By Sarah Mervosh, Mike Baker, Patricia Mazzei and Mark Walker
After the White House declined to pursue a unified national strategy, governors faced off against lobbyists, health experts and a restless public consumed by misinformation.
People walk to the bus stop last month in Denver as two cases of a new coronavirus variant were discovered in the state.Credit...Daniel Brenner for The New York Times
The path to beating the coronavirus was clear, but Kelley Vollmar had never felt so helpless.
As the top health official in Missouri’s Jefferson County, Ms. Vollmar knew a mandate requiring people to wear masks could help save lives. She pressed the governor’s office to issue a statewide order, and hospital leaders were making a similar push. Even the White House, at a time when President Trump was sometimes mocking people who wore masks, was privately urging the Republican governor to impose a mandate.
Still, Gov. Mike Parson resisted, and in the suburbs of St. Louis, Ms. Vollmar found herself under attack. A member of the county health board called her a liar. The sheriff announced that he would not enforce a local mandate. After anti-mask activists posted her address online, Ms. Vollmar installed a security system at her home.
“This past year, everything that we’ve done has been questioned,” said Ms. Vollmar, whose own mother, 77, died from complications of the coronavirus in December. “It feels like the Lorax from the old Dr. Seuss story: I’m here to save the trees, and nobody is listening.”
For nearly the entire pandemic, political polarization and a rejection of science have stymied the United States’ ability to control the coronavirus. That has been clearest and most damaging at the federal level, where Mr. Trump claimed that the virus would “disappear,” clashed with his top scientists and, in a pivotal failure, abdicated responsibility for a pandemic that required a national effort to defeat it, handing key decisions over to states under the assumption that they would take on the fight and get the country back to business.
But governors and local officials who were left in charge of the crisis squandered the little momentum the country had as they sidelined health experts, ignored warnings from their own advisers and, in some cases, stocked their advisory committees with more business representatives than doctors.
“This past year, everything that we’ve done has been questioned,” said Kelley Vollmar, the top health official in Jefferson County, Mo. “It feels like the Lorax from the old Dr. Seuss story: I’m here to save the trees, and nobody is listening.”Credit...Whitney Curtis for The New York TimesMs. Vollmar tried to persuade Gov. Mike Parson to require people to wear masks in public places. The governor resisted, and at home in the suburbs of St. Louis, Ms. Vollmar found herself under attack.Credit...Whitney Curtis for The New York Times
Nearly one year since the first known coronavirus case in the United States was announced north of Seattle on Jan. 21, 2020, the full extent of the nation’s failures has come into clear view: The country is hurtling toward 400,000 total deaths, and cases, hospitalizations and deaths have reached record highs, as the nation endures its darkest chapter of the pandemic yet.
The situation has turned dire just as the Trump administration, in its final days, begins to see the fruits of perhaps its biggest coronavirus success, the Operation Warp Speed vaccine program. But already, a lack of federal coordination in distributing doses has emerged as a troubling roadblock.
The incoming president, Joseph R. Biden Jr., has said he will reassert a federal strategy to bring the virus under control, including a call for everyone to wear masks over the next 100 days and a coordinated plan to widen the delivery of vaccines. “We will manage the hell out of this operation,” Mr. Biden said on Friday. “Our administration will lead with science and scientists.”
The strategy signals a shift from the past year, during which the Trump administration largely delegated responsibility for controlling the virus and reopening the economy to 50 governors, fracturing the nation’s response. Interviews with more than 100 health, political and community leaders around the country and a review of emails and other state government records offer a fuller picture of all that went wrong:
The severity of the current outbreak can be traced to the rush to reopen last spring. Many governors moved quickly, sometimes acting over the objections of their advisers. The reopenings nationally led to a surge of new infections that grew over time: Never again would the country’s average drop below 20,000 new cases a day.
Science was sidelined at every level of government. More than 100 state and local health officials have been fired or have resigned since the beginning of the pandemic. In Florida, leading scientists offered their expertise to the governor’s office but were marginalized, while Gov. Ron DeSantis turned to Dr. Scott W. Atlas, a Trump adviser, and others whose views were embraced in conservative circles but rejected by scores of scientists.
While the president publicly downplayed the need for masks, White House officials were privately recommending that certain states with worsening outbreaks require face coverings in public spaces. But records show that at least 26 states ignored recommendations from the White House on masks and other health issues. In South Dakota, Gov. Kristi Noem, boasted to political allies about not requiring masks even as her state was in the midst of an outbreak that became one of the worst in the nation.
Gov. Jared Polis of Colorado said states had faced difficult choices in balancing the virus — often hearing competing voices on how to do it best — and said Mr. Trump had left them without the political support they needed as they urged the public to accept masks and social distancing. “The single biggest thing that would have made a difference was the clarity of message from the person at the top,” Mr. Polis said in an interview.
The pandemic indeed came with significant challenges, including record unemployment and a dynamic disease that continued to circle the globe. Without a national strategy from the White House, it is unlikely that any state could have fully stopped the pandemic’s spread.
But the majority of deaths in the United States have come since the strategies needed to contain it were clear to state leaders, who had a range of options, from mask orders to targeted shutdowns and increased testing. Disparities have emerged between states that took restrictions seriously and those that did not.
America now makes up 4 percent of the world’s population but accounts for about 20 percent of global deaths. While Australia, Japan and South Korea showed it was possible to keep deaths low, the United States — armed with wealth, scientific prowess and global power — became the world leader: it now has one of the highest concentrations of deaths, with nearly twice as many reported fatalities as any other country.
SPRING
The rush to reopen was ‘the opportune moment that was lost’
The country once had a chance to set itself on a path to defeat the virus.
There had been many early missteps. The United States failed to create a vast testing and contact tracing network in January and February, which could have identified the earliest cases and perhaps held back the crisis. Then, cases silently exploded in New York, while Gov. Andrew M. Cuomo and Mayor Bill de Blasio waited crucial days to close schools and businesses.
Thousands of lives might have been saved in the New York metropolitan area alone if measures had been in place even a week earlier, researchers found. Driven by the spring surge, New York and New Jersey to this day have the worst death rates in the nation.
Elsewhere, though, most of the country had an opportunity to get ahead.
By mid-April, most states had resorted to historic stay-at-home orders to avoid the horror seen in the Northeast. At the time, about 30,000 people had died, and the worst of the outbreak was still concentrated in the Northeast.
It was during this period that experts say the country had an opportunity to get a handle on the crisis — had it invested in testing and contact tracing and endured a prolonged, if painful, shutdown until cases had been identified and controlled. At the time, the United States was doing only about one-third of the testing researchers thought was necessary.
Sources: State and local health agencies, U.S. Census Bureau | Note: Data is for the week ending April 10, 2020.
But the White House balked at enforcing its own guidelines, and Mr. Trump was openly encouraging states to open up. He turned over control to governors on April 16. “You’re going to call your own shots,” he told them.
Looking back, public health experts trace the bulk of the nation’s cases, now reflected in a record death toll, back to this turning point in late April.
“That was the critical time,” said Jeffrey Shaman, an infectious-disease expert at Columbia University. “That was the opportune moment that was lost.”
In their hurry to get back to business, many governors moved swiftly to reopen and balked at ordering new closures, sometimes ignoring the pleas of local health boards and mayors, according to interviews with health officials and a review of thousands of records obtained under public records law by The New York Times and other groups, such as Accountable.US and the Documenting Covid-19 public record project.
In Colorado, a local health official warned that his state’s reopening plan risked upending the gains made during painful shutdowns. In South Carolina, health officials failed to persuade the governor to delay opening indoor dining and the state epidemiologist, Dr. Linda Bell, suggested in emails, first reported by The State newspaper, that health officials needed to step forward and provide different messages to the public.
“I will not ‘stand next to the governor’ anymore without speaking to what the science tells us is the right thing to do,” she tapped out on her iPhone one Sunday morning.
In Iowa, the health director in Black Hawk County, Dr. Nafissa Cisse Egbuonye, was stunned in April when she found employees working elbow to elbow at a Tyson meatpacking plant — only some of them in masks.
For weeks, she said, her calls to the governor’s office about closing down the plant went nowhere, as infections rose so steeply that the local hospital was overrun. “We didn’t know where the resistance was occurring, whether it was Tyson or at the state government level,” Dr. Egbuonye said. “It was falling on deaf ears.”
Gov. Kim Reynolds said at the time that it was essential to keep the nation’s food supply chain up and running. The plant shut down only after the virus had disabled much of its work force — more than a thousand employees were infected, many of them immigrants, and at least five workers died.
Perhaps nowhere were the consequences of reopening more clear than in Texas.
With 29 million residents and a conservative identity built upon being friendly for business, Texas was among the states that were later in enacting stay-at-home orders. Within two weeks, protesters were clamoring outside the governor’s mansion, waving flags emblazed with the motto “Don’t Tread on Me” and demanding to be able to go back to work.
Gov. Greg Abbott was quickly pivoting toward reopening. One day after Mr. Trump’s call handing authority to governors, Mr. Abbott announced a “strike force to open Texas.” More than half of its members had donated to Mr. Abbott’s campaigns, including the real estate developer Ross Perot Jr. and Drayton McLane Jr., a former owner of the Houston Astros.
In a series of phone calls and meetings over the course of several weeks, the strike force hashed out ideas. The Texas Restaurant Association submitted a plan to reopen restaurants. Each step of the way, the ideas were funneled through a panel of four medical experts, who were empowered to veto ideas.
But the task before them was clear: how to get Texas’s $1.8 trillion economy up and running again.
By late April, Mr. Abbott was considering opening up the economy in phases.
“My advice was to go a bit slower,” said one member of the governor’s team, Dr. Mark McClellan, a former commissioner of the U.S. Food and Drug Administration. He worried that the state was not allowing time between phases to measure any upticks in infection before progressing through further reopenings, and he feared a surge in new infections.
But on May 1, Texas opened back up, starting with restaurants, stores and movie theaters. By Memorial Day, Texas was effectively up and running.
A spokesman for Mr. Abbott pointed to states like California and New York, which kept restrictions in place for longer but have recently seen resurgences of the virus, as evidence that “lockdowns for months after months” do not work. He said Mr. Abbott had balanced “saving lives, while preserving livelihoods.”
From late May to late July, new infections in Texas soared tenfold, from around 1,000 new cases a day to as many as 10,000.
“It was like a wildfire in brush,” said Dr. Jose Vazquez, who served as the health authority in Starr County, Texas, and who contracted the virus himself as the state’s Southern border region was hard hit over the summer.
By late June, Mr. Abbott called another meeting of his medical advisers. Reversing course, he shut down bars. Days later, he issued a mask order, which was credited with saving lives in the months to come.
Deaths continued to soar into August, and for weeks this summer, Dr. Vazquez watched as helicopters swooped into Starr County to pick up patients, taking them to hospitals as far away as Oklahoma and New Mexico.
‘It was just horrific’: Health experts were exhausted, threatened and sidelined
Summer was supposed to bring a reprieve from the horror.
Across the Northeast, deaths were subsiding. The weather was growing warm, a chance to spend more time outdoors, where the virus spreads less easily. Health officials hoped the season would be the bridge they needed to prepare for the fall, when infections were expected to worsen.
Instead, as officials in New Zealand were recording 100 days in a row without a single new infection and countries like Germany were recording only a few new deaths per day, the United States nearly broke its spring coronavirus hospitalization record.
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