President Trump has publicly blamed the World Health Organization for being slow to sound alarm bells about the coronavirus.
"On March 3, 2020, the World Health Organization cited official Chinese data to downplay the very serious risk of asymptomatic spread, telling the world that 'COVID- 19 does not transmit as efficiently as influenza,' " Trump wrote in a May 18 letter addressed to WHO leadership. "It is now clear that China's assertions, repeated to the world by the World Health Organization, were wildly inaccurate."
"Many lives could have been saved" had WHO warned the world earlier, Trump wrote. Later that month, he announced that the U.S. would withdraw from the global health agency.
Now, taped conversations between the president and journalist Bob Woodward, as reported in the forthcoming book Rage, indicate that in early February, Trump was well aware of the dangers of the coronavirus and chose to downplay the public health threat to Americans.
"This is deadly stuff," Trump told Woodward in a Feb. 7 conversation. "You just breathe the air and that's how it's passed. And so that's a very tricky one. That's a very delicate one. It's also more deadly than even your strenuous flu."
For public health expert Jeremy Konyndyk, the conversations clearly demonstrate that the president has been scapegoating WHO for failures of his administration. "These tapes make clear that the very things that the president was accusing WHO of failing to share, specifically the lethality and the transmissibility of this virus, were things he was already well aware of," said Konyndyk, a senior policy fellow at the Center for Global Development who led the U.S. response to international disasters in the Obama administration.
"To blame it on the WHO and then pull out technical and financial support is absurd," said Nancy Cox, who retired in 2014 as director of the Influenza Division at the Centers for Disease Control and Prevention, where she also headed up a WHO collaborating center on flu control.
The Woodward interviews underscore the fact that, despite Trump's assignment of blame, the U.S. did not rely on information from WHO or official Chinese sources to make decisions around its pandemic response, said Jimmy Kolker, a former U.S. ambassador who served as assistant secretary for global affairs at the U.S. Department of Health and Human Services.
"We had our own people on the ground in China, who were observing the situation in Wuhan and throughout [China]," he said, "We had plenty of information which should have given us grounds to take more dramatic action in the U.S. earlier."
Trump told Woodward in a subsequent interview in March that he was downplaying the virus's severity to avoid panic — a point he reiterated at a news conference Thursday. "I don't want to jump up and down and start screaming, 'Death! Death!' " the president said.
But public health experts said the president's attempts to reassure the public have had the opposite effect. "If you want the public to remain reasonably calm, if you want them not to be confused and uncertain, you tell them the truth," said Lawrence Gostin, head of the O'Neill Institute for National and Global Health Law at Georgetown University and director of a WHO collaborating center on global health law.
Gostin believes that public trust is gained when "you level with the American population" and tell what's known about a situation, what's still unclear and when and how the uncertainties will be resolved. Instead, when "the World Health Organization said it was serious and Trump downplayed it — that's a recipe for fear and panic," he said.
The president's strategy of misrepresenting the threat set the tone for administration officials further down the chain of command, Konyndyk said. "There were a lot of people within the administration who recognized the true nature of this risk, who were advising the president on it, but did not mirror that publicly," he said. "Had the president set a different tone at the top, I think we would be in a very different place today."
Konyndyk theorizes that if Trump had been forthright, administration officials could have publicly acknowledged the severity of the situation and effectively promoted science-based measures to prevent disease spread.
The president blamed WHO for the way the pandemic has unfolded because it's a "soft target," Konyndyk said. "It's easier to attack [WHO] than to attack China [directly] — they can't really push back. They make for a convenient scapegoat for the president."
As for the president's decision to end the U.S. relationship with the global health agency, public health specialists interviewed for this story said it's a dangerous move that risks prolonging the pandemic.
"The rest of the world is at a disadvantage if [the U.S. and WHO,] two main sources of public health information and expertise, are not working together," which could delay work on vaccines, treatments and potential cures for COVID-19, Kolker said.
Gostin said that turning WHO into a political football in the geopolitical struggle between China and the United States has been "hugely distracting" to the agency: "I think, [it has] made them less effective than they otherwise would be."
At a press conference Thursday, WHO Director-General Tedros Adhanom Ghebreyesus declined to comment on the revelations from Woodward's book.
Beyond this pandemic, withdrawing U.S. expertise and funding from WHO has "so many real-world consequences" to both WHO and the U.S., Cox said. It interrupts years of work on suppressing infectious diseases such as polio and measles, she said: "If these diseases aren't eradicated, if they continue to spread, there will be [re]introduction of these diseases into the U.S. population."
What's more, if the U.S. stops participating in WHO's global disease surveillance networks, "we're behind the curve in terms of being prepared for the next influenza pandemic or pandemic of whatever disease emerges next," Cox said.
November's presidential election could have major consequences for the future of U.S. engagement in global health, Gostin said. Democratic nominee Joe Biden has pledged to "immediately restore [the U.S.] relationship with the World Health Organization." A second-term Trump is expected to stick to his plan to withdraw the U.S. from WHO. Because of a mandatory one-year waiting period, the exit would be effective in July.
The Trump administration said it will redirect the resources withdrawn from WHO to other global health partners but has not specified which ones.
MICHEL MARTIN, HOST:
Revelations that President Trump understood the threat of the coronavirus early on and downplayed it to the public have riled the global health community. They say the president has unfairly blamed the World Health Organization for withholding information that he already knew. NPR's Pien Huang reports.
PIEN HUANG, BYLINE: In the first week of February, President Trump told journalist Bob Woodward that the virus was deadly stuff. Here's part of the recorded interview published in The Washington Post.
(SOUNDBITE OF ARCHIVED RECORDING)
PRESIDENT DONALD TRUMP: You just breathe the air. That's how it's passed. And so that's a very tricky one. That's a very delicate one. It's also more deadly than your - you know, your - even your strenuous flus.
HUANG: In a March interview with Woodward, Trump admitted he deliberately downplayed the seriousness of the virus in public. The revelations are published in Woodward's new book on President Trump called "Rage." He repeated some of the assertions again this week at a White House press briefing.
(SOUNDBITE OF PRESS CONFERENCE)
TRUMP: I don't want to jump up and down and start screaming death, death.
HUANG: And what has global health experts frustrated is that Trump put the blame on the United Nations health agency for not warning the world early enough about the virus. Jeremy Konyndyk, who led the U.S. government's response to global disasters in the Obama administration, says the recordings show the president's accusations against WHO do not hold up.
JEREMY KONYNDYK: These tapes make clear that the very things that the president was accusing WHO of failing to share - you know, specifically the lethality and the transmissibility of this virus - were things he was already well aware of.
HUANG: The president claims the global health agency is too China-centric and did not push China to reveal information earlier. He's used these claims to justify withdrawing from WHO in the middle of a pandemic. Public health experts like Nancy Cox, former director of the CDC's influenza division, say that move could actually prolong the situation.
NANCY COX: To blame it on the WHO and then pull out technical and financial support is absurd. It's just absurd.
HUANG: The president says he held back on sharing the dangers of the virus because he didn't want people to panic. But Jimmy Kolker, a former ambassador and career diplomat, says that misleading the public actually makes people feel like they can't trust the government.
JIMMY KOLKER: The way to avoid a panic is for the public to have confidence that they're getting the right information that they need as soon as it's available to the authorities.
HUANG: Global health experts think Trump used WHO as a scapegoat because it's a soft target with no political base in the U.S. and no ability to fight back. Larry Gostin, a professor of Global Health Law at Georgetown University, also points out that taking the U.S. out of WHO has had big impacts on global coordination for this pandemic.
LARRY GOSTIN: The United States leadership, its finance, its moral authority is missing. And that is making a big difference in terms of the spread of COVID worldwide.
HUANG: And if the U.S. stops working with WHO on things like disease eradication and flu surveillance, Nancy Cox, formerly with the CDC, says U.S. researchers will lose access to conversations where countries share early information with each other. That means the U.S. could be flying blind into future outbreaks.
COX: We're behind the curve in terms of being prepared for the next influenza pandemic or pandemic of whatever disease emerges next.
HUANG: If Trump is re-elected in November, his withdrawal from the agency will go into effect July, 2021.
Pien Huang, NPR News.
(SOUNDBITE OF SPAM ALLSTARS' "FIESTA DE LOS FEOS") Transcript provided by NPR, Copyright NPR.