数万人死亡。数百万人被感染。经济陷入瘫痪。我们是怎么到这里的?
去年年底,当新型冠状病毒在中国武汉爆发时,很少有人能想象它的破坏力有多强。这种病毒跨越了国界和海洋,最终在美国蔓延开来,并永远改变了那些被它感染的人的生活。
现在,几个月后,一项广泛的美国广播公司新闻调查通过广泛采访当前和以前的公共卫生和国家安全官员。
他们共同的声音讲述了一个病毒感染的故事领导力差距这让数百万美国人变得脆弱。
以下是美国广播公司新闻调查的五个关键要点:
《赤色黎明》:一群前官员敲响了警钟。他们听到了吗?
今年1月和2月,随着新生的冠状病毒从爆发到流行再到大流行,一群前公共卫生和国家安全官员私下鼓励特朗普政府的官员注意即将到来的灾难的警告。他们中的一些人曾帮助起草一套所谓的“大流行剧本”,以帮助指导统一的联邦应对措施。
曾在布什政府和奥巴马政府期间担任国家安全委员会(NSC)官员的詹姆斯·劳勒(James Lawler)博士专门从事大流行防范工作,他说,这是一个“严肃的群体”,“许多人对大流行有着长期的思考。”
在这张2020年2月6日的照片中,詹姆斯·劳勒博士参加了内布拉斯加州奥马哈市内布拉斯加大学医学中心的新闻发布会
至少对他们来说,威胁的严重性显而易见。
劳勒告诉美国广播公司新闻:“我们的各个小组,看着这些东西,给对方的游戏,我们听到了什么,我们看到了什么。”“很明显,在1月初,这有可能成为一个严重的全球性事件。”
他们在一封长长的电子邮件中交换了关切和想法,他们称之为“赤色黎明崛起”——指的是冷战时期的一部同名电影,在这部电影中,一群美国人努力击退苏联入侵者。事后看来,他们提出的担忧似乎是预言性的。
这一群专家对总统似乎有意淡化疾病的威胁感到沮丧,他们中的六人接受了美国广播公司新闻采访,其中许多人是第一次公开采访。他们向政府高级官员,包括国防部、国土安全部、退伍军人事务部以及卫生和公众服务部的高级医疗顾问,表达了他们的真实想法。
弗吉尼亚的生物安全和灾难应对专家丹·汉弗里博士在接受美国广播公司采访时表示:“总统开始说,没人能想象这样的事情会真的发生。”“事实是,我们当中有一群人一直在试图拉响警报。”
2020年6月30日,在华盛顿DC国会山举行的参议院健康、教育、劳工和养老金委员会听证会上,美国国家过敏和传染病研究所所长安东尼·福西博士作证。
在危机前夕,一个大流行准备办公室被取消了
白宫国家安全委员会曾经设立了一个流行病防范部门,负责监控对美国安全的生物威胁。
它的解散——不到一年前,新型冠状病毒首次在中国出现——已经成为总统批评者的素材。
该办公室的历史可以追溯到2015年,当时被派去协调奥巴马政府应对埃博拉疫情的罗恩·克莱恩(Ron Klain)建议在国家安全委员会留下一个永久性职位,负责应对大流行的准备工作。奥巴马同意了,白宫国家安全委员会全球健康安全和生物防御局诞生了。
然后约翰·博尔顿执掌特朗普总统的第三任国家安全顾问。博尔顿急于撼动国家安全官僚机构并缩减员工规模,因此在2018年解散了该办公室。
伊丽莎白·诺伊曼(Elizabeth Neumann)说:“我的理解是,他们试图缩小国家安全委员会(National Security Council)的规模,对于为什么这是一件好事,有很多理由。”直到最近,她还担任特朗普政府负责威胁预防和安全政策的助理国土安全部部长。“也就是说,国家安全委员会在危机和机构间协调方面发挥着非常重要的作用。”
一位政府高级官员否认了博尔顿和特朗普解散该办公室的说法,他告诉美国广播公司新闻,该办公室的工作被国家安全委员会其他部门吸收,以“优化对基本重叠领域的挑战的应对能力。”这位官员补充道,在重组过程中,“没有任何与大流行防范相关的职位被取消。”
博尔顿回应了政府官员的否认,坚称该办公室的解散只不过是国家安全委员会的“精简”,但批评者强烈认为,博尔顿的决定妨碍了联邦政府有效应对新型冠状病毒的能力,因为它取消了一个协调办公室,并发出了大流行防范不是优先事项的信号。
汉弗莱告诉美国广播公司新闻:“我演奏音乐。”“有人领导,有人实际上在发出变革的信号,并计算时间等等,这非常有帮助,我认为这就是那个办公室应该提供的。”
“现在回想起来,”他说,“不是什么了不起的举动。
2020年7月8日,美国疾病控制和预防中心主任罗伯特·雷德菲尔德在华盛顿特区教育部举行的白宫冠状病毒特别工作组简报会上发言。
失去的时间:在早期行动后,机会被浪费了
专家表示,联邦政府反应迟缓以及缺乏外国同行的合作,阻碍了国家为大流行做准备的能力。
疾病控制和预防中心主任罗伯特·雷德菲尔德说,尽管疾病控制和预防中心提供了帮助,但中国中央政府拒绝美国的帮助,这是美国科学派在危机早期了解病毒的一个错失的机会。
“我认为这是不幸的,”雷德菲尔德告诉美国广播公司新闻。“如果我们能在1月的头几周帮助中国,我想今天的情况会有所不同。…我们有大约20到30个人准备进去帮忙,然后被告知,“退下。”是啊,真让人沮丧。"
美国最高传染病专家安东尼·福奇博士告诉美国广播公司新闻,中国政府拒绝向美国科学家提供真实病毒的样本,这导致了对病毒在人与人之间传播速度的理解的又一次重大延迟。福奇说,当华盛顿州的疫情表明病毒是通过人类接触传播时,社区传播已经取得了显著进展。
福西告诉美国广播公司新闻:“这不是你知道一切,你将知道从第一天。”“社区传播的阴险之处在于……你不知道谁在感染谁。一旦发生这种情况,那就是我们有一个真正严重问题的危险信号。就在那时,我们开始意识到第一次社区传播与一个可识别的来源无关。现在我们看到了爆炸。这正是在纽约、芝加哥和新奥尔良所发生的事情,而现在,正如你和我所说的,在南方几个州也在发生。”
伊丽莎白·诺伊曼(Elizabeth Neumann)说,一旦公共卫生官员发现这种传染病具有潜在的灾难性,他们面临的挑战是立即采取行动,让领导层和公众站在同一战线上。她在4月份之前一直担任国土安全部负责威胁预防和安全政策的助理部长。
纽曼告诉美国广播公司新闻:“当你是一个应急管理专业人员,你不断平衡不想成为鸡小。”“‘天塌下来了,天塌下来了’然后什么都没发生,下一次你不得不说天要塌了,没人相信你。"
“所以总是有一种紧张,”诺伊曼说,“试图清楚地与公众沟通,清楚地与领导沟通,什么是关注,什么是潜在的灾难的可能性。”
战略、政策和计划办公室负责威胁预防和安全政策的助理国土安全部部长伊丽莎白·诺伊曼于2019年9月24日在DC国会山作证。
特朗普总统的前国土安全顾问、美国广播公司(ABC News)撰稿人汤姆博斯特(Tom Bossert)表示,在有确凿证据证明社区传播之前,坚持采取遏制措施是在关键的最初几个月犯下的“连续错误”,因为有症状和无症状的传染性人群“在任何给定的时间在任何社区走动,不仅公共卫生部门不知道,病人也不知道。”
“一旦流行率达到1%或更高,”Bossert说,“人类的非药物干预就很难控制它。”
不充分的测试蒙蔽了领导者
直到四月,美国远远落在后面许多其他国家也在进行测试,尽管社区传播在全国和世界各地都在积极进行。
Klain告诉ABC新闻:“就像任何威胁一样,如果你不知道它在哪里,你就无法对抗它。”
被特朗普总统任命监督冠状病毒检测的美国最高卫生官员、助理卫生部长布雷特·吉尔洛对美国广播公司新闻说,政府不准备加强对冠状病毒的检测大流行早期的测试工作因为测试用品不是国家储备的一部分。
吉尔洛告诉美国广播公司新闻:“当我看到那里有什么,那里什么也没有。”“我们不知道涉及哪些行业。我们需要这些叫做棉签的奇怪东西。谁做棉签?”
根据疾病预防控制中心主任雷德菲尔德的说法,在冠状病毒危机的早期,由于过去经历过非典和市场反应综合症,公司很少进行检测。他说,因为这些疾病从未广泛传播,私人实验室发现测试没有使用。
雷德菲尔德告诉美国广播公司新闻:“当他们开发的测试没有市场的测试。”
2017年9月8日,美国国土安全部美国总统唐纳德·特朗普的助理汤姆·博塞特在华盛顿白宫新闻发布会上发表讲话。
但是总统的批评者说,政府应该很快利用国防生产法案来促进早期的测试工作现在正在实施就像一些州和私人实验室一样再次面对测试短缺、供应问题以及测试结果的周转时间明显滞后,这种大流行已经持续了将近半年,尽管联邦政府和全国各州都已显著加大了测试力度。
美国食品和药物管理局委员、白宫冠状病毒特别工作组成员斯蒂芬·哈恩将目前的检测短缺归因于需求的增加,因为检测向无症状人群开放。
哈恩告诉美国广播公司新闻:“我认为这是一个合理的公共卫生战略,我们已经这样做了。”“我们在美国食品和药物管理局的工作是说,‘好吧,下一代测试在哪里,这样我们就可以每月增加数千万个测试?’幸运的是,这正在发生。"
但是包括加利福尼亚在内的几个州最近又开始优先考虑有症状的病人。前纽约市卫生专员玛丽·巴塞特博士告诉美国广播公司新闻,检测结果的周转时间滞后——在某些地方长达一周——是“不可接受的。”
监督纽约市埃博拉应对工作的巴塞特说:“它把所有传染病的公共卫生预防策略搞得一团糟。”“你必须迅速扭转局面。”
2020年7月2日,美国卫生与公众服务部(HHS)助理国务卿布雷特·p·吉尔洛上将在国会众议院冠状病毒危机听证会小组委员会作证,听证会主题为“政府对个人防护设备和关键医疗用品持续短缺的回应”。
混杂的信息削弱了公众对回应的信心
2005年,当乔治·w·布什总统派遣他的高级公共卫生官员起草一份大流行防备计划时,当务之急是向美国人民传达一个关于联邦政府应对措施的明确、统一的信息。
2002年至2009年间负责疾病控制中心并帮助说服国会采纳布什战略的朱莉·格伯丁博士说:“回顾并重读2005年的大流行计划很有意思。”“如果你从清单上往下看,它包括……与值得信赖的发言人的沟通能力发展。”
公共卫生官员表示,特朗普总统的言论阻碍了向美国人传达统一信息的努力。
总统的支持者和批评者都指责他低估了流行病的威胁。
特朗普的前国土安全顾问、2005年大流行计划实施时也是布什的安全助理的汤姆·波塞特(Tom Bossert)说:“当我从1月到2月和3月观察到很多这样的情况时,我担心会出现一些错误,在我看来,这些错误是由外界造成的,或者至少是在与公众的沟通中造成的。”“我的意思是,这部分对我来说太难了。是的,当然,现在有糟糕的领导。不言而喻,你不需要我说。”
总统和他的亲密政治顾问经常提供与他的公共卫生专家直接冲突的信息。本月早些时候,当总统的贸易顾问彼得·纳瓦罗(Peter Navarro)在《今日美国》(USA Today)上发表评论文章,批评政府的最高传染病专家福奇(Fauci)时,两派之间的摩擦达到了顶点。
“当联邦政府有重新开放的计划,而总统却告诉人们不要理会他的专家们自己的重新开放计划时,人们应该怎么想?”克林问。这让每个人都很困惑。它导致政治、分裂和分裂。这导致了你看到的一些抗议。"
2020年7月21日,华盛顿,唐纳德·特朗普在白宫布雷迪新闻发布室的新闻发布会上向记者发表讲话。
特朗普总统实施了欧洲旅行禁令,他认为这是一个重要的早期回应。但是一些健康专家说,在需要社会距离的时候,它也驱使大量的人回到美国。
Klain说:“他说他禁止所有人,这导致了恐慌。”“这导致成千上万的人从欧洲回来,他们不需要回来。它导致人们被困在美国机场,很可能许多冠状病毒被带到这个国家,并在这个国家传播一次。”
诺伊曼说:“这一计划的实施本可以做得更好,因为人们在拥挤的走廊里呆了很长一段时间。”"许多人被曝光,据报道,他们已经通过了,因为他们的曝光等待通关."
公共卫生专家也不能幸免于对他们错误的批评。例如,在三月初,福西将美国人感染这种疾病的风险描述为“相对较低”,而卫生局局长不鼓励使用口罩。
特朗普政府的测试协调员布雷特·吉尔洛(Brett Giroir)上将描述了相互矛盾的信息如何侵蚀公众对政府回应的信任——以及作为坏消息传递者所面临的挑战。
“我可以告诉你,我和我的所有同事都尽了最大努力,努力做到对美国人民完全透明和公开。”有人指责我是一个更消极的人。”“我一直努力保持在球道的正下方。”因为我相信对美国人民来说……知道这是非常严重的事情是很重要的。”
'American Catastrophe: How Did We Get Here?': 5 key takeaways
Tens of thousands dead. Millions more infected. An economy crippled. How did we get here?
When an outbreak of the novel coronavirus emerged late last year in Wuhan, China, few could have imagined the depth of its devastation. The virus crossed borders and oceans, eventually spreading throughout the United States and forever reshaping the lives of those left in its wake.
Now, months later, a wide-ranging ABC News investigation examines the evolution of the global pandemic through extensive interviews with current and former public health andnational securityofficials.
Their collective voice tells the story of a viral infection that exposedgaps in leadershipthat left millions of Americans vulnerable.
Here are five key takeaways from the ABC News investigation:
'Red Dawn': A collection of former officials sounded an alarm. Were they heard?
In January and February, as the nascent coronavirus grew from outbreak to epidemic to pandemic, a group of former public health and national security officials, some of whom had helped craft a set of so-called "pandemic playbooks" to help guide a unified federal response, privately encouraged officials across the Trump administration to heed warnings of an impending disaster.
Dr. James Lawler, a former National Security Council (NSC) official during both the Bush and Obama administrations who worked specifically on pandemic preparedness, said this was "a serious group," with "many folks who had thought for a long time about pandemics."
To them, at least, the seriousness of the threat was clear.
"Our various groups that look at these things were giving each other the play-by-play on what we were hearing and what we were seeing," Lawler told ABC News. "It was obvious very early on, in January, that this had the potential to be a serious global event."
They exchanged concerns and ideas in a lengthy email thread, which they called "Red Dawn Rising" – a reference to the Cold War-era film by the same name in which a band of Americans work to repel Soviet invaders. In hindsight, the concerns they raised seem prophetic.
Frustrated with a president who seemed intent on downplaying the disease's threat, this band of experts – six of whom spoke with ABC News, many for the first time publicly – offered their unvarnished thoughts to senior administration officials, including top medical advisors in the departments of Defense, Homeland Security, Veterans Affairs, and Health and Human Services.
"The president began to say that nobody could imagine that something like this could actually occur," Dr. Dan Hanfling, a biosecurity and disaster response expert in Virginia, told ABC News. "The truth is that there was a group of us that had been trying to raise the alarm."
On the eve of crisis, a pandemic preparedness office scrapped
The White House National Security Council once featured a pandemic preparedness desk that monitored for biological threats to the security of the United States.
Its dissolution – less than a year before the novel coronavirus first emerged in China – has become fodder for the president's critics.
The office traced its roots back to 2015, when Ron Klain, who had been brought on to coordinate the Obama administration's Ebola response, suggested leaving a permanent position in place at the NSC to deal with pandemic preparedness. Obama agreed, and the White House's National Security Council Directorate for Global Health Security and Biodefense was born.
ThenJohn Boltontook the helm as President Trump's third national security advisor. Eager to shake up the national security bureaucracy and downsize the staff, Bolton disbanded the office in 2018.
"It is my understanding that they were trying to reduce the size of the National Security Council, and there are a lot of arguments for why that is a good thing," said Elizabeth Neumann, who until recently served as the Trump administration's assistant homeland security secretary for threat prevention and security policy. "That said, the National Security Council plays a really critical role when it comes to crises and inter-agency coordination."
A senior administration official rejected claims that Bolton and Trump disbanded the office, telling ABC News that its work was absorbed elsewhere within the NSC to "optimize responsiveness to challenges in largely overlapping fields." The official added that "no positions related to pandemic preparedness were eliminated" in the re-shuffling.
Bolton echoed the administration official's denial, insisting the office's dissolution amounted to nothing more than a "streamlining" of the NSC, but critics feel strongly that Bolton's decision impeded the federal government's ability to react effectively to the novel coronavirus by removing a coordinating office and signaling that pandemic preparedness was not a priority.
"I play music," Hanfling told ABC News. "It's pretty helpful to have somebody leading, somebody who is actually signaling the changes and counting the time and so on, and I think that's what that office would have provided."
"In retrospect," he said, "not such a great move.
Lost time: After early action, opportunities squandered
Experts say that a delayed response from the federal government and a lack of cooperation from foreign counterparts hampered the nation's ability to prepare for the pandemic.
Robert Redfield, director of the Centers for Disease Control and Prevention, said the Chinese central government's resistance to help from the U.S., despite the CDC's offers, was a missed opportunity for American scientists to learn about the virus early in the crisis.
"I think that was unfortunate," Redfield told ABC News. "If we could've gotten in to assist China in the first weeks of January, I think there would be a different situation today. … We had literally 20, 30 people ready to go in and assist, and then to be sorta told, 'Stand down.' Yeah, it's frustrating."
Dr. Anthony Fauci, the nation's top infectious-disease expert, told ABC News the Chinese government's refusal to provide a sample of the actual virus to American scientists caused another significant delay in understanding that speed at which it the virus was spreading from person to person. By the time the outbreak in Washington state made it clear the virus was spreading through human contact, Fauci said, community spread had already progressed significantly.
"It isn't something where you know everything that you're going to know from day one," Fauci told ABC News. "The insidious aspect about community spread is that … you don't know who is infecting who. Once that happens, that is the big red flag that we have a real serious problem. And that's when we first started realizing the first community spread that was not related to an identifiable source. Now we see an explosion of that. That's exactly what went on in New York, went on in Chicago and New Orleans, and what is currently now, as you and I are speaking, which is going on in several of the southern states."
Once public health officials identified the potentially catastrophic nature of the contagion, the challenge was to act immediately and get leadership and the public on the same page, said Elizabeth Neumann, who until April served as assistant homeland security secretary for threat prevention and security policy.
"When you're an emergency management professional, you're constantly balancing not wanting to be Chicken Little," Neumann told ABC News. "'The sky is falling, the sky is falling.' Then nothing happens, and the next time you have to say the sky is falling, nobody believes you."
"So there's always a tension there," Neumann said, "in trying to clearly communicate to the public, clearly communicate to leadership, what the concerns might be, what the likelihood of a potential disaster could be."
Tom Bossert, former homeland security adviser to President Trump and an ABC News contributor, said sticking with containment efforts until there was hard evidence of community spread was a "sequential mistake" made during those critical early months as symptomatic and asymptomatic infectious people were "walking around in any community at any given time, unbeknownst to not only the public health authorities, but to the people that were sick."
"Once there's 1% or more prevalence," Bossert said, "it becomes very difficult for human, non-pharmaceutical interventions to contain it."
Inadequate testing blinds leaders
Until April, the United Stateslagged far behindnumerous other countries on testing even as community spread was actively occurring across the country and around the world.
"Like any threat, you can't fight it if you don't know where it is," Klain told ABC News.
Assistant Secretary of Health Adm. Brett Giroir, the nation's top health official tapped by President Trump to oversee coronavirus testing, told ABC News the government was not prepared to ramp up itstesting efforts early in the pandemicbecause testing supplies were not part of the national stockpile.
"When I looked to see what was there, there was nothing there," Giroir told ABC News. "We didn't know what industries were involved. We needed these strange things called swabs. Who makes swabs?"
According to CDC Director Redfield, companies were slow to jump into testing early on in the coronavirus crisis because of their past experience with SARS and MERS. Because those ailments never spread widely, private labs saw tests go unused, he said.
"By the time they developed the test there was no market for the test," Redfield told ABC News.
But the president's critics say the administration should have quickly used the Defense Production Act to boost testing efforts early on -- an effort that'snow being implementedas several states and private labs areonce again faced withtesting shortages, supply issues and a significant lag in turnaround time for test results nearly half a year into the pandemic even after the federal government and states across the country have significantly ramped up testing efforts.
FDA Commissioner and White House Coronavirus Task Force member Stephen Hahn attributes the current testing shortage to an increase in demand as tests open up to asymptomatic people.
"I think it's a reasonable public health strategy that we've done that," Hahn told ABC News. "Our job at FDA is to say, 'Okay, where's the next generation of tests so that we can scale up by tens of millions per month?' Fortunately, that's happening."
But several states, including California, have recently reverted to prioritizing symptomatic patients. Former New York City Health Commissioner Dr. Mary Bassett told ABC News the lag in turnaround time for testing results -- which is as long as a week in some places -- are "not acceptable."
"It makes a complete mess of all public health prevention strategies of a communicable disease," said Bassett, who oversaw New York City's Ebola response. "You have to have rapid turnaround."
Mixed messages undermine a public's confidence in response
In 2005, when President George W. Bush dispatched his top public health officials to craft a pandemic preparedness plan, a top priority was to convey a clear, unified message to the American people about the federal government's response.
"It was interesting to go back and reread the pandemic plan from 2005," said Dr. Julie Gerberding, who directed the Centers for Disease and Control from 2002 to 2009 and helped convince Congress to adopt the Bush strategy. "If you go down the list, it included … communication capability development with trustworthy spokespeople."
Public health officials say President Trump's rhetoric has set back efforts to convey a unified message to Americans.
Both supporters and critics of the president have accused him of downplaying the threat of the pandemic.
"As I watched a lot of this evolve from January through February and March, I was worried about a number of mistakes that, it appeared to me from the outside, were being made, or at least in communication with the public were being made," said Tom Bossert, a former homeland security advisor to Trump who was also a security aide to Bush when the 2005 pandemic plan was enacted. "I mean, this is the part that's so hard for me. Yes, of course, there's bad leadership right now. It's so self-evident that you don't need me to say."
The president and his close political advisors often offered messages in direct conflict with his public health experts. The friction between the two factions came to a head earlier this month when the president's trade advisor, Peter Navarro, penned an op-ed in USA Today critical of Fauci, the administration's top infectious disease expert.
"What are people supposed to think when the federal government has a plan for reopening and the president is telling people to ignore his experts' own plan for reopening?" asked Klain. "That confuses everyone. It leads to politics, division, divisiveness. It leads to some of these protests you were seeing."
President Trump imposed a travel ban from Europe, which he has cited as an important early response. But some health experts say it also drove a massive number of people back to the U.S. at a time when social distancing was needed.
"He said he was banning everyone, and that led to a panic," Klain said. "It led to thousands and thousands of people coming back from Europe who didn't need to come back. It led to people being jammed up in U.S. airports and probably a lot of coronavirus was brought to this country and spread once in this country."
"The implementation of that could have gone much -- needed to have gone better, because people ended up in those crowded hallways for a long period of time," Neumann said. "And many were exposed, and reportedly have passed because of their exposure waiting to clear customs."
Public health experts haven't been immune from criticism for their mistakes. In early March, for example, Fauci characterized the risk of Americans contracting the illness as "really relatively low" while the surgeon general discouraged the use of masks.
Adm. Brett Giroir, the Trump administration's testing coordinator, described how conflicting messages erode public trust in the government's response – and the challenges of being the bearer of bad news.
"I can tell you I've tried – and all my colleagues have tried, to the best of our ability – to be completely transparent and open with the American people. I've been accused of being the person who's more negative," Giroir said. "I've tried to be right down the middle of the fairway. Because I believe it's important for the American people … to know that this is very serious."