Blinking Red: 25 Missed Pandemic Warning Signs

In April 2020, 60 Minutes interviewed Trump advisor Peter Navarro about the COVID-19 pandemic response and the short supply of medical equipment. Irked by the pointed questioning, Navarro directly challenged correspondent Bill Whittaker: “Show me the 60 Minutes episode [that said] ‘Hey, global pandemic’s coming, you’ve got to do X, Y and Z’…  Show me that episode. Then you’ll have some credence.”

“I guarantee you we did,” Whittaker replied. Exhibits A and B were episodes broadcast in 2009 (“H1N1”) and 2005, a segment called “Chasing the Flu.”

Alarmed by an advance copy of John Barry’s book The Great Influenza, then President George W. Bush gave a speech on November 1, 2005, at the National Institutes of Health (NIH) on plans to prevent a pandemic. The plan included detecting outbreaks around the world, stockpiling vaccines and drugs, and improving vaccine production capacity. “A pandemic can continue spreading destruction in repeated ways that can last for a year or more,” Bush said. “One day, lives may be needlessly lost because we failed to act today.”

Bush’s Health & Human Services secretary, Michael Leavitt, also sounded the alarm and worked to implement Bush’s plans. 2005 was also the year that GEN published its first pandemic warning.

During a February 2006 TED talk, Larry Brilliant warned about the likelihood of a future pandemic. In a straw poll, 90 percent of epidemiologists predicted a pandemic in the next 1–2 generations, potentially affecting 1 billion people and the loss of 165 million lives. Brilliant also noted that the economic cost of such an outbreak would extend and even overshadow the loss of life from the disease itself.

In July 2006, Mayor Michael Bloomberg issued a pandemic preparation plan for New York City. A massive pandemic would leave the city critically short of ventilators. A ventilator stockpile was built but dwindled due to budget cutbacks and lack of maintenance.

In February 2007, best-selling author and pandemic expert Laurie Garrett gave a TED talk, “Lessons from the 1918 flu.” Garrett stamped her credentials in this arena with her 1994 book, The Coming Plague. At the end of her TED talk, Garrett describes the dire consequences of viral infection that are bone-chillingly relevant 13 years later:

“Your immune system sends out all its sentinels and says, ‘I don’t know what the heck this is. We’ve never seen anything even remotely like this before.’ It won’t do any good to bring in the sharpshooters because those antibodies aren’t here. And it won’t do any good to bring in the tanks and the artillery because those T-cells don’t recognize it either. So we’re going to have to go all-out thermonuclear response, stimulate the total cytokine cascade. The whole immune system swarms into the lungs. And yes they die, drowning in their own fluids, of pneumonia. But it’s not bacterial pneumonia. And it’s not a pneumonia that would respond to a vaccine.”

In August 2010, the Director General of the World Health Organization (WHO) gave a press conference after the worst of the H1N1 pandemic period. “Pandemics are unpredictable and prone to deliver surprises. No two pandemics are ever alike,” he said. While the H1N1 turned out to be relatively mild, “had things gone wrong… we would be in a very different situation today.”

In 2011, Steven Soderbergh directed an all-star cast including Kate Winslet, Matt Damon, and Gwyneth Paltrow in a highly realistic thriller, which is doing a brisk business now a pandemic similar to the one depicted is actually happening. CNBC’s Chrissy Farr interviewed the film’s medical advisors. Usually science fiction films have enough plot holes to drive a truck through. Unfortunately for us, the same cannot be said about Contagion. The film even has Kate Winslet explaining R0 in thirty seconds.

As the Matt Damon character said in a more recent sci-fi blockbuster, we’re “gonna have to science the s**t out of this.”

Spillover: Animal Infections and the Next Human Pandemic is one of author David Quammen’s best books. In her review, Alice Roberts called the book “extraordinary”, noting that “humans are part of the natural world, not separate from it — and there lies the problem.” Many other superb books have discussed the lessons from the 1918 flu pandemic.

In a speech at NIH on December 2, 2014, following the Ebola outbreak, Barack Obama warned of a future deadly airborne disease. “We have to put in place an infrastructure…. that allows us to see it quickly, isolate it quickly, respond to it quickly… If and when a new strain of flu (like the Spanish flu) crops up —five years from now or a decade from now —we’ve made the investment.”

During a tour of the National Institute of Allergy and Infectious Disease (NIAID), Obama heard about the latest science under the watchful eye of director Anthony Fauci. It turns out Obama predicted the Covid-19 pandemic almost to the day.

In March 2015, wearing a tasteful pink sweater, Bill Gates delivered a TED talk entitled “The next outbreak? We’re not ready.” Gates said: “Today, the greatest risk of global catastrophe… looks like this… a highly infectious virus. Not missiles, but microbes.” He repeated the warning 20 months later at the World Economic Forum in Davos, Switzerland, and again in October 2017 in a plenary address at the American Society of Human Genetics conference, before a fireside chat with NIH director Francis Collins in front of several thousand geneticists.

Gates called for new tools to help with a pandemic, the rapid development of diagnostics and vaccines, “ideally one that confers protection within hours rather than days or weeks.” Gates also championed new vaccine production methods, using adeno-associated viruses, RNA/DNA vaccines, or even “gene editing on B cells to produce the antibodies you want.” These would be “miraculous tools… so that unknown risk of a pandemic could be handled.”

Ralph Baric, a veteran coronavirus epidemiologist at the University of North Carolina, has been warning about outbreaks for years. In a recent article, former NBC science correspondent Robert Bazell recalled Baric’s 2015 paper in Nature Medicine, in which he warned of “a potential risk of SARS-CoV re-emergence from viruses currently circulating in bat populations.” He followed that with a PNAS paper in 2016 warning that a coronavirus outbreak was “poised for human emergence.”

Throughout 2016, the National Security Council (NSC) prepared a 69-page, color-coded document, the “Playbook for Early Response to High-Consequence Emerging Infectious Disease Threats and Biological Incidents.” Former chief Susan Rice shortened it to the “Pandemics for Dummies” playbook.

On January 13, 2017, one week before Trump’s inauguration, the incoming administration was briefed on pandemic preparation in a three-hour meeting with their Obama counterparts. Fewer than a third of the Trump officials present at that meeting remain with the administration, according to Politico.

In January 2017, Anthony Fauci delivered a lecture at Georgetown University entitled “Pandemic Preparedness in the Next Administration.” Fauci’s main message was that there would be a challenge. “There will be a surprise outbreak,” he said. There’s no doubt in anyone’s mind that they [the next Administration] will be faced with the challenges that their predecessors faced.”

“A major new global health crisis is a question of when, not if,” wrote Jeremy Konyndyk, former director of USAID’s Office of U.S. Foreign Disaster Assistance, in Politico a few weeks after Fauci’s speech. “So far, Trump’s relationship with science has been fraught,” Konyndyk continued, citing Trump’s reaction to the Ebola crisis and climate change. “If he disregards the U.S. government’s own scientists when the next crisis hits, he will undercut his administration’s ability to manage it. Botch the diagnosis, botch the prescription.”

On May 8, 2018, Rear Admiral Timothy Ziemer, the top White House official in charge of pandemic preparation, abruptly left the administration, following a reorganization by then national security advisor John Bolton. Along with other personnel departures and reassignments, the result “seems to actively unlearn the lessons we learned through very hard experience over the last 15 years,” Konyndyk told the Washington Post. “These moves make us materially less safe. It’s inexplicable.” Shortly before Ziemer’s departure, another former Trump official, Luciana Borio, told a conference marking the centennial of the 1918 flu pandemic that the threat of a new outbreak was a global health priority. “Are we ready to respond? I fear the answer is no.” Bolton recently defended his decision to streamline the NSC pandemic team.

The brilliant science writer Ed Yong, author of I Contain Multitudes, penned a bracing story for The Atlantic in the summer of 2018 entitled “The Next Plague is Coming: Is America Ready?” Of the H1N1 flu outbreak that began in Mexico and caught the U.S. by surprise, Yong wrote: “One of the most sophisticated disease-detecting networks in the world had been blindsided by a virus that had sprung up in its backyard, circulated for months, and snuck into the country unnoticed.”

The White House, Yong wrote, “is now home to an inattentive, conspiracy-minded president. We should not underestimate what that could mean.” Yong also interviewed Fauci, who was talking about a universal vaccine. As for Trump, Fauci said: “I haven’t had any interaction with him yet. But in fairness, there hasn’t been a situation.”

The Director of National Intelligence, Dan Coats, issued the 2019 Worldwide Threat Assessment of the U.S. intelligence community. Under the section of Human Security/Global Health, the report stated: “The United States and the world will remain vulnerable to the next flu pandemic or largescale outbreak of a contagious disease that could lead to massive rates of death and disability, severely affect the world economy, strain international resources, and increase calls on the United States for support.”

At the Biodefense Summit in April 2019, DHHS secretary Alex Azar said: “Of course, the thing that people ask: ‘What keeps you most up at night in the biodefense world?’ Pandemic flu, of course. I think everyone in this room probably shares that concern.”

In a scenario contained within the 2019 National Threat and Hazard Identification and Risk Assessment report, FEMA (Federal Emergency Management Agency) predicted that a novel virus pandemic without a vaccine would lead to a serious shortage of medical supplies, place strain on hospitals and could result in an economic shutdown.

A confidential report issued in late November 2019 by the military’s National Center for Medical Intelligence warned of a contagion sweeping through Wuhan, China, which was assessed as a possibly “cataclysmic” event. Sources told ABC that the report was briefed to the National Security Council, the Pentagon and the White House, although the Defense secretary, Mark Esper, denied any awareness of it.

Four days after China alerted WHO about the outbreak, three days after the closure of the Wuhan seafood market, and one day after Chinese officials briefed the CDC director, Helen Branswell sounded the alarm about a cluster of unusual pneumonia cases in the Chinese city of Wuhan. Writing for STAT, Branswell noted the possibility that the outbreak might be traced to a novel coronavirus. Some commentators argued the lack of clear answers “is reminiscent of China’s behavior during the 2002–2003 SARS outbreak.”

Branswell closed by quoting UNC’s Professor Baric: “If the number of cases keeps increasing, then it becomes more and more of a global public health threat. The chance of [infected] people slipping through the screening platforms for international travel or travel elsewhere in China become greater as long as they don’t know what the pathogen is.”

“Once again, a deadly virus is emanating from China,” tweeted Arkansas Republican Senator Tom Cotton. He also drew flak for airing a conspiracy theory that the SARS-CoV-2 virus was developed in a bioweapon laboratory in Wuhan, although that theory is still doing the rounds in some circles.

According to the Washington Post, U.S. Intelligence was circulating reports in January and February about the pandemic threat. According to one official, “Trump may not have been expecting this, but a lot of other people in the government were — they just couldn’t get him to do anything about it. The system was blinking red.”

One of the country’s top public health experts, the director of CDC’s National Center for Immunization and Respiratory Diseases, Nancy Messonnier, MD, said, “We need to be preparing as if this is a pandemic.”

A month later, Messonnier issued further warnings. “We want to make sure the American public is prepared,” she said as she feared that successful containment at the border would become increasingly difficult. She recommended that parents start talking to schools and businesses explore telecommuting arrangements. “Disruption to everyday life might be severe,” she said. Messonnier’s candor had consequences; it preceded, if not precipitated, the stock market crash. Since then she has kept a low profile in the administration’s response.

On an email chain entitled “Red Dawn” hosted by Duane Caneva, the chief medical officer at the Department of Homeland Security, medical experts expressed alarm about the growing outbreak. Carter Mecher (Veterans Affairs) warned that WHO and CDC were behind the curve: “The projected size of the outbreak already seems hard to believe.”

James Lawler (University of Nebraska), who advised presidents Bush and Obama, followed with this sarcastic email:
“Great Understatements in History:
Napoleon’s retreat from Moscow — “just a little stroll gone bad”
Pompeii— “a bit of a dust storm”
Hiroshima — “a bad summer heatwave”
AND
Wuhan — “just a bad flu season”

The next day, President Trump’s economic advisor, Peter Navarro, sent the first of two memoranda to the NSC. He speculated that without containment, COVID-19 could claim more than 500,000 lives and economic losses in the trillions of dollars. (In a second memo on February 23, Navarro raised the loss-of-life estimate to 1–2 million souls.) Although Trump has not acknowledged seeing the memo, he said he largely agreed with it. Two days later, he initiated one of Navarro’s recommendations – the travel ban on visitors from China.