We are at war. It is a hot war, a life-threatening war, and potentially, a near-extinction event. This should not be a war of economics, it should not be a war of opinions, and it is not an enemy that will miraculously vanish one day. This is a classic war of life and death. While our notions of war evoke nuclear-armed threats from another country, where a different language is spoken, in this war, the enemy won’t negotiate, won’t make a deal, is invisible, and possibly the most lethal one we have ever faced.
At the onset of any war there is chaos, confusion and fear. In order to organize a country towards winning a war, the leadership must act quickly. A first step is to activate previously developed and practiced already in-place, plans and procedures. We adjust and augment those plans to respond to a specific threat. We follow the advice of our best minds and strategists in order to minimize casualties and focus our resources to defeat the enemy. In a hot war against a human adversary we expect our leaders to call upon our best military and strategic minds. We expect our leaders to minimize confusion, speculation, and contradictory advice. These concepts are valid in both a human war and a war against a virus.
Imagine if an adversary, like North Korea, told us that on a specific date they will launch nuclear missiles (or a virus) against random U.S. targets, and the U.S. President then told each state that the burden of the fight was on them. They must purchase their own supplies, treat their own casualties, and, do their best. They are told they should consider trying this or that, not all of it recommended by experts, and eventually the war will just go away. Why, because we are the best country on earth.
Our leadership has failed us in their response to this viral attack. This was not like the sneak attack on Pearl Harbor. We were aware of the threat at the end of 2019. We knew of the real outbreak at the beginning of 2020. Following 9/11, to their credit, the Bush Administration with Congress funded the development of response plans, including those to a pandemic. These plans were generally ignored. The pandemic “special operation” teams trained to respond were disbanded. The critical stockpiles of supplies were not maintained, or ”given away.” Critical information related to the dangers of this viral enemy were collected haphazardly, and often, not believed. Even today the accuracy of the infection rates and death statistics are still being questioned, and even denied, by some in leadership.
We have lost the major battle of this war and we are now fighting as guerillas. We remain poorly armed against this enemy. Some states collaborate, but there are new hot spots daily, pockets of resistance, but still no coordinated national response.
Our experts have repeatedly emphasized the need for universal, rapid diagnostic testing, contact tracing, social distancing, and the wearing of masks. The experts have often been ignored, contradicted, marginalized, and replaced by incompetents.
The public remains confused and misled by comments that only 6% of deaths were actually caused by COVID-19, when in fact we know that it was a contributing cause of death in every single one of them. It is beyond my comprehension that a United States senator** would accuse our health care professionals, who unselfishly risk their lives daily, of purposely inflating the COVID death rate for personal financial gain.
We are now seeing people who were previously ill becoming reinfected and others suffering from long-term disabilities or disorders.
There is no confusion on my part. There are no extraneous factors, economic or otherwise that supersede life. There is no bigger picture to consider. We were attacked, our response to that attack was politicized, pathetic, and still weak, uncoordinated, confused, resulting in many unnecessary deaths.
To fight this viral enemy, we need a definitive plan developed by central leadership. A flexible, scalable plan that can be implemented locally, regionally and nationally in a timely fashion. A “just what I need, just in time plan.” A plan crafted by a cross section of subject matter experts with input from scientists, economists, pharma, manufactures, experts in information management, experts in transportation, clergy, law enforcement, etc. etc. Why, because we are at war.
The last thing we need, in a life and death situation, is continued “off the cuff” leadership with divisive and confusing suggestions.
We are in critical need of definitive leadership but based on what has happened to date I don’t expect that will happen. If we will continue down this present path I expect the virus to burn out over a two-year cycle and leave us with 1 million plus direct and indirect deaths. Should we accept that?
Steven J. Phillips, MD, practiced cardiac surgery in Des Moines from 1974-2000. He subsequently spent 15 years in a leadership role at the NIH heading up a Division whose activities were part of the U.S. pandemic team. He also served as an officer in the USAR from 1968-93, including two deployments to Vietnam.
** Senator Joni Enrst (R, Iowa)