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The Trump administration has also downplayed global health threats through structural changes within the White House’s national-security architecture. It downgraded the role of homeland security adviser so that it didn’t report directly to the president after Monaco’s successor, Tom Bossert, was dismissed in 2018. (Bossert was an advocate of developing a biodefense strategy for addressing biological attacks and pandemic diseases like influenza.) That same year, it closed a pandemic-response unit that the Obama administration had created after the Ebola outbreak, folding some of the remnants into other NSC directorates. Tim Morrison, who led the resulting counterproliferation and biodefense office before leaving the administration in 2019, has argued that the shake-up was an effort to reduce “bloat” at the NSC. But the consequences were serious: When the novel coronavirus first broke out, there were no senior administration officials focused solely on combatting such threats and coordinating global health security policy across agencies.

Monaco said that the Trump administration and its predecessors did not do enough to fund America’s public-health infrastructure, which in the coming weeks is at risk of being “overwhelmed by the onslaught” of cases of COVID-19, the disease caused by the coronavirus.

“I’m not saying that having that structure in place means that the coronavirus wouldn’t have happened or wouldn’t have arrived here,” Monaco clarified. But “back in December, when we first saw [the coronavirus emerge], who was asking, ‘Do we have sufficient tests?’ Who was asking, ‘Do we have sufficient personal protective equipment if this gets here and gets here at scale?’ Who was asking, ‘What is our public-health capacity, and let’s model this out. If this really spreads, how many ICU beds are we going to need?’ Who’s developing that list of questions and getting them answered? That’s got to happen at the White House to really bring all of the government to bear.”

When I spoke with Toner last Thursday (what admittedly seems like an eternity ago at the pace of this crisis), he said that “it’s clear that the administration through its actions did not prioritize public-health preparedness until last week or so,” and that this is not the kind of crisis that can be prepared for in a week—not even the couple months that Trump administration officials claim they lost because China wasn’t initially forthcoming about the virus. Pandemics move at lightning speed, but pandemic preparedness is measured in years.

When the virus was first detected in China, Toner told me, a more prepared U.S. government would have immediately begun bracing for the “inevitable arrival of the disease” by bolstering hospitals and helping state and local governments implement the social-distancing and other mitigation measures they are now scrambling to put in place. “It would have been much easier to do those things with more time than we have now,” he explained.

The irony is that this is all occurring in a country, the United States, that for decades “has been a leader in pandemic preparedness,” Toner said. “We were better prepared than others,” he acknowledged, “but no one, no country, is prepared for what we’re seeing now.”

Just as the spread of the coronavirus is a function of human nature, so too is humanity’s capacity to be caught unprepared for it—despite warning after warning after warning that we would live to regret it.

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