Ricochet is the best place on the internet to discuss the issues of the day, either through commenting on posts or writing your own for our active and dynamic community in a fully moderated environment. In addition, the Ricochet Audio Network offers over 50 original podcasts with new episodes released every day.
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:
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
Science Friday (NPR)
Center for Health Security hosts Clade X pandemic exercise
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
New York Post
The world is completely unprepared for the next pandemic
The Week (UK)
Global pandemic could wipe out 900 million people
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
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
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
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:
- The National Biodefense Strategy
- Presidential Memorandum on the Support for National Biodefense
- Press Briefing on the National Biodefense Strategy
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.
[ . . . ]
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:Published in