The Trump administration is under fire for its slow, sometimes incompetent, response to the outbreak of a novel coronavirus, “SARS-CoV-2”, which causes a disease named COVID-19. Though COVID-19 was first recognized in China in December 2019, President Trump’s priorities in the three years leading up to the outbreak put the U.S. at a distinct disadvantage to confront an outbreak that is already approaching a pandemic. Rather than emphasize expertise and experience, Trump has chosen loyalty and obedience in his subordinates. Instead of funding medical research and global disease prevention, Trump has directed billions of dollars to vanity projects and tax breaks for the wealthy.

700 vacancies at the CDC

Going back to the very start of the administration, on his second full day in office President Trump instituted a federal hiring freeze that stayed in place for nearly 90 days. Though officials tried to reassure the public that the freeze would not have a negative effect on the federal government – and was actually required to “counter the dramatic expansion of the federal workforce” – in the weeks after the freeze was lifted nearly 700 positions sat vacant at the Centers for Disease Control and Prevention (CDC). According to researchers and officials interviewed in May 2017, the freeze affected “programs supporting local and state public health emergency readiness, infectious disease control, and chronic disease prevention”:

Many of the unfilled jobs are high-level positions, at least GS-12 and above… Several positions are in the Office of Public Health Preparedness and Response, which regulates some of the world’s most dangerous bacteria and viruses and manages the nation’s stockpile of emergency medical countermeasures. Others include positions in the director’s office, infectious disease offices and the office for noncommunicable diseases, injury and environmental health.

Senior epidemic-response positions left unfilled

To make matters worse, the Trump administration took months to fill numerous senior positions that are critical to responding to an outbreak. A permanent Director of the CDC was not appointed until July 2017, six months after taking office, and the top position at the U.S. Agency for International Development (USAID) remained empty for nearly eight months. Second-in-command positions also remained empty across health-related agencies: Within the Department of Health and Human Services (HHS), there was no Assistant Secretary for Health for over a year, no Assistant Secretary for Preparedness and Response for eight months, and no Director of the Office of Global Affairs for five months. USAID just received its first permanent deputy administrator last year, in 2019!

Global health security teams disbanded

When Ebola broke out in West Africa in 2014, President Barack Obama responded by creating an “epidemic czar” with teams inside the National Security Council (NSC) and HHS to coordinate the operations of multiple U.S. government departments and agencies at home and overseas. These global health security teams stayed on through the transition to the Trump administration, until Trump ordered the NSC’s entire unit dissolved and its leader, Rear Adm. Tim Ziemer, reassigned in May 2018. Just one month earlier, then-National Security Advisor John Bolton forced Homeland Security Adviser Tom Bossert to resign along with his global health security team. Neither the NSC nor DHS teams have been replaced.

“Health security is very fragmented, with many different agencies,” said J. Stephen Morrison, senior vice president at the Center for Strategic and International Studies. “It means coordination and direction from the White House is terribly important. ”

Unprecedented National Security Council turnover

In addition to the dissolution of global health security units, the NSC has experienced unprecedented turnover during Trump’s administration. There have been four National Security Advisors (in addition to two acting NSAs) in Trump’s three years in office. This is compared to Barack Obama’s three NSAs in eight years and two in George W. Bush’s eight years. Trump has had five Deputy National Security Advisors in 3 years, while Obama had four in eight years and W. Bush had three in eight years. Trump has had four Homeland Security Advisors (plus one acting HSA) in three years compared to two in Obama’s eight years and four in W. Bush’s eight years.

The NSC played a crucial role in the Obama administration’s response to the Ebola virus outbreak. Former White House staffer Ned Price credits the council for the success of the administration’s response:

“The NSC is the only place at the fulcrum of foreign policy where you can also pull the levers of domestic policy. … What we found was that there was a degree of running in circles until the White House National Security Council staff began directing the effort.”

In the months leading up to and during the coronavirus outbreak, the Trump administration’s approach has been the opposite. Instead of turning to NSC experts for guidance and leadership, current National Security Advisor Robert O’Brien has focused on cutting their ranks by 30%. The move was spurred by the impeachment inquiry against President Trump, during which several current- and former-NSC staffers testified about his inappropriate and illegal conduct. In the aftermath of the trial, Trump has purged officials that are believed to be insufficiently loyal, risking having too few qualified people to meet the myriad security challenges facing the country – including global health challenges like COVID-19. In fact, of the roughly 115 policy specialists at the NSC, there are currently only two people who specialize in pandemics on staff.

CDC forced to downsize epidemic prevention

Due to a lack of funds, the CDC had to cut its epidemic prevention programs back by 80% in 2018, terminating its activities in 39 out of 49 countries. The programs were made possible by a one-time emergency package of $600 million from Congress in 2014 to respond to the Ebola epidemic. The Trump administration proposed moving $59 million from other global health programs at the agency instead of replenishing the account. A full replenishment would have required $120 million annually, without reducing the global health budget in other areas.

Accordingly, the CDC chose to focus on only ten countries, cutting epidemic prevention in 39 countries including China, the source of COVID-19, and the Democratic Republic of Congo, the center of the most recent Ebola outbreak.

Global health organizations said critical momentum will be lost if epidemic prevention funding is reduced, leaving the world unprepared for the next outbreak. The risks of deadly and costly pandemic threats are higher than ever, especially in low- and middle-income countries with the weakest public health systems, experts say. A rapid response by a country can mean the difference between an isolated outbreak and a global catastrophe. In less than 36 hours, infectious disease and pathogens can travel from a remote village to major cities on any continent to become a global crisis.

Reducing uniformed public health professionals

The U.S. Public Health Service Commissioned Corps (PHSCC) are federal uniformed health professionals who deploy both nationally and globally to assist in natural disasters like hurricanes, manmade emergencies like mass shootings, and disease outbreaks like Ebola and Zika. In 2018, the White House Office of Management and Budget released a plan to “streamline” federal government with massive personnel and budget cuts. The PHSCC was specifically targeted with a 40% minimum reduction of officers, from 6,500 to “no more than 4,000 officers.”

Congress has so far managed to block the Corps layoffs, but the administration has successfully prevented retiring officers from being replaced, resulting in a continual decline in personnel. Trump’s plan was so universally-panned that even the Heritage Foundation, a conservative think tank, published a piece opposing the idea.

Jim Currie, executive director of the Commissioned Officers Association of the U.S. Public Health Service, said the reductions would greatly affect the Corps’ ability to respond to disaster sites as it routinely does now. “I don’t quite understand the animosity toward the Commissioned Corps,” he said. “These folks are doing day jobs” — at the Centers for Disease Control and Prevention, National Institutes of Health and elsewhere within the government — “and when they’re needed, they go and deploy and work their butts off for 12 to 14 hours a day.”

End of U.S. aid to Palestinian refugees

For the fiscal year of 2018, the Trump administration drastically cut its contributions to the UN agency for Palestinian Refugees (UNRWA) by 83%, from $360 million to only $60 million. The funds are used to provide vital life-saving services, including vaccinations and health clinics, to 3.1 million stateless refugees in the Middle East. Such a large reduction of funding to an agency that depended on the U.S. for roughly a third of its budget caused the loss of hundreds of jobs.

Nowhere are the UNRWA cuts more acute than in the Gaza Strip, where about two million souls inhabit a tiny area twice the size of Washington, DC that few can gain permission to leave. There, UNRWA provides services to 1.3 million people, spending about 40 percent of its overall budget.

Trump told American Jewish leaders that he cut aid as a negotiation tactic: “What I will tell you is I stopped massive amounts of money that we were paying to the Palestinians and the Palestinian leaders…And I say, ‘You’ll get money, but we’re not paying until you make a deal. If you don’t make a deal, we’re not paying.’”

The following year, Trump completely eliminated U.S. funding for the UNRWA for fiscal year 2019 after complaining that the U.S. has received “no appreciation or respect” for its contributions. That decision may come to haunt both the U.S. and Israeli governments as the coronavirus spreads in the West Bank. On Match 3, 2020, the Palestinian Health Ministry declared a state of emergency in Bethlehem and Jericho due to numerous suspected COVID-19 cases. As readers may suspect, viruses do not respect ideological or political boundaries – in the Israeli/Palestinian ecosystem, everyone is fair game to COVID-19.

Collapse of zoonotic virus detection program

Since 2009, the United States Agency for International Development has run a program to detect and discover zoonotic diseases called PREDICT. All coronaviruses are zoonotic, meaning the disease is transmitted from animals to people, though it is not yet known which animal population COVID-19 originated from. The PREDICT program may have been useful in identifying the virus from within the source species before it jumped to humans… however, the Trump administration shut down its activities in 2019.

Dennis Carroll, the former director of USAID’s emerging threats division who helped design and oversaw the operation of PREDICT, told the New York Times that the Obama and Bush administrations were “enormously supportive” of the program, but under Trump “things got complicated.”

The end of the program “is definitely a loss,” said Peter Daszak, president of the EcoHealth Alliance, a nonprofit global health organization that received funding from the program. “Predict was an approach to heading off pandemics, instead of sitting there waiting for them to emerge and then mobilizing. That’s expensive.”

War on science decimates ranks and sends morale plummeting

The Trump administration’s focus on cutting costs through eliminating programs and terminating employees has taken a harsh toll on the ranks of scientists whose work informs government policy. In Trump’s first two years in office, over 1,600 federal scientists left government – a 1.5% drop compared with the 8% increase during Obama’s first two years. Many of these scientists voluntarily resigned due to the undervalued and diminished role of science reflected in administration policies.

A 2018 survey conducted by the Union of Concerned Scientists of more than 63,000 scientific experts employed by the federal government found that across all agencies, the majority of federal scientists reported low morale, decreased job effectiveness, and decreased job satisfaction. At the CDC specifically, 48% of respondents agreed that “political interests hindered the ability of their [agency] to make science-based decisions.” One respondent at the CDC had the following to say:

“Proposed funding cuts limits our [agency’s] capacity for responding to infectious disease overseas and domestically. These cuts don’t just affect our ability to prepare and respond at a federal level either. These will disproportionally affect smaller state and local health departments and grant funded programs.”

Amidst this exodus of scientists, Trump has left gaping holes in the leadership posts. In George W. Bush’s first three in office, 68 scientific leadership positions were filled with only three vacancies. Obama appointed experts to all 79 positions during his first three years. In comparison, Trump filled just 44 positions, with 39 vacancies in scientific leadership positions remaining at the end of his third year in office.

A loss of senior scientists means a downgrading of expertise, institutional knowledge, and perhaps even entire programs and areas of work led by those scientists. This is the science that helps us identify, understand and deal with existing risks, as we anticipate future, unknown risks.

To make the situation worse, last year President Trump signed an executive order requiring that all federal agencies cut the number of government advisory committees by a third. These panels are made up of outside scholars and specialists who come together to form a wellspring of knowledge and expertise that typical political officials often lack. Their loss not only impairs informed policy decisions, but also undermines the credibility of the government’s actions.

“For the past two years they have been shrinking and restricting the role of federal science advisory committees,” said Gretchen Goldman, research director for the Center for Science and Democracy at the Union of Concerned Scientists. “Now they’re removing the possibility of even making decisions based on robust science advice. It’s no longer death by a thousand cuts. It’s taking a knife to the jugular.”

Repeated budget cuts to health-related programs every year

In spite of the crucial role played by agencies like the CDC, NIH, and WHO, President Trump has consistently cut their funding in his annual proposed budgets. Luckily for all of us, Congress has rejected most of these cuts and mitigated others, minimizing the impact of Trump’s intended budget reductions. Nevertheless, it is instructive to look at the programs Trump wants to impair because it illustrates where his priorities lie.

As will be made clear, President Trump systematically defunds agencies that protect national and global health, at times succeeding in curtailing critical health security agenda.

CDC

The Centers for Disease Control and Prevention (CDC) is the leading national agency for the research, detection, and prevention of infectious diseases like COVID-19. The CDC also works with other organizations around the world to surveil and treat illness, working to contain disease threats at their source.

For the fiscal year (FY) 2018, President Trump’s first budget slashed $1.209 billion (16.8%) from the CDC’s total budget (Graph 1). For FY 2019, he wanted to cut $1.360 billion (19.4%) and in FY 2020 he proposed a $750.5 million (10.3%) reduction Trump’s most recent budget proposal, released in the middle of the coronavirus outbreak – a month after the first death in China and 11 days after the World Health Organization declared the outbreak a public health emergency of international concerns – featured a $693.2 million (9%) reduction in the CDC’s total budget (note, the Washington Post has identified a 16% decrease but it is not clear which programs this is based on).

Looking at the specific programs most relevant to the COVID-19 outbreak, the president has recommended over $177 million in cuts across the past four budgets to the CDC’s Global Health division, averaging nearly $44.3 million in cuts annually (Graph 2). As the division’s website states, “a disease threat anywhere is a disease threat everywhere.” In addition to the previously mentioned cuts to epidemic prevention in 49 countries to only 10, Trump’s repeated global health funding reductions weaken the CDC’s ability to detect and contain international disease threats at their source.

Similarly, Trump has also recommended slashing $313 million from the CDC’s Emerging and Zoonotic Infectious Diseases program over the past four fiscal years – an average of $78.2 million proposed cuts annually (Graph 3). Like Ebola and Zika, COVID-19 is a zoonotic disease, originating in an unknown animal population. His most recent budget, released amidst the coronavirus outbreak, proposed a 13% cut the emerging and zoonotic diseases programs.

Once a disease reaches the U.S., the CDC is on the front lines of the response effort. Public health officials work tirelessly to train staff, prepare plans of action, and guide communities through all public health emergencies. The importance of their work is undermined by President Trump’s attempted budget cuts to the CDC’s public health and preparedness divisions: across the four budgets submitted since taking office, Trump has recommended cutting $150.5 million (average $37.6 million a year) from the Public Health Scientific Services (Graph 4) and over $787 million (average $197.8 million a year) from Public Health Preparedness and Response (PHPR) programs (Graph 5). As you can see in Graph 5, Trump’s FY 2019 proposed cuts to PHPR programs were accepted by Congress, setting a trend for the next two years of lower funding.

Last month, the Department of Health and Human Services told Congress that the CDC was already running out of money set aside for emergency public-health responses in the FY 2020 budget. The emergency account, called the infectious disease response reserve fund, was created by Congress in 2018. In his most recent proposal, released last month, Trump recommended reducing funding for the program by 43%, slashing $35 million.

Experts at the CDC’s immunization and respiratory diseases division are responsible for the testing of and immunization against infectious diseases such as COVID-19. Across his four proposed budgets, Trump has attempted to cut nearly $154 million from its programs, averaging to $38.4 million proposed cuts annually (Graph 6). The president’s FY 2021 budget added $40 million to the division’s influenza planning and response activities, but this addition is offset by the numerous other reductions to companion programs.

National Institutes of Health

The Trump administration has also consistently proposed cuts to the National Institutes of Health (NIH), which is the nation’s premier medical research agency. A top member of the president’s coronavirus task force, Dr. Anthony Fauci, is the director of the National Institute of Allergy and Infectious Diseases (NIAID), a division within NIH. NIAID is currently conducting and funding critical research to find a treatment and a vaccine for COVID-19.

Trump’s first budget, for FY 2018, proposed a $7.7 billion (22%) cut. $72 million was sourced from the complete elimination of the biomedical research and training Fogarty International Center. Fortunately, Congress did not give Trump’s suggestion any weight, instead adding a million dollars to the Center’s 2017 funding level. Congress additionally increased each NIH division’s funding by at least 5% compared to 2017 levels.

Christine Lubinski, vice president of the Infectious Diseases Society of America, said the work the Fogarty center funds was necessary to help predict and contain epidemics, and called on the global health community to defend it. “This vital, lifesaving, modestly funded program has been earmarked for elimination … to preserve Fogarty is a vital public and global resource,” she said.

The president’s FY 2019 budget originally recommended slashing $5.8 billion (~18%) from the NIH budget and proposed paying grant recipients less money for their research. Congress intervened, striking a deal that resulted in only a $2 billion (~5%) cut in funds from FY 2018 levels. For FY 2020, our current operating year, Trump wanted to reduce NIH funding by $4.9 billion or 12.6%. This included a $769 million (13.9%) cut to the NIAID budget.

Finally, the most recent budget proposed by the White House in the midst of the coronavirus outbreak suggested a $2.6 billion (6.5%) reduction to NIH funding, including a $430 million (7.3%) cut to NIAID.

FEMA

Last week it was reported that the Federal Emergency Management Agency (FEMA) is preparing for the possibility that Trump could declare an “infectious disease emergency declaration” to assist in the administration’s coronavirus response effort. Such a declaration allows FEMA to utilize the Disaster Relief Fund to bring in additional funds and personnel at all levels – assisting the CDC, HHS, state, local, and tribal governments.

However, in the past, Trump has not placed a priority on funding FEMA and has in fact taken tens of millions of dollars from the agency to fund his pet projects. In 2018, Trump ordered nearly $10 million taken from FEMA’s budget and transferred to fund U.S. Immigration and Customs Enforcement (ICE). The move was roundly criticized by Democratic lawmakers:

“This is yet another example of the Trump administration’s outrageously misplaced homeland security priorities. We have a president who cares more about locking up families seeking asylum and putting kids in cages than ensuring FEMA has every resource necessary to prepare for and respond to disasters,” Mississippi Rep. Bennie Thompson, ranking member of the [House Homeland Security] committee, said in a statement Wednesday.

Last year, Trump again took funding from FEMA to instead support ICE activities: The Department of Homeland Security alerted Congress in July that the administration was diverting $155 million from FEMA’s disaster relief fund to pay for additional immigrant detention beds temporary hearing locations for asylum-seekers who have been forced to wait in Mexico. “Once again, this administration is endangering America by moving funds away from emergency management for their extremist border agenda,” Sen. Jeff Merkley (D-OR) said.

Most recently, the president’s proposed FY 2021 budget cuts $535 million from FEMA. Continuing past trends, Trump requests billions of dollars for ICE and Customs and Border Patrol instead, including $2 billion for new border fencing.

Foreign aid: USAID, U.N., and WHO

Organizations that provide aid to the international community contribute to the prevention of the spread of disease through increased access to health resources, improved sanity conditions, training for local medical personnel, and funding for research in far-flung corners of the globe.

Trump’s budget for FY 2021, released last month, proposed cutting the US Agency for International Development (USAID) budget by $2.3 billion and the State Department’s foreign aid budget by $2 billion. All programs combined, the president recommended a 22% decrease to foreign aid.

Last year, the administration froze all remaining foreign aid funds in the State Department and USAID accounts, preventing the agencies from distributing an estimated $2 billion. The freeze – which included areas of global health funding – was denounced by lawmakers as “contempt for Congress.” The administration planned on re-designating the funds for projects it considered more important, but faced with public backlash the Office of Management and Budget released the hold 10 days later.

Also slashed in Trump’s FY 2021 proposal: $58 million from the World Health Organization, a whopping 47% decrease.

“This is precisely the wrong time to be cutting funds to the World Health Organization, which is on the front lines of tackling the coronavirus epidemic and trying to keep it from spreading wildly to other countries,” Peter Yeo, the president of the Better World Campaign, told Foreign Policy, who expects the proposed cuts to be rejected by Congress. “It is out of synch with the front-line realities of our foreign policy and national security.”

Continuous attacks on healthcare at home

As the coronavirus spreads through the nation, Americans will rely on our medical infrastructure for testing and treatment. Despite repeatedly proclaiming that he has no intention of cutting Medicare and Medicaid, President Trump’s FY 2021 budget would cut $465 billion from Medicare providers such as hospitals and take $700 billion out of Medicaid over a decade.

Meanwhile, Trump is just beginning to grasp that hospitals and doctors will need assistance to be able to care for people infected with the novel coronavirus. He is reportedly “considering” using the National Disaster Medical System reimbursement program to pay medical providers to care for uninsured patients.

Under Obama’s administration, the Affordable Care Act brought the number of uninsured Americans to historic lows. At the program’s inception, 46.5 million (17.8%) people did not have health insurance. By 2016, the uninsured rate dropped dramatically to 26.7 million (10.0%). The decline was brought to an abrupt end when the Republican-controlled House, Senate, and executive office began to dismantle the program, causing the uninsured rate to rise in 2017 – the first increase in uninsured since the ACA took effect in 2010. The Congressional Budget Office projects that the number of uninsured will continue to increase, predicting 7 million more people without insurance by 2021.

With an epidemic – on the verge of being declared a pandemic – rapidly spreading through the country, the financial cost of seeking testing, treatment, and quarantine should not be a burden to the population. The Trump administration is now covering the cost of testing for Medicaid and Medicare patients, but tests conducted at academic or commercial facilities may still come with a charge. Last month, a Florida man was charged $3,270 for a coronavirus test at Jackson Memorial Hospital. According to the Miami Herald, he had purchased a “junk plan” through the ACA insurance marketplace after Trump rolled back regulations in 2018:

“When someone has flu-like symptoms, you want them to seek medical care,” said Sabrina Corlette, a Georgetown University professor and co-director of the Center on Health Insurance Reforms. “If they have one of these junk plans and they know they might be on the hook for more than they can afford to seek that care, a lot of them just won’t, and that is a public health concern.”

Quarantine and treatment can impose additional costs, even with insurance. Last month, a man in Pennsylvania received $3,918 in bills for 2-weeks of mandatory quarantine. He ultimately tested negative for the virus, which was a good thing considering the average day in a U.S. hospital costs $4,293, compared with $1,308 in Australia and $481 in Spain. “The hospital stays may be especially costly for patients without health insurance or for those who have large deductibles, which they must pay before their health benefits kick in,” the New York Times points out. In the past decade, the average deductible for a single person with employer insurance has increased 162%, from $533 in 2009 to $1,396 last year. The average deductible for the lower monthly cost plans in the ACA marketplace was $5,861 last year.

Trump’s current priorities

As should be clear by now, the president has spent his entire time in office sabotaging the infrastructure designed to protect us from pandemic threats. Faced with COVID-19, Trump has proven that he is more concerned about creating the appearance that the outbreak is under control than he is about actually getting it under control.

While visiting the CDC last week – wearing his campaign’s Keep America Great hat – the President of the United States said that he’d rather have passengers aboard the Grand Princess cruise ship remain on the boat offshore in order to keep the confirmed cases artificially low. “I don’t need to have the numbers double because of one ship that wasn’t our fault,” he said. Though officials only tested 46 passengers, 21 of them were positive for the virus. Trump’s admission means that he would rather condemn hundreds of other passengers to also catch the virus – and possibly die from it – rather than add to the number of cases in the U.S.

Since the start of the outbreak in America, Trump has been preoccupied with the number of cases of coronavirus, even calling the rate of death reported by the World Health Organization “a false number.” Last month, Trump claimed that 15 cases “within a couple of days is going to be down close to zero.” Just minutes earlier, at the same press conference, CDC Principal Deputy Director Anne Schuchat said more coronavirus cases were expected.

A leading factor in the low number of confirmed cases is the administration’s failure to test people for the disease. Last month, the CDC sent out faulty test kits to state labs, hobbling the government’s response from the beginning. Instead of widespread testing of anyone with symptoms, the government also limited testing to people who have traveled to infected areas like China and Iran. Lacking supplies to test for the virus and under orders to test a narrow set of people has given the virus a head start to spread undetected. And, conveniently for Trump, has resulted in an artificially low number of COVID-19 cases in the U.S.

Trump has repeatedly contradicted his own experts on everything from logistics to the mindset Americans should have. On Friday, Trump told reporters “anyone who wants a test, can get a test.” Just one day earlier, Vice President Pence, the head of Trump’s coronavirus task force, told reporters that “we don’t have enough tests today to meet what we anticipate will be the demand going forward.” Whereas Trump told the press that Americans should “view this the same as the flu,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told Congress that COVID-19 will cause a mortality rate “multiple times” higher than the seasonal flu.

The Executive Office for Immigration Review recently ordered that all CDC informational posters be removed from immigration courts across the country, according to the National Association of Immigration Judges. These posters, pictured below, inform staff, visitors, and immigrants about the best practices to slow the spread of coronavirus.

Experts and officials inside the administration blame Trump for the botched response:

“They’ve simply lost time they can’t make up. You can’t get back six weeks of blindness,” said Jeremy Konyndyk, who oversaw the international response to Ebola during the Obama administration and is a senior policy fellow at the Center for Global Development. “To the extent that there’s someone to blame here, the blame is on poor, chaotic management from the White House and failure to acknowledge the big picture.” (WaPo) “It always ladders to the top,” said one person helping advise the administration’s response, who noted that Trump’s aides discouraged Azar from briefing the president about the coronavirus threat back in January. “Trump’s created an atmosphere where the judgment of his staff is that he shouldn’t need to know these things.” (Politico)

As usual, Trump has avoided responsibility for his own government’s actions, falsely blaming President Obama for somehow slowing diagnostic testing and claiming that the Democrats are at fault for the bad press surrounding his response to the outbreak: “The Democrats are politicizing the coronavirus… They tried the impeachment hoax that was on a perfect conversation. This is their new hoax,” he said, referring to the coronavirus.

Facts are inescapable, however. No matter how many lies and how much misinformation Trump pushes, he cannot change his past actions: The president has repeatedly attempted to cut critical funding and personnel for programs necessary to prevent a pandemic – sometimes succeeding – and has undermined the government’s outbreak response at every given opportunity. In my opinion, this amounts to sabotage: intentionally damaging the nation’s epidemic prevention and control infrastructure, ignoring “inconvenient” warnings from scientists and experts. Officials have known for over a year that our nation is not prepared for a global pandemic and, yet, the administration continues to hide information: The Director of National Intelligence (DNI) has postponed a Worldwide Threat Assessment briefing because, like last year’s report, it contains the following warning:

“The United States will remain vulnerable to the next flu pandemic or large-scale 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.”

The worst aspects of Trump’s presidency have culminated in this moment, proving once and for all that an incompetent and narcissistic leader with autocratic-tendencies is not fit to be president of the United States.

Unfortunately, things will get worse before they get better. November can’t get here quick enough.

Update 3/14/2020: Since publishing, we have learned more unfortunate details about just how unprepared we are for this pandemic: