As we head into what are expected to be the deadliest days of the coronavirus outbreak in the United States, a former administrator of Medicare and Medicaid said that President Donald Trump has “violated about every rule” there is for leading a country through a medical crisis.
“We need calm and consistency. We need clarity of messaging. We need a combination of absolute honesty — telling the facts — and hope. And in this particular case, we need honoring of science so that we do the right thing scientifically to protect the public. And in every one of those elements, this president has failed,” said Dr. Donald Berwick, who served as the administrator for Medicare and Medicaid under President Barack Obama, speaking Tuesday with Jim Braude on WGBH News' Greater Boston.
Berwick said the Trump administration is the latest in “a long history of weakness” when it comes to public health.
“We haven’t had the will to invest in infrastructure at the level that we need,” he said. “Luckily the private sector is stepping up right now, in absence of federal leadership, to really come together — and it’s quite moving to see that happen. But we’re getting by by the skin of our teeth, if at all.”
“We’ve gotta learn from this. If you’re not prepared for public health emergencies, you get hurt bad,” he added.
More than 10,000 people have died after testing positive for the coronavirus so far in the U.S., including 356 deaths in Massachusetts. Models from the University of Washington, which have been cited by the White House, predict as many as 80,000 Americans will have died by August 4.
Berwick said it’s not too late to mitigate some of the worst projections of the coming surge.
“We need to pull out the stops to reach out where the virus is coming. Part of that is strengthening the Medicaid system, the safety net so that people can get the care they want. Part of it reaching out to hospitals so they have the supplies they want,” he said. “And in the long run, we have got to move everything we can toward coming up with diagnostics testing, antiviral treatments and vaccines as fast as we can. It’s a war.”
Berwick said his daughter, who works as an emergency physician in Boston, likened her experience on the frontlines of this crisis to her memories of treating the victims of the 2013 Boston Marathon bombing.
“The marathon memory was of a patient being wheeled into the emergency room … bleeding on the floor. They tried to wipe the floor and the policeman who wheeled him in said, ‘Don’t bother, there’s a lot more coming,’” he said. “This uncertainty, this sense of a wave hit, and she said it was the same thing. We know coronavirus now; we understand how it behaves. And when you see that first case, you just know there’s a lot behind it.”
Berwick also cited other stories from the frontlines of the coronavirus crisis, including a doctor in Italy who reportedly died after caring for patients without adequate protective equipment.
“People are being heroic today,” he said. “We shouldn’t have to ask them to be that heroic.”