2/25/20
The Trump administration, state officials and even individual hospital workers are now racing against each other to get the necessary masks, gloves and other safety equipment to fight coronavirus — a scramble that hospitals and doctors say has come too late and left them at risk. But according to a previously unrevealed White House playbook, the government should’ve begun a federal-wide effort to procure that personal protective equipment at least two months ago. “Is there sufficient personal protective equipment for healthcare workers who are providing medical care?” the playbook instructs its readers, as one early decision that officials should address when facing a potential pandemic. “If YES: What are the triggers to signal exhaustion of supplies? Are additional supplies available? If NO: Should the Strategic National Stockpile release PPE to states?” The strategies are among hundreds of tactics and key policy decisions laid out in a 69-page National Security Council playbook on fighting pandemics. Other recommendations include that the government move swiftly to fully detect potential outbreaks, secure supplemental funding and consider invoking the Defense Production Act — all steps in which the Trump administration lagged behind the timeline laid out in the playbook. “Each section of this playbook includes specific questions that should be asked and decisions that should be made at multiple levels” within the national security apparatus, the playbook urges, repeatedly advising officials to question the numbers on viral spread, ensure appropriate diagnostic capacity and check on the U.S. stockpile of emergency resources.
The playbook also stresses the significant responsibility facing the White House to contain risks of potential pandemics, a stark contrast with the Trump administration’s delays in deploying an all-of-government response and President Donald Trump's recent signals that he might roll back public health recommendations. The guide further calls for a “unified message” on the federal response, in order to best manage the American public's questions and concerns. The NSC devised the guide — officially called the Playbook for Early Response to High-Consequence Emerging Infectious Disease Threats and Biological Incidents, but known colloquially as “the pandemic playbook” — across 2016. The Trump administration was briefed on the playbook’s existence in 2017, said four former officials. The playbook was designed “so there wasn’t piecemeal thinking when trying to fight the next public health battle,” said one former official who contributed to the playbook, warning that “the fog of war” can lead to gaps in strategies. Under that timeline, the federal government by late January should have been taking a lead role in “coordination of workforce protection activities including… [personal protective equipment] determination, procurement and deployment.” Those efforts are only now getting underway, health workers and doctors say. It is not clear if the administration’s failure to follow the NSC playbook was the result of an oversight or a deliberate decision to follow a different course.