Contributor Post Created with Sketch. Recommended by Ricochet Members Created with Sketch. We Should Have Known It Was Coming

 

Yesterday, I pointed out that a major pandemic planning exercise was run in May of 2018. This prompted sensational headlines across major media, but we, as a people and as governments, were terribly distracted by the Russia hoax, the attempted coup by senior officials, with dual status as civil servants and Democrat activists, seeking to subvert our constitution. Nevertheless, President Trump actually juggled those balls and many more, driving his administration to respond with a new bioterrorism and pandemic threat strategy and working group, plus taking significant steps to replenish the National Strategic Stockpile.

We knew. Clade X was hosted by Johns Hopkins Bloomberg School of Public Health and the Center for Health Security. Look at the cited media coverage:

PBS
Why another flu pandemic is likely just a matter of when

Washington Post
This mock pandemic killed 150 million people. Next time it might not be a drill.

The New Yorker
The terrifying lessons of a pandemic simulation

MIT Technology Review
It’s fiction, but America just got wiped out by a man-made terror germ

AJ+
Mock pandemic ends in millions dead

Science Friday (NPR)
Center for Health Security hosts Clade X pandemic exercise

Business Insider
A leading medical institution created a simulation that shows how a new disease could kill 900 million people — and it reveals how unprepared we are

Vox
A pandemic killing tens of millions of people is a real possibility — and we are not prepared for it
“Designer bugs”: how the next pandemic might come from a lab

New England Journal of Medicine
Politics and Pandemics (“Perspective” column by Ron Klain)

Washington Post (op-ed)
Our lack of pandemic preparedness could prove deadly

Agenda (World Economic Forum blog)
6 ways countries can prepare for the next infectious disease pandemic

Fox News
Emergency preparedness drill exposes gaps in response after mock virus ‘kills’ 900M

STAT
Securing the US from its most dangerous invader: infectious disease

Toronto Sun
Next pandemic could kill a billion people: researchers

News.com (Australia)
How a virus attack just ended the world (sort of)
Also in Queensland TimesThe Morning Bulletin, and Perth Now

New York Post
The world is completely unprepared for the next pandemic

The Week (UK)
Global pandemic could wipe out 900 million people

War on the Rocks
Death in the air: Revisiting the 2001 Anthrax mailings and the Amerithrax investigation

The Evan Solomon Show, 580 CFRA (Canada)
A group of scientists say the world is not ready for the next pandemic… and the death toll could reach 1 billion

Contagion Live
Clade X Simulation Reveals United States is Not Prepared for Severe Pandemics

Daily Mail (UK)
A global pandemic of a flu-like virus could kill 900 million people if it started to spread tomorrow, experts warn
G20 experts stage a fake superbug pandemic to test how the world would react to a deadly outbreak of an antibiotic-resistant disease

PA Times (ASPA)
Clade X is more than an exercise, it is a call to action

Global Health Now
Clade X: A mock, yet entirely plausible, pandemic

Business Insider
The FDA just approved a drug to treat smallpox in case of a bioterrorism attack — here’s why that scenario is so scary

Homeland Preparedness News
Mock Clade X pandemic decimates human population; denotes global pre-planning needs

Homeland Preparedness News
Clade X: Simulated pandemic to put political leaders, public on notice

Homeland Security Newswire
Clade X pandemic exercise: Preventing the worst outcomes in future pandemics

Washington Post
The many ways our world could end

Everybody knew. It was our planning systems, our institutions, that were dreadfully misaligned and maladaptive. Perhaps now we will finally get an equivalent in homeland security to the fundamental forced cooperation and unity of command imposed on our military services in 1949, when the Department of War, Department of the Navy (including the Marine Corps), and the new Air Force were all made to fall under one boss of bosses, with one master budget in the Department of Defense.

As a reminder, here is what was projected just two years ago about ventilators:

The US Department of Health and Human Services (HHS) estimates that 865,000 US residents would be hospitalized during a moderate pandemic (as in 1957 and 1968) and 9.9 million during a severe pandemic (as in 1918).

o Moderate (1958/68-like) = 64,875 would need mechanical ventilation

o Severe (1918-like) = 742,500 would need mechanical ventilation

One study estimated that US acute care hospitals own approximately 62,000 full-feature mechanical ventilators. Calculations suggest that around 28,883 of these ventilators (46.4%) can be used to ventilate pediatric and neonatal patients. The study also reported an additional 98,000 ventilators that are not fullfeatured but can still provide basic function.

• Based on these numbers, the maximum number that can be potentially ventilated is around 160,000.

• US: 20.5 ICU beds with mechanical ventilation capability per 100,000 population

• Canada: 8.7 ICU beds with mechanical ventilation capability per 100,000 population

• Australia & New Zealand: 5.4 ICU beds with mechanical ventilation capability per 100,000 population

o These numbers suggest that the capacity of other countries to provide ventilation therapy might be significantly lower than our own.

In addition, the CDC Strategic National Stockpile has an estimated 8,900 ventilators as of 2010. Ventilators are stored and kept as managed inventory.

As of January 2020, we had increased the ventilator stockpile to somewhere north of 10,000, possibly 14,000, with the number kept shrouded by “national security,” indicating the real concern was against bioterrorism or a foreign state attacking us in a nightmare scenario that overwhelms local and state responses. This accords with President Trump repeatedly linking medical supplies and Department of Defense munitions shortfalls when he entered office.

In September of 2018, we were again distracted by Mueller’s collusion with the Democrats, for the purpose of taking control of at least the House of Representatives in 2018, while President Trump issued top-level guidance to get the whole of the government engaged in planning our response to the identified threats of bioterrorism and pandemics:

MR. MARQUIS: I’m Garrett Marquis at the NSC. We’re here for a briefing that’s off camera, but on record, on the National Biodefense Strategy.

We have Ambassador John Bolton, National Security Advisor, and Health and Human Services Secretary Azar, as well. How this will flow is the Ambassador will make a few remarks, followed by Secretary Azar, and then brief Q&A, which I’ll manage.

We have about 25 minutes, maybe a little bit less. And the focus of this, of course, is on the National Biodefense Strategy, so please make sure your questions are relative to that.

[ . . . ]

SECRETARY AZAR:

As you’ll notice — and once you see the materials — at each stage, the growing complexity of these threats demanded the involvement of more and more of the top-flight biomedical and public health expertise that we have at HHS. Back in the ’90s, the Secretary, Donna Shalala, declared HHS a national security agency, detailing a Public Health Service Commissioned Corps officer to the National Security Council for the very first time.

The 1990s? Yes, indeed. As soon as the Cold War ended, our nation’s military leaders, from mid-grade officers up, were looking at the emerging threats, not just of “loose nukes” but of poor men’s weapons of mass destruction. We were concerned about the diffusion of chemistry and biology knowledge and basic equipment, as well as the ugly arsenals deep in territories the Communist Russian state used to firmly control. What might be sold to some very bad actors?

Remember, again, that the Secretary of HHS could not reveal the number of respirators, or other stocks, in the National Strategic Stockpile, until President Trump partially declassified the information, allowing Vice President Pence to say “over 10,000,” while Secretary of Defense Esper said he could release “2,000” from war stocks. A virus is not fooled by a classification stamp. Only human enemies can profit from precise numbers describing our defense capabilities.

In searching my files for another document on “coronavirus,” I ran across an unclassified, publicly releasable, reference paper from my 2006 Army War College classes. The 2005 publication was entitled “Chinese National Security Decisionmaking under Stress.” One chapter was on the 2003 SARS outbreak. Here is a relevant quote:

Seldom does a domestic health emergency spin out of control the way the Severe Acute Respiratory Syndrome (SARS) crisis did in China during the early months of 2003, threatening global health and economic stability. After over 5 months of denial, as information of the spread of the disease to Beijing was exposed, growing external pressure forced Chinese leaders to shift into action. The Chinese Communist Party (CCP), headed by General Secretary Hu Jintao since the November 2002 16th Party Congress, when the epidemic emerged, was forced to dramatically shift its SARS response strategy between late March and early April 2003, as foreign confidence that the leadership had the situation under control evaporated. Fearing economic and international implications, the CCP leadership initiated aggressive and highly visible actions in the fight against SARS by mid-April 2003.

[. . .]

This chapter will focus on how the CCP’s crisis response methodology allowed SARS to spread within China and internationally. It raises questions about the CCP’s ability to handle future crises, especially public welfare problems.3 As the Party’s key guarantor of stability and power, the PLA’s mixed record and short- comings in civil-military cooperation will also be discussed.

The SARS crisis illustrates how the CCP’s priorities have become so intertwined with the Party’s own survival and maintaining a monopoly on power that the Party leadership from the bottom to the top often cannot balance public interest against their own self- interests. Further, the SARS case illustrates that the CCP has also become dependent on foreign investment and trade to underwrite its legitimacy that it will delay decisions and conceal information in order to protect foreign economic interests, rather than promote the public welfare. This latter point was driven home when the CCP only decided to take action after SARS had radiated out internationally from China, and information about the rate of infection in Beijing had been leaked to the international community. But, in the end, foreign pressure and scrutiny can still encourage Beijing to take positive action.

I thank a Ricochet commenter for pointing out that there was another iteration, although with a possibly less rigorous structure, of the Johns Hopkins exercise in October 2019, Event 201:

The Johns Hopkins Center for Health Security in partnership with the World Economic Forum and the Bill and Melinda Gates Foundation hosted Event 201, a high-level pandemic exercise on October 18, 2019, in New York, NY. The exercise illustrated areas where public/private partnerships will be necessary during the response to a severe pandemic in order to diminish large-scale economic and societal consequences.

They have since hastened to clarify [emphasis added]:

In October 2019, the Johns Hopkins Center for Health Security hosted a pandemic tabletop exercise called Event 201 with partners, the World Economic Forum and the Bill & Melinda Gates Foundation. Recently, the Center for Health Security has received questions about whether that pandemic exercise predicted the current novel coronavirus outbreak in China. To be clear, the Center for Health Security and partners did not make a prediction during our tabletop exercise. For the scenario, we modeled a fictional coronavirus pandemic, but we explicitly stated that it was not a prediction. Instead, the exercise served to highlight preparedness and response challenges that would likely arise in a very severe pandemic. We are not now predicting that the nCoV-2019 outbreak will kill 65 million people. Although our tabletop exercise included a mock novel coronavirus, the inputs we used for modeling the potential impact of that fictional virus are not similar to nCoV-2019.

A check of the media page shows far less coverage than the 2018 version. Why? Perhaps because it was dead center on the Democrats’ fake impeachment inquiry. Clade X was in the midst of the drawn-out Mueller probe. Event 201 also reinforced Clade X claims, rather than generating novel news.

So, everybody knew. And once again it took a disruptive leader to get us moving off the institutional status quo. This virus is not appearing to be taking the same lethal course projected in 2018 as the “moderate case.” We seem to be doing better, so far, and not by accident. When we emerge, as spring turns to summer, we must not forget, we must use the projected second wave as the whip to force real, meaningful, biodefense reform, measured by significant strategic medical logistical planning.

Let’s not have this theme next year:

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  1. CarolJoy, Above Top Secret Coolidge

    I have to seriously wonder if General Michael Flynn had not been tossed out on his arse by the ever vigilant and patriotic Dems, that perhaps we would be far ahead of the game of being prepared for both this viral “pandemic” and the next one.

    It should also be noted that inside the Federal system of agencies are several agencies that are already tasked with preparing for epidemics. The procurement of test kits for any and all viral diseases is not rocket science. (Obtaining the specific DNA or RNA structures so the lab techs assessing the results of the long q tip swabs is a bit trickier. But having extra long sterile Q tip swabs is not a difficult mission.) 

    Why it is that neither BARDA, the agency created in 2003 to look out for the US public in the event of a pandemic emergency and another agency called Bioshield could not have ample supplies for the test kits is beyond anyone’s guess at this point. Heads should roll, but then if Trump does put a few jobs on the chopping block, he will most likely get another whole round of impeachment hearings for his trouble.

    State legislators should also be investigating why state agencies charged with looking out for the health of their state’s constituents also have been getting a F grade on this, their final exam.

    • #1
    • April 1, 2020, at 3:04 PM PDT
    • 5 likes
  2. CarolJoy, Above Top Secret Coolidge

    I was unaware of CLADE, and I thank you for shedding the light on the matter.

    Excellent compendium and wish I could issue a round of applause.

    • #2
    • April 1, 2020, at 3:06 PM PDT
    • 5 likes
  3. Clifford A. Brown Contributor
    Clifford A. Brown

    CarolJoy, Above Top Secret (View Comment):

    I have to seriously wonder if General Michael Flynn had not been tossed out on his arse by the ever vigilant and patriotic Dems, that perhaps we would be far ahead of the game of being prepared for both this viral “pandemic” and the next one.

    It should also be noted that inside the Federal system of agencies are several agencies that are already tasked with preparing for epidemics. The procurement of test kits for any and all viral diseases is not rocket science. (Obtaining the specific DNA or RNA structures so the lab techs assessing the results of the long q tip swabs is a bit trickier. But having extra long sterile Q tip swabs is not a difficult mission.)

    Why it is that neither BARDA, the agency created in 2003 to look out for the US public in the event of a pandemic emergency and another agency called Bioshield could not have ample supplies for the test kits is beyond anyone’s guess at this point. Heads should roll, but then if Trump does put a few jobs on the chopping block, he will most likely get another whole round of impeachment hearings for his trouble.

    State legislators should also be investigating why state agencies charged with looking out for the health of their state’s constituents also have been getting a F grade on this, their final exam.

    The question of proper organization is well worth pursuing in a separate post. I note that we have a U.S. Public Health Service, one of our uniformed services, that was created long before HHS, CDC, and NIH. It was the original biodefense service, the federal lead, in an era when we had no effective medications and almost no vaccines. It’s weapons: surveillance and quarantine, especially at sea ports in the age before air travel. It is well worth reading their brief telling of two centuries of American history: USPHS history.

    Maybe that is where we need to realign and refocus our national biodefense efforts.

    • #3
    • April 1, 2020, at 3:15 PM PDT
    • 4 likes
    • This comment has been edited.
  4. Clifford A. Brown Contributor
    Clifford A. Brown

    CarolJoy, Above Top Secret (View Comment):

    I was unaware of CLADE, and I thank you for shedding the light on the matter.

    Excellent compendium and wish I could issue a round of applause.

    I was just trying to get an answer on the real number of respirators in America, the rest was gravy, good gravy.

    • #4
    • April 1, 2020, at 3:17 PM PDT
    • 4 likes
  5. DonG (skeptic) Coolidge

    CLADE X is less creepy that “Event 201” run in 2019.

    • #5
    • April 1, 2020, at 5:24 PM PDT
    • 3 likes
  6. Clifford A. Brown Contributor
    Clifford A. Brown

    DonG (skeptic) (View Comment):

    CLADE X is less creepy that “Event 201” run in 2019.

    Yes, and Event 201 was far too close in to allow any real reaction this year. However, it was a coronavirus model. And so, once again, “everybody knew,” but it was drowned out by, wait for it, impeachment!

    • #6
    • April 1, 2020, at 6:19 PM PDT
    • 3 likes
  7. Stina Member

    I wonder if they could add ventilation certification (like CPR certification) to the pandemic preparedness.

    We need to create some mechanism where the general public can have the ability to help when needed and not just rely on expensive degreed specialists in emergency situations.

    • #7
    • April 2, 2020, at 9:43 AM PDT
    • 2 likes
  8. Roderic Coolidge

    Preparation for this pandemic wasn’t perfect, but the US was still the most prepared nation on earth.

    We were expecting this to happen. It would have helped a lot of the Communist Chinese government had not lied about and covered up the epidemic developing there even while people traveled back and forth from China.

    • #8
    • April 2, 2020, at 1:13 PM PDT
    • 3 likes
  9. Clifford A. Brown Contributor
    Clifford A. Brown

    Roderic (View Comment):

    Preparation for this pandemic wasn’t perfect, but the US was still the most prepared nation on earth.

    We were expecting this to happen. It would have helped a lot of the Communist Chinese government had not lied about and covered up the epidemic developing there even while people traveled back and forth from China.

    Yes, and we knew they would lie, because that is how they have always behaved.

    • #9
    • April 2, 2020, at 1:21 PM PDT
    • 2 likes
  10. Roderic Coolidge

    Stina (View Comment):

    I wonder if they could add ventilation certification (like CPR certification) to the pandemic preparedness.

    We need to create some mechanism where the general public can have the ability to help when needed and not just rely on expensive degreed specialists in emergency situations.

    Ventilators need not be these expensive computerized machines we see in hospitals these days. For years the main machine for that was a device the size of a breadbox, the Bird Respirator, that ran on compressed air, no electronics, just valves, springs, and diaphragms. Very cheap.

    • #10
    • April 2, 2020, at 1:24 PM PDT
    • 3 likes
  11. Jerry Giordano (Arizona Patrio… Member

    I disagree with the OP very strongly. Sorry, Clifford. We’re often in agreement about many things, but I don’t find this finger-pointing to be either helpful or convincing.

    In my opinion, there as absolutely no reason to seriously expect some sort of major pandemic. Sure, I know that they have happened. Name three.

    Well, there was the Black Death, about 650 years ago. There was the Spanish Flu, about 100 years ago. And there was . . . well, nothing else comes to mind.

    But I’m old enough to remember the long litany of supposed pandemics, surrounded by hype and hysteria, that ended up being no big deal. Obviously, they kill some people, and that’s always tragic in detail, but there was nothing that created a major death toll in the US. Who remembers:

    • Legionnaire’s Disease
    • The Avian Flu
    • SARS
    • MERS
    • The Swine Flu
    • Ebola
    • Even AIDS

    For that matter, there was the hole in the ozone and killer bees, and running out of everything by the 1980s (according to the Club of Rome), and the Population Bomb causing mass starvation even in the West (according to Paul Ehrlich). And acid rain.

    That’s a lot of little boys crying wolf.

    Also, it’s not at all clear what anyone could do to effectively respond to a truly devastating pandemic.

    The early response was quite reasonable in the present COVID-19 outbreak, in my estimation. It looked a lot like SARS and MERS, which were also a coronavirus.

    Do you know how many people died in the US from SARS? Zero, per the CDC. There were 8 laboratory-confirmed cases. Do you know how many people in the US died from MERS? Zero, per the CDC. There were 2 cases in the US, both of whom had lived and worked in Saudi Arabia.

    So no, I do not think that there is any reason to think that we should have seen this coming.

    • #11
    • April 2, 2020, at 2:35 PM PDT
    • 3 likes
  12. Clifford A. Brown Contributor
    Clifford A. Brown

    Jerry Giordano (Arizona Patrio… (View Comment):

    I disagree with the OP very strongly. Sorry, Clifford. We’re often in agreement about many things, but I don’t find this finger-pointing to be either helpful or convincing.

    In my opinion, there as absolutely no reason to seriously expect some sort of major pandemic. Sure, I know that they have happened. Name three.

    Well, there was the Black Death, about 650 years ago. There was the Spanish Flu, about 100 years ago. And there was . . . well, nothing else comes to mind.

    But I’m old enough to remember the long litany of supposed pandemics, surrounded by hype and hysteria, that ended up being no big deal. Obviously, they kill some people, and that’s always tragic in detail, but there was nothing that created a major death toll in the US. Who remembers:

    • Legionnaire’s Disease
    • The Avian Flu
    • SARS
    • MERS
    • The Swine Flu
    • Ebola
    • Even AIDS

    For that matter, there was the hole in the ozone and killer bees, and running out of everything by the 1980s (according to the Club of Rome), and the Population Bomb causing mass starvation even in the West (according to Paul Ehrlich). And acid rain.

    That’s a lot of little boys crying wolf.

    Also, it’s not at all clear what anyone could do to effectively respond to a truly devastating pandemic.

    The early response was quite reasonable in the present COVID-19 outbreak, in my estimation. It looked a lot like SARS and MERS, which were also a coronavirus.

    Do you know how many people died in the US from SARS? Zero, per the CDC. There were 8 laboratory-confirmed cases. Do you know how many people in the US died from MERS? Zero, per the CDC. There were 2 cases in the US, both of whom had lived and worked in Saudi Arabia.

    So no, I do not think that there is any reason to think that we should have seen this coming.

    Name one major bioterrorism attack in the United States. And yet, we were supposedly planning and resourcing and exercising to respond effectively. Same for pandemics. We have multiple agencies with massive budgets, in business for many decades or a century plus. And yet. I am not finger pointing, that is not my intent, but rather identifying the fact that all of our local, state, and federal agencies have long considered and yet never been effectively organized, let along gathering and maintaining the relevant baseline data on our capabilities.

    Now, on April 2, 2020, we finally hear from a professional, a truly expert logistician, who has already mastered visibility of the relevant supply chains and of real demand expected over the next relevant periods. 

    • #12
    • April 2, 2020, at 5:51 PM PDT
    • 1 like
  13. Jerry Giordano (Arizona Patrio… Member

    Clifford A. Brown (View Comment):

    Name one major bioterrorism attack in the United States. And yet, we were supposedly planning and resourcing and exercising to respond effectively. Same for pandemics. We have multiple agencies with massive budgets, in business for many decades or a century plus. And yet. I am not finger pointing, that is not my intent, but rather identifying the fact that all of our local, state, and federal agencies have long considered and yet never been effectively organized, let along gathering and maintaining the relevant baseline data on our capabilities.

    Now, on April 2, 2020, we finally hear from a professional, a truly expert logistician, who has already mastered visibility of the relevant supply chains and of real demand expected over the next relevant periods. 

    These are good points. I simply do not expect the government, which is generally rather inefficient, to be well-prepared for a major crisis like a pandemic.

    Even the military doesn’t do very well in reacting to crises, at least not initially. We got the living daylights beaten out of us in the early part of WWII, and the Civil War too. The lesson that I draw is that you generally can’t be well prepared for a real calamity, but you can react realistically and with resolve.

    I think that you make good points about putting people trained in management and logistics in charge, rather than medical and epidemiological experts. Both are valuable and useful skill sets, but they are very different.

    • #13
    • April 2, 2020, at 7:22 PM PDT
    • 2 likes
  14. Roderic Coolidge

    Jerry Giordano (Arizona Patrio… (View Comment):

    • Legionnaire’s Disease
    • The Avian Flu
    • SARS
    • MERS
    • The Swine Flu
    • Ebola
    • Even AIDS

    The swine flu infected between 43 and 89 million people in 2009 causing ~18,000 deaths.

    The AIDS pandemic isn’t over yet. The death toll so far is 35 million.

    • #14
    • April 4, 2020, at 2:04 PM PDT
    • 1 like