- Former President Trump announced his "15 days to slow the spread" campaign one year ago, which urged Americans to stay home to combat the coronavirus pandemic.
- A look back reveals how little was known about the virus, public health specialists said.
- The guidance failed to acknowledge that people who don't have symptoms can spread the virus and didn't say anything about wearing masks.
Tuesday marked one year since President Donald Trump announced his administration's "15 days to slow the spread" campaign, asking Americans to stay home for about two weeks in an effort to contain the coronavirus.
The United States had confirmed just over 4,000 Covid-19 cases. At the time, as city and state officials rushed to implement restrictions to curb the outbreak. Countries were closing borders, the stock market was cratering and Trump — in what proved to be prescient remarks — acknowledged the outbreak could extend beyond the summer.
Trump asked people to stay home, avoid gathering in groups, forgo discretionary travel and stop eating in food courts and bars for the next 15 days.
"If everyone makes this change or these critical changes and sacrifices now, we will rally together as one nation and we will defeat the virus and we're going to have a big celebration all together," Trump said at a White House press briefing on March 16, 2020, where he also announced the first vaccine candidate entering phase 1 clinical trials. "With several of weeks of focused action we can turn the tide and turn it quickly."
A look back at the first coronavirus guidelines issued by the federal government demonstrates just how little was known at the time about the virus that has sickened almost 30 million Americans and killed at least 535,000 in the U.S.
The two largest failings of the guidance were that it didn't acknowledge that people without symptoms can spread the virus and didn't say anything about wearing masks, former Baltimore health commissioner Dr. Leana Wen said. Instead, that early guidance focused mostly on urging people who feel sick to stay home and for everyone to avoid gatherings of more than 10 people.
"There was so much we didn't know about this disease at the time," Wen said. "There were two key elements in our scientific knowledge that we didn't fully understand. One was the degree of asymptomatic transmission, and two was the aerosols, how this is not just transmitted through people sneezing and coughing."
Wen, who is also an emergency physician and public health professor at George Washington University, noted it wasn't just politicians, but also scientists, who didn't understand how to fight the virus. It wasn't until early April that the Centers for Disease Control and Prevention and the World Health Organization acknowledged that wearing a mask could help protect people, she said.
In fact, top U.S. health officials were urging Americans not to buy masks at the end of February in a bid to preserve supply for health-care providers.
"Seriously people — STOP BUYING MASKS!" then-U.S. Surgeon General Jerome Adams tweeted on Feb. 29, 2020. "They are NOT effective in preventing general public from catching coronavirus, but if health-care providers can't get them to care for sick patients, it puts them and our communities at risk!"
Dr. Deborah Birx, who served as the White House Covid-19 Task Force coordinator under Trump, offered a glimpse last week into the early confusion over the science. In one of her first public appearances since leaving her role in the White House, Birx said there were doctors "from credible universities who came to the White House with these opposite opinions."
"There were people with legitimate credentials and stellar careers that were feeding information, and I had never seen that before, and that was enormously difficult," Birx said Thursday at a virtual symposium hosted by the New York Academy of Sciences and NYU Grossman School of Medicine.
Legitimate disagreement within the scientific community is common, but perhaps never before has the debate played out so publicly or with such high stakes. Birx, who left the CDC last week and took a couple of private sector positions, said the discussion around early Covid policy was not so simple as science vs. politics. She added that little was known at the time about the virus, and it was difficult to parse good science from bad.
Other public health specialists weren't so forgiving of the White House's early response to the pandemic. Saskia Popescu, an epidemiologist and biodefense professor at George Mason University, said the "15 days to slow the spread" guidance demonstrated "a lack of awareness for managing outbreak response." The initiative should not have been tied to a timeline, she said, but instead to a specific task like reducing daily new infections to a certain level.
"Simply put, 15 days is not enough to address so much of what we were facing in March 2020 and this plan really reveals an administration and national plan that was quite superficial in response," Popescu said in an email.
"Truly, for many of us in public health, this was a red flag — an indication that the administration had an unrealistic view of pandemic control measures and was not aware of the reality — a pandemic cannot be solved in 15 days and any strategy needs to include a serious amount of work resource, and personnel," she added.
Dr. Oxiris Barbot — the former New York City health chief who led the Big Apple through the beginning of the pandemic when the state was seeing almost 1,000 daily deaths — told CNBC it was apparent by late February that the coronavirus had the potential to become catastrophic. She added that failings by the federal government to prioritize the testing of large parts of the population was one of the earliest missteps.
Some of the early tests the CDC developed and shipped were faulty, and only a limited group of Americans were granted access to them. White House chief medical officer Dr. Anthony Fauci told congressional lawmakers on March 12, 2020 — just days before Trump's 15-day guidance — that the U.S. wasn't able to test as many people for the disease as other countries, calling it "a failing."
Notably, the 15-day guidance made no mention of who should seek out testing and under what circumstances.
Barbot, now a professor at the Columbia University Mailman School of Public Health, said in a phone interview that the federal government's testing woes put the city "behind the eight ball before the game even got started."
"I think one of the biggest regrets that I have is that we didn't have the testing that we needed to have," Barbot said. "In retrospect, I do think in February there were a significant number of undetected infections taking place, and we were scrambling to try and identify them."
She added that early on, officials should have acted more swiftly when cases were detected to prevent spread through the closure of businesses.
"There should've been earlier shutdowns," Barbot said. "I think that's where federal leadership fell short because on the national stage, we had the former president downplaying the importance, where on the front lines, we were seeing a different picture."