they had already worked with undergarment manufacturers like Haines and Jockey to outfit some of their manufacturing facilities to produce masks to send to every American household, and they would have produced 650 million masks by May, which would be enough to send every American about two, and the idea was to send it from the U.S. government, to send it from the president to send this unified message that we all are going to wear masks to protect ourselves and to protect our neighbors. And then, keeping with masks, the president was told over the summer that 80 percent of Republicans would be fine with a mask mandate as long as it was sort of messaged as being able to reopen the economy, and again that opportunity was lost; they didn't do it. And there are a number of other incidents, places where the case count was low and you could have used that to try to quash the virus and prevent a more deadly wave from coming. But this was just such a tragic tale of missed opportunities and there are so many people who suffered needlessly because of that.

ALCINDOR

And one more follow up for you. When you - when you think about the decisions that you just outlined there, there hasn't been this reckoning when it comes to people being held accountable for their decision-making. What's your reporting tell you about why that hasn't happened, why there haven't been people held accountable, possibly even just investigations into the decision-making specifically on the virus, and could that - could that even happen?

ABUTALEB

I think so much of it is because we don't have a 9/11-style commission and Congress investigating the administration's response to the virus. We spent, you know, time investigating this, talking to more than 180 people. I think there are still a lot of things to learn about the response, a lot of questions that probably only Congress could answer because of the power they have to investigate these types of things, but I think for similar reasons that there isn't going to be GOP participation in a commission on what happened on January 6th. There doesn't seem to be any motivation to create a bipartisan commission to investigate the administration's response. You see these people struggling to get jobs, you know, but other than that, there - like you said, there isn't a lot of accountability, and I don't know how that would come short of some kind of bipartisan congressional investigation.

ALCINDOR

And Damian, both you and Yasmeen, you write about Dr. Fauci specifically and we - and him trying to toe the line with science and also keeping the president not get - from not getting mad at him. Talk to us a little bit about how he walked that line.

PALETTA

Yeah, I mean, I think Dr. Fauci was such a fascinating character in 2020, and he actually remains one in 2021. But last year, you know, he's a very recognizable face. He was in some ways a foil to President Trump. You know, they were both from New York, they were both about the same age. One's kind of a big guy, one's a little guy; one's really into science, one could care less about science. And so I think the president was shocked that there was this other person, this other New Yorker, who was really good at the media and really good at, you know, spin, and so the president became obsessed with Dr. Fauci. And you know, Dr. Fauci was, you know, kind of stubbornly brave. I mean, he wasn't afraid to challenge the president when the president would say something at the microphone; you know, Dr. Fauci would say, well, I don't agree with that, that's not the case, or the real situation is this. Now, he was careful not to criticize the president. He was careful not to, you know, question the president's motives, but I think he became this kind of resistance hero and that made the president even angrier. And so there was a point in February and March when Dr. Fauci did have a lot of influence inside the White House. He and Dr. Birx worked quite closely and did have a big impact on policy decisions that Trump made, but by the end of March and as we got into April the president really turned on Dr. Fauci because he thought that he was being upstaged and he thought that Dr. Fauci was more focused on, you know, kind of shutting the economy down than reopening the economy, which is what President Trump thought was necessary for him to win reelection. So they kind of went along on these parallel tracks. I mean, they couldn't quit each other almost, you know, as the year went on, and things obviously got much more tense as we got into the fall.

ALCINDOR

And I want to ask you about other officials, especially Dr. Birx. What did you learn about her role that maybe we didn't know before?

PALETTA

Yeah, I mean, Yasmeen and I spent so much time talking about Dr. Birx with each other. We just - it was - she was such a three-dimensional character for us. She's incredibly complicated. I think a lot of Americans misunderstand her. You know, there's a lot of resentment towards her still, which, you know, we found quite surprising. Our understanding or our reporting shows that she, you know, definitely pulled back and pulled her punches initially. She was not one to criticize the president. She, you know, was from the military, so she believes in the military chain of command, you never question your superiors in public. And so when the president would say something that obviously she disagreed with and other scientists might speak up, she would not challenge him, and that allowed her initially to have a lot of influence with him because he thought, wow, she seems like she's really loyal, I'll give her the benefit of the doubt. And she was able to, especially in March, have a lot of impact on his decisions to do the 15 days to slow the spread and then the 30 days to slow the spread. She doesn't really get credit for that. Now, the president eventually decided he didn't need to listen to her - he didn't need to listen to her or Fauci. So her reputation was kind of destroyed because she went along with him and then he just kind of threw her out. And so obviously you saw Speaker Pelosi ended up attacking her, even though Fauci remained kind of this hero. And so as the year went on, she just got more and more frustrated. She tried to travel the country, speak to governors and others to try to get, you know, local politicians to clamp down on mask wearing in their areas. But really, she never recovered and her reputation, you know, will never be the same.

ALCINDOR

And one of the biggest revelations in the book is about former President Trump. You report that when he had COVID-19 he was sicker than we publicly knew, and you mention that White House chief of staff at the time Mark Meadows even thought the former president could die from the virus. Yasmeen, I want to come to you. Why did the Trump administration not tell the truth or reveal more about the president's condition, and what impact did that have on Trump supporters' views of the virus and the vaccines?

ABUTALEB

That's such a great question. I think so much of it came from the president's obsession with this projection of strength and power. And if people knew how sick he was, then he would be seen as vulnerable and not in command. And we also report that even though he was sick and his doctors were fearing he might have to go on a ventilator, there was never any discussion with Vice President Mike Pence's team about a plan of succession if the president became incapacitated, even though that seemed like a real possibility. And to the second part of your question, the president - even though he was gravely ill for a couple of days but had this rapid turnaround because of the extraordinary medical care he had, including a then-experimental drug that one person that we spoke with familiar with his condition said they were almost certain was positive for his rapid recovery - the president comes back defiant, and triumphant, and says, don't let it ruin your life. Don't let it dominate your life. Don't be scared of it. And Damian and I think that that had a huge influence, because he basically used himself as a test case to say, look, I got it and I recovered fine, instead of using it as a moment of humility to say, I got it, I got really sick. I had access to extraordinary medical care because I'm the president. But you really should be worried about this. You should wear a mask. You should protect yourself. You should protect your family. And so many of his health and political advisors saw that as a huge missed opportunity, especially as they were anticipating that horrible, deadly winter that we all endured.

ALCINDOR

And, Yasmeen, I want to come to you and think a little bit about where we are now. What's the road to going back to normal? I know, of course, that President Biden wanted this to be the celebration this weekend of freedom from the vaccine. But there's now this Delta variant going on. What's your reporting tell you about what's happening right now and how worried people should be?

ABUTALEB

It's such a tricky time to know what our - what our new normal is going to look like. Obviously, things have gotten significantly better over the last several months. And a lot of us are able to mostly go back to normal, especially if we're vaccinated. We don't have to wear masks in a lot of places. We can return to the office, can see loved ones. But the concern is that as long as the variants are spreading, even among unvaccinated populations, we're going to have to keep studying whether - with each variant - can vaccinated people get sick? How sick can they get? Even if they don't get sick, can they still transmit it to other people? And of course, the other big thing is that kids still can't get the vaccine - kids under 12. And I think that makes it very concerning for a lot of families who do have young children and what risk they might pose to other more vulnerable members of their family. So I think there are still a lot of questions about what a return to, quote/unquote, "normal" looks like. Scientists have generally agreed, we're never going to get rid of COVID. We have to learn to live with it, like we do with lots of other viruses. But as long as there are significant unvaccinated portions of the country, it's always going to be a risk.

ALCINDOR

And, Damian, last question to you, thinking about Yasmeen talking about this always being a risk, some of the most vaccine hesitant groups that we're seeing are in the South. They're conservatives, Republican men in particular. We also have seen former President Trump now going back on the campaign - or, I should say, going to rallies. It feels like a campaign trail. But he's back out in public talking to large groups. What role do we think that the former president could play? And has his tone changed at all? Could he be helpful in trying to get more people vaccinated?

PALETTA

Absolutely. I mean, and we have underestimated this virus every step of the way. You know, we thought we snuffed it out last May. We didn't. We thought we snuffed it out as we got closer to the election. Of course, we didn't. And now obviously the vaccination numbers are great, but as you've mentioned we've kind of plateaued. And it is concerning as we're about to head into another fall with many Americans in certain pockets of the country unvaccinated. I think clearly the way that these vaccines have become so political is really troubling. And I think if the president would not only talk about it, you know, off hand, but if he would sort of get invested, and involved, and show up at a vaccination site and, you know, help bring people - even, quite frankly, have vaccines at his rallies. You know, that would really help I think kind of normalize this, make people feel more comfortable with it. And then we'd be in much better shape heading into the fall and winter, because the last thing we want - the last nightmare scenario would be to go into the fall and the winter, and have another - you know, have outbreaks in certain states, and then we'd have to go through this all over again. The, you know, heartache is just not worth it. And I think the less political this could be, the more we would all benefit.

ALCINDOR

Well, this was a fascinating conversation. You should - everyone should get this book. It's just a window into the year that we all lived in, and what we're still living through. So the Nightmare Scenario. It's - that's the name of the book. Of course, two great authors. That's it for this edition of the Washington Week Bookshelf. Thank you so much to Yasmeen and Damian for your insights. And thank you all for joining us. Make sure to sign up for the Washington Week newsletter on our website. We will give you the behind-the-scenes look into all things Washington. I'm Yamiche Alcindor. Have a safe and healthy July 4th. Good night.