The coronavirus spreading across the United States has exposed a deep and pervasive failure to plan for what experts and former government officials have warned of for years, the prospect of a global pandemic that threatens to overwhelm health systems and kill millions.

Instead, two months after the first American tested positive and as the number of confirmed cases inside the country soars past 10,000, a decentralized governmental response has been scattered and uneven, a mix of action and inaction, urgency and passivity.

The federalist nature of American democracy means the response to any disaster will vary based on the competency of state and local officials. It will not look like China, for better and for worse.

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“We're a decentralized public health system,” said Janet Baseman, an epidemiologist and associate dean of the School of Public Health at the University of Washington. “We're not set up to do anything like the centralized, organized lock down that China did.”

Mistakes and inaction by some leaders, even after it was clear the coronavirus would spread deeply into the nation, could cost thousands of lives and trillions of dollars, say experts closely following the U.S. response.

The mixed messages start at the very top, where President Trump Donald John TrumpUS reimposes UN sanctions on Iran amid increasing tensions Jeff Flake: Republicans 'should hold the same position' on SCOTUS vacancy as 2016 Trump supporters chant 'Fill that seat' at North Carolina rally MORE spent months downplaying the threat posed by the virus before claiming Tuesday that he had always seen it as a pandemic.

If so, public health experts ask why weeks were wasted without stocking up on supplies and preparing the public. Trump continues to say the virus will be swept away as his own advisers say the worst is yet to come.

“What we have seen out of the Trump administration is a persistent desire to downplay,” said Jeremy Konyndyk, a senior fellow at the Center for Global Development who ran the U.S. Agency for International Development's Office of Foreign Disaster Assistance during the 2014-2015 Ebola outbreak in West Africa. “There is no credible way to say that we didn't see this sort of event coming.”

On Thursday, Trump accused reporters of siding with China while he insisted, contrary to all evidence, that earlier problems with a lack of tests for the virus had been solved.

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“I'm hearing very good things on the ground,” Trump said.

“We were very prepared,” he added.

But interviews with those who are on the ground, and with experts who have been on the ground in past outbreaks, show an unprepared government that did not heed its own warnings about what is likely the largest public health crisis in a hundred years.

“This global level concern is really unprecedented since the 1918 flu,” said Joseph Eisenberg, who chairs the epidemiology department at the University of Michigan's School of Public Health. “In modern times, this seems pretty unique.”

Across the nation, hospitals are running low on personal protective equipment, on ventilators and respirators for patients who experience the most severe symptoms, and on money they need to keep their doors open. State and local governments are scrambling to build capacity so that patients are not denied care, scrambling to secure the necessary supplies and make up for a decade of funding cuts to health agencies.

In some cases, the response has exposed the painfully inadequate state of the public health system. The Centers for Disease Control and Prevention's failed tests and a persistent lag in building testing capacity will stand as a singular failure, a setback suffered by no other country in the world.

On Wednesday, public health agencies, hospitals and private laboratories tested about 20,000 people for the coronavirus, a fraction of the number of tests being conducted in South Korea on a daily basis. New York began making its own hand sanitizer, while Virginia and schools like the University of Washington and the University of Michigan began developing their own tests for the virus. The NBA suspended play without any direction from the federal government.

There are smaller signs of the chronic unpreparedness of the nation's health infrastructure.

New York City Mayor Bill de Blasio Bill de BlasioNew York to honor Ginsburg with statue in Brooklyn The Hill's Morning Report - Sponsored by The Air Line Pilots Association - White House moves closer to Pelosi on virus relief bill New York again pushes back in-person classes MORE (D) on Thursday reached out to Elon Musk Elon Reeve MuskThe pandemic showed states that businesses don't need special favors Would becoming one of the first people to settle Mars be worth dying for? Hillicon Valley: Twitter flags Trump campaign tweet of Biden clip as manipulated media | Democrats demand in-person election security briefings resume | Proposed rules to protect power grid raise concerns MORE, the founder of Tesla and SpaceX, to help backfill a shortage of ventilators, because the government has neither the stockpile nor the capacity to create a stockpile.

Governors of New York and Washington cheered when Trump announced he would send two massive hospital ships their way, only to find that both ships are undergoing routine maintenance.

Florida Gov. Ron DeSantis Ron DeSantisKey swing-state election lawsuits could help shape the presidential race First death reported from Hurricane Sally in Alabama Trump tells Gulf Coast residents to prepare for 'extremely dangerous' Hurricane Sally MORE (R) said Tuesday he would not close his state's beaches to spring break revelers, while Missouri Gov. Mike Parson (R) said on a St. Louis radio show that there was little government could do to fix things, a day before he declared a state of emergency and five days before he ordered schools and casinos to close.

Alarming reports of warnings unheeded have trickled out of government offices, too.

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The Obama administration walked incoming Trump administration officials through a hypothetical pandemic scenario just before inauguration day in 2016.

The Health and Human Services Department ran a massive war game that involved a respiratory virus spreading around the world from an epicenter in China that ended only last August, The New York Times reported Thursday; the only thing the exercise got wrong in predicting the coronavirus is that they guessed it would land in Chicago and not Seattle.

Trump said Wednesday he would invoke the Defense Production Act, which would allow the administration to use American industry to manufacture critical supplies. But he has yet to actually use it to get production lines rolling. Instead, Trump focused on how the virus started in China, a move seemed to shift focus to areas were he feels more comfortable.

“I only signed the Defense Production Act to combat the Chinese Virus should we need to invoke it in a worst case scenario in the future. Hopefully there will be no need, but we are all in this TOGETHER!” Trump tweeted Wednesday.

Without a sufficient testing capacity, with no treatment that works to combat the virus and with a vaccine a year away under the best circumstances, Americans are left to engage in increasingly strict social distancing practices that take further harm on the economy.

The divergent paths the nation faces depends on how well those practices work.

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In South Korea, Singapore and Taiwan, governments aggressively tested tens of thousands of people per day and isolated anyone who might spread the virus. Those countries seem to have flattened the curve of their coronavirus cases.

In Italy, the health system is so overwhelmed that doctors are making gut-wrenching decisions about who gets treated and who does not. Obituary sections are dozens of pages long.

“It's all going to be a function of how well these measures work. With Italy, they realized it a little too late. I don't feel like it's too late,” Baseman, of the University of Washington, said. She worried Americans do not yet understand just what is at stake: “Somehow people are not processing the gravity of the situation, and that is what happened in Italy.”

The coronavirus itself poses such a unique danger because of the ease with which it transmits from one person to another. That makes it even more crucial that governments move with haste and determination to stop its spread.

“Be fast. Have no regrets. You must be the first mover. The virus will always get you if you don't move quickly,” Mike Ryan, executive director of the World Health Organization's health emergencies program, said at a press conference this week.

“If you need to be right before you move, you will never win. Perfection is the enemy of the good when it comes to emergency management. Speed trumps perfection. And the problem we have in society we have at the moment is everyone is afraid of making a mistake. Everyone is afraid of the consequence of error. But the greatest error is not to move. The greatest error is to be paralyzed by the fear of failure.”

Two months after the first case of coronavirus landed on American shores, many doubt Ryan’s lesson has reached American ears.