Donald Trump is president of the United States,

but he told that none of this is his fault.

Why Trump refused to wear a face mask?

How Trump's speech 
on the coronavirus has changed

January 22, 2020

  Joe Kernen interviews Trump on CNBC from Davos 

January 30: Trump says coronavirus outbreak
is ‘all under control’ and a ‘very small problem’
in the U.S.

Spring Break 2020 Fort Lauderdale on the Beach

Trump’s responsibility

in the public health crisis

Manuel Castro Rodríguez

March 20, 2020

By late February, cases of novel coronavirus began spreading across the United States. There are 18,170 confirmed coronavirus cases and 241 people have died of the virus.

Florida Department of Health reported new cases, bring Florida’s total to 563. Florida’s Commissioner of Agriculture Nikki Fried urged Governor Ron DeSantis to issue a statewide stay-at-home order for all Floridians.

Local officials in Florida towns and cities are taking it upon themselves to close beaches amid the coronavirus outbreak after Gov. DeSantis refused to, even as spring breakers and others crowd the shores. At the height of the college break rush, DeSantis said Tuesday that he would not order the beaches closed, but he did limit parties on beaches to 10 people per group. DeSantis is a Trump loyalist because the president helped propel the Republican congressman into the governor’s mansion in 2018. 

The White House disbanded the global health security team in 2018 following a shake-up by then-national security adviser John Bolton. However, President Trump says he does not know anything about pandemic office his admin disbanded. Experts say Trump’s decision to disband pandemic team hindered coronavirus response.

On March 13, the president said he was declaring a "national emergency" to free up federal resources to combat coronavirus, when nearly 1,900 people in the United States had tested positive for COVID-19 and 41 had died. At least 30 states had declared states of emergency, school systems had shut down and moved to distance learning, professional sports leagues had put their games on hold, and the absence of a coherent policy from White House had created a contagion of fear and anxiety reflected in the plummeting stock market.

By comparison, Canada has spent the past two decades preparing for this moment. Canada had tested 15,000 people and had seen just 157 confirmed cases — the majority of which were imported from other countries — and 8 had died.

Public health experts largely agree that the lack of available tests In the United States makes determining the real number of infections nearly impossible, which has the effect of making it harder to slow the spread of infection. According to the Atlantic, approximately 13,000 people in the U.S. have been tested. By comparison, South Korea is testing 10,000 people per day. But, according to President Trump, those low numbers are not his fault.

NBC News’ Kristin Welker asked the president if he is to blame for the lag in testing. “No, I don’t take responsibility at all,” he responded, insisting instead — without offering evidence — that fault lies with his predecessor, “We were given rules, regulations, and specifications from a different time.”

Trump’s responsibility for the emerging crisis came up again when Yamiche Alcindor from PBS NewsHour asked about the dismantling of a pandemic-preparedness office that was once part of the National Security Council. “You said that you don’t take responsibility, but you did disband the White House pandemic office,” she said. “The officials that worked in that office said the White House lost valuable time because that office was disbanded.”

Un coronavirus en la era Trump
Manuel Castro Rodríguez

8 de abril de 2020

Un nuevo coronavirus —COVID-19, nombrado así por la Organización Mundial de la Salud desde el 11 de febrero— se está extendiendo por todo el territorio norteamericano ocasionando la peor crisis sanitaria del último siglo. 

Según el mapa interactivo creado por la universidad Johns Hopkins, los casos confirmados de coronavirus en Estados Unidos superan los cuatrocientos treinta y dos mil, mientras que las muertes sobrepasan las catorce mil ochocientas —incluyendo el fallecimiento de cientos de jóvenes: la evidencia demuestra que “el hecho de que sean jóvenes no significa que no sean vulnerables”.

El 17 de noviembre de 2019 es la fecha del primer caso en el mundo del nuevo coronavirus. El 27 de diciembre, Zhang Jixian, médico del Hospital Provincial de Medicina Integrada China y Occidental de Hubei, advirtió a las autoridades de salud que la enfermedad que tenían los pacientes era un nuevo coronavirus. 

El 31 de diciembre de 2019, China reportó un grupo de casos de neumonía en personas relacionadas con el mercado mayorista de mariscos Huanan en Wuhan, provincia de Hubei. El 7 de enero de este año, las autoridades sanitarias chinas confirmaron que estos casos estaban relacionados con un nuevo coronavirus, 2019-nCoV.  

Hace 3 meses, el 19 de enero de este año, se conoció que un hombre de 35 años residente en Seattle, en el estado de Washington, que 4 días antes había llegado al aeropuerto internacional de Seattle-Tacoma, procedente de Wuhan, China, en ese entonces epicentro del brote del virus, era el primer caso confirmado del nuevo coronavirus en Estados Unidos. 

El 22 de enero, el presidente Trump hizo sus primeros comentarios sobre el coronavirus cuando le preguntaron en una entrevista de CNBC: “¿Hay preocupaciones sobre una pandemia en este momento?” El presidente respondió: “No. En absoluto. Y lo tenemos totalmente bajo control. Es una persona que viene de China, y lo tenemos bajo control. Va a estar bien”.

El 24 de enero, una mujer de Chicago de 60 años fue diagnosticada como el segundo caso confirmado del nuevo coronavirus. 

Tan solo dos meses después, las cifras espeluznantes de casos confirmados y fallecimientos que está sufriendo la sociedad norteamericana, ha llevado a Estados Unidos a encabezar la lista de los países más afectados por el nuevo coronavirus. En la patria de Lincoln reside el 29% de los casos confirmados del nuevo coronavirus existentes en nuestro planeta. 

China, el país más poblado del mundo con mil trescientos millones de habitantes y donde comenzó la pandemia, ha tenido alrededor de ochenta y tres mil casos confirmados de COVID-19 y tres mil trescientas cincuenta muertes. Hoy, Wuhan, la ciudad china de once millones de habitantes donde se originó la pandemia, salió del aislamiento después de dos meses y medio. El pasado 23 de enero el gobierno de China decretó el confinamiento de los habitantes de Wuhan, los cuales sufrieron estrictas restricciones de movimiento. Sus once millones de habitantes quedaron sin poder salir de Wuhan, salvo raras excepciones.

En Estados Unidos, con una población de trescientos veintisiete millones de personas, o sea, la cuarta parte de la población de China, ya ha muerto el triple de personas que en China, y quintuplica los casos confirmados de COVID-19 que tiene China.

Más preocupante aún que este triste panorama es que podría ser mucho más tétrico, porque probablemente el número real de personas infectadas con el coronavirus sea mucho mayor, debido a todos los problemas que desde hace varios meses se han tenido en Estados Unidos con las pruebas para detectar el COVID-19, así como como con otros insumos y equipos médicos, y que todavía existen. 

Incluso, la Administración de Alimentos y Medicamentos (FDA, por sus siglas en inglés) reconoció el 7 de abril en su sitio en internet que “hay escasez de equipo de protección personal (EPP) como guantes, mascarillas y respiradores N95”, así como ventiladores.

Según el Comité de Supervisión y Reforma de la Cámara, el Departamento de Salud y Servicios Humanos dijo que la administración Trump no distribuyó suministros de la Reserva Estratégica Nacional a los estados en función de sus necesidades individuales durante la pandemia de coronavirus.

Poder usar un respirador artificial es una cuestión de vida o muerte cuando un paciente con COVID-19 sufre insuficiencia respiratoria. El doctor Armando Castro explica la función que cumplen los respiradores artificiales en la lucha contra el nuevo coronavirus.

La universidad canadiense McGill publicó la experiencia de la doctora Cristina Teodorescu atendiendo a pacientes con el nuevo coronavirus en Nueva Orleans, mostrando las pésimas condiciones en que se encuentran trabajando muchos médicos en Estados Unidos. 

El 1 de marzo, el gobernador de Nueva York, Andrew Cuomo, dijo que el primer caso confirmado de COVID-19 en el estado es una mujer de unos 30 años que había estado recientemente en Irán, que ya estaba aislada en su casa. Se esperaban casos locales, agregó Cuomo, diciendo que les solicitó a los legisladores estatales que aprobaran $40 millones en fondos de emergencia para combatir el virus de rápida propagación.

Aunque el estado de Nueva York es el epicentro del coronavirus en Estados Unidos, todavía tiene escasez de respiradores artificiales para poder enfrentar la crisis. Su gobernador, Andrew Cuomo, declaró el 2 de abril: “Solo tenemos respiradores artificiales para seis días”.

En cinco estados —Nueva York, Nueva Jersey, Luisiana, Washington y California— se encuentran dos tercios aproximadamente de las muertes por coronavirus en EE.UU. Por segundo día consecutivo, Nueva York y Nueva Jersey establecieron récord de víctimas mortales: 779 en Nueva York y 275 en Nueva Jersey.

Esos 779 fallecimientos elevó el número de muertos por el virus a 6.268 en el estado de Nueva York, que el gobernador Cuomo observó que era más del doble de personas que el estado había perdido en los ataques del 11 de septiembre de 2001.

Según el mapa interactivo de la universidad Johns Hopkins, el estado de Nueva York, con casi ciento cincuenta mil casos positivos conocidos hasta la fecha, tiene más casos que cualquier otro país que no sea Estados Unidos.

Durante su conferencia de prensa diaria, el gobernador de Nueva York, dijo que la cantidad de muertes continuará aumentando, incluso a medida que disminuyan las hospitalizaciones porque las muertes son un “indicador rezagado” del brote. Eso significa que las personas que han estado hospitalizadas durante mucho tiempo están comenzando a morir, mientras que han ocurrido menos nuevos ingresos.

Aún así, dijo que las medidas de distanciamiento social están funcionando y que la curva de infección se está aplanando. Cuomo lo atribuye un aumento en la capacidad hospitalaria, así como el intercambio de equipos entre “diferentes socios en el sistema de salud”. “No hay duda de que ahora estamos doblando la curva, y no hay duda de que no podemos dejar de hacer lo que estamos haciendo”, dijo Cuomo, y agregó que si la tasa de hospitalización continúa disminuyendo, el sistema de hospitales del estado “debería estabilizarse estas próximas dos semanas”.

Cuomo advirtió que las noticias positivas no significan que las medidas de mitigación deban detenerse. Reiteró que a principios de esta semana, duplicó la multa a $1.000 para las personas que desobedecen la orden de distanciamiento social del estado. 

Una nueva investigación indica que el coronavirus comenzó a circular en el área de Nueva York a mediados de febrero, semanas antes del primer caso confirmado, y que los viajeros trajeron el virus principalmente de Europa, no de Asia.

El presidente Trump ha reclamado crédito por desacelerar la propagación de COVID-19 en Estados Unidos al imponer una prohibición a fines de enero a algunos viajeros que recientemente habían estado en China. Desde entonces, la administración Trump ha prohibido la entrada a los viajeros que han estado en Irán y unos 30 países europeos, incluido el Reino Unido.

La Casa Blanca ni siquiera impuso restricciones a los pasajeros que habían estado en Corea del Sur, que también enfrentó un gran brote. Por cierto, el coronavirus puede “reactivarse” en personas que han sido curadas de la enfermedad, según los Centros para el Control y la Prevención de Enfermedades de Corea. Y las restricciones se les aplicaron solo a los extranjeros, a pesar del hecho de que el virus podría transmitirse con la misma facilidad por los norteamericanos que regresaron sin que se les pusiera en cuarentena.

El 31 de enero, el presidente Trump prohibió a los extranjeros ingresar a Estados Unidos si habían estado en China durante las dos semanas anteriores. No sería hasta finales de febrero que Italia comenzaría a bloquear pueblos y ciudades, y el 11 de marzo cuando Trump dijo que bloquearía a los viajeros de la mayoría de los países europeos. 

La inacción de la Casa Blanca ha llevado a estados y ciudades a tomar la iniciativa contra el nuevo coronavirus. 

¿La administración Trump está haciendo todo lo posible para detener esta pandemia?  Le sugiero que califique a cada político por su gestión del coronavirus.

Trump's failed coronavirus response

Robert Reich

April 14, 2020

On April 16, was published The spies who predicted COVID-19. Kent Harrington, a former senior CIA analyst, who served as national intelligence officer for East Asia, chief of station in Asia, and the CIA’s director of public affairs, says (emphasis mine),

Intelligence agencies are used to making headlines when they fail to do their job. But after months of President Donald Trump ignoring their warnings about COVID-19, and after years of his administration discounting their alerts about the danger of a pandemic more generally, it is time that intelligence professionals receive the credit they deserve.

It should come as no surprise that Trump repeatedly dismissed intelligence about the threat of the coronavirus throughout January and February. Trump has long made clear that he has no patience for those who don’t pander to his views. When intelligence leaders contradicted him on several issues in their annual briefing to Congress last year, he told them to “go back to school.”

This year, the bill for Trump’s war on intelligence is coming due in the form of lost lives and overwhelmed health-care systems. U.S. intelligence agencies had sounded the alarm and even provided the enemy’s battleplan, detailing precisely how a novel coronavirus pandemic would unfold. Still, the wannabe wartime president did nothing. Res ipsa loquitur — the negligence speaks for itself.

It is very clear that many COVID-19 deaths and cases would have been prevented. 

On May 1, was published Public health measures and the reproduction number of SARS-CoV-2. Thomas V. Inglesby, who is Professor and the director of Johns Hopkins Center for Health Security (tinglesby@jhu.edu), says,

The US Centers for Disease Control and Prevention (CDC) should regularly report on the R_t for the US and for each of the 50 states so that political and public health leaders can gauge how well the combined organizational and individual social distancing measures in place around the country are working to diminish transmission of this virus. The CDC should then communicate this transparently to the public to increase public buy-in and understanding of the actions being taken to slow the spread of COVID-19. 

How America lost the war on COVID-19
Paul Krugman*

July 7, 2020

This administration’s policies on the coronavirus crisis 
are all about making Trump look good, not about the 
national interest.

So Donald Trump is now calling COVID-19 the 
“Chinese virus.” Of course he is: Racism and blaming 
other people for his own failures are the defining 
features of his presidency. But if we’re going to give it a 
nickname, much better to refer to it as the 
“Trump pandemic.”

True, the virus didn’t originate here. But the U.S. 
response to the threat has been catastrophically slow 
and inadequate, and the buck stops with Trump, who
 minimized the threat and discouraged action until just 
a few days ago.

Compare, for example, America’s handling of the 
coronavirus with that of South Korea. Both countries 
reported their first case on Jan. 20. But Korea moved 
quickly to implement widespread testing; it has used 
the data from that testing to guide social distancing and
other containment measures; and the disease appears 
to be on the wane there. 

In the U.S., by contrast, testing has barely begun
 — we’ve tested only 60,000 people compared with 
South Korea’s 290,000, even though we have six times 
its population, and the number of cases here appears to 
be skyrocketing.

The details of our failure are complex, but they all flow
ultimately from Trump’s minimization of the threat: He 
was asserting that COVID-19 was no worse than the flu 
just last week (although true to form, he’s now claiming
to have known all along that a pandemic was coming).

Why did Trump and his team deny and delay? All the 
evidence suggests that he didn’t want to do or say 
anything that might drive down stock prices, which he 
seems to regard as the key measure of his success. 
That’s presumably why as late as Feb. 25 Larry Kudlow, 
the administration’s chief economist, declared that the 
U.S. had “contained” the coronavirus, and that the 
economy was “holding up nicely.”

Well, that was a bad bet. Since then, the stock market 
has more or less given up all its gains under the Trump 
presidency. More important, the economy is clearly in 
free-fall. So what should we do now?

I’ll leave health policy to the experts. On economic 
policy, I’d suggest three principles. First, focus on 
hardship, not GDP. Second, stop worrying about 
incentives to work. Third, don’t trust Trump.

On the first point: Many of the job losses we’ll 
experience over the next few months will be not just 
unavoidable but actually desirable. We want workers
 who are or might be sick to stay home, to “flatten the 
curve” of the virus’ spread. We want to partly or wholly 
close large business establishments, like auto plants, 
that could act as human petri dishes. We want to close 
restaurants, bars and nonessential retail establishments.

Now, there will surely be additional, unnecessary job 
losses caused by a plunge in consumer and business 
spending, which is why we should be engaged in 
substantial overall stimulus. But policy can’t and 
shouldn’t prevent widespread temporary job loss.

What policy can do is reduce the hardship facing 
those who are temporarily out of work. That means that
 we need to spend much more on programs like paid 
sick leave, unemployment benefits, food stamps and 
Medicaid that aid Americans in distress, who need far 
more help than they’ll get from an across-the-board 
cash drop. This spending would also provide stimulus, 
but that’s a secondary concern.

Which brings me to my second point. The usual suspects 
are already objecting that helping Americans in need 
reduces their incentive to work. That’s a lousy argument
 even in good times, but it’s absurd in the face of a 
pandemic. And state governments that have been 
trying, with encouragement from the Trump 
administration, to reduce public assistance by imposing 
work requirements should suspend all such 
requirements, immediately.

Finally, about Trump: Over the past few days state TV, 
I mean Fox News, and right-wing pundits have abruptly 
pivoted from dismissing COVID-19 as a liberal hoax to 
demanding an end to all criticism of the president in a 
time of national emergency. This should come as no 
surprise.

But this is where the history of the Trump pandemic — 
all those wasted weeks when we did nothing because 
Donald Trump didn’t want to hear anything that might 
hurt him politically — becomes relevant. It shows that 
even when American lives are at risk, this 
administration’s policy is all about Trump, about what 
he thinks will make him look good, never mind the 
national interest.

What this means is that as Congress allocates money to 
reduce the economic pain from COVID-19, it shouldn’t 
give Trump any discretion over how the money is spent. 
For example, while it may be necessary to provide funds
 for some business bailouts, Congress must specify the 
rules for who gets those funds and under what 
conditions. Otherwise you know what will happen: 
Trump will abuse any discretion to reward his friends 
and punish his enemies. That’s just who he is.

Dealing with the coronavirus would be hard in the best 
of circumstances. It will be especially hard when we 
know that we can’t trust either the judgment or the 
motives of the man who should be leading the response. 
But you go into a pandemic with the president you have,
not the president you wish you had.

* Paul Krugman is a Nobel laureate in economics.

The federal government’s coronavirus response 

— Public health timeline

Philip A. Wallach and Justus Myers

March 31, 2020

A colossal failure of Trump's leadership

Peter Bergen

July 29, 2020

During his campaign to become president, Donald Trump repeatedly claimed that other countries were "laughing" at the United States. Of course, Trump never cited any evidence for this.

Today, those countries are not only not laughing at the US, they are treating Americans like lepers.

The dark blue US passport used to open pretty much every door around the globe; now those doors are slammed shut. A roll call of some of America's closest allies that won't let Americans visit include Canada, France, Germany and Italy.

And for good reason: This past week, 18 American states set records for their numbers of confirmed coronavirus cases. There are now more than four million confirmed cases in the US; a quarter of the total number of known cases in the world, yet Americans make up just over 4% of the global population.

This isn't the “first wave” of the coronavirus; it's the first tsunami. And how the US got here has much to do with a catastrophic failure of national leadership.

The federal government abdicated its role by not issuing a national shutdown order and a mandate to wear masks. After the expiration of the voluntary 45-day federal advisory to “slow the spread,” the Centers for Disease Control and Prevention guidance on how to reopen carefully in phases was ignored in many states.

By prioritizing “reopening” over public health, the nation has chosen to accept that many hundreds of thousands of Americans will die of Covid-19. The CDC estimates that nearly half of Americans have underlying conditions that put them at risk of contracting a severe case of the disease. Many millions more are then likely to have a severe case that may not end in death, but will nonetheless result in prolonged illness.

The agency said more than a third of those surveyed had not returned to their normal good health two to three weeks after being diagnosed with the disease.

There are few tools that we know that work to stop the spread of the virus; they are social distancing and wearing a mask in public.

Trump, of course, has for months denigrated mask-wearing and has almost invariably refused to wear a mask himself. In doing so, he has turned masks into political footballs rather than symbols of sound public health policy.

Trump pressed states to "open" early before many of them had met CDC thresholds for doing so. In many states, social distancing went out the window.

In defiance of CDC guidelines on large gatherings, Trump held a large indoor rally in Tulsa, Oklahoma, last month which “likely” contributed to a spike of cases there, according to local health officials.

One of the attendees at the Tulsa rally was Republican Governor Kevin Stitt, who subsequently became the first US governor to test positive for the virus.

Trump is pressing now for schools around the United States to fully reopen and is threatening to withhold federal funds to school systems that don't comply.

Meanwhile, the private school in Maryland attended by Trump's son Barron is contemplating either going fully online or some sort of “hybrid” of in-person and online teaching.

Trump has consistently placed faith in the wisdom of his own gut over science, claiming that hydroxychloroquine was a “game changer” when in fact it can increase the chance that Covid-19 patients might die of heart failure. As recently as Tuesday, Trump continued to tout the drug at the White House. He has also suggested without evidence that warm weather would chase away the virus.

Instead of taking a summer vacation, the virus has barreled through Arizona, Florida and Texas, all sweltering in the heat of summer and all of which have set records for their numbers of coronavirus cases.

Trump has trumpeted the number of coronavirus tests done in the US and has claimed falsely and repeatedly that the rising numbers of cases results from the rising number of tests, rather than the result of widely spreading infections.

One could go on about the marginalization of the CDC and the White House attempts to besmirch scientists like Dr. Anthony Fauci and the litany of other failures of the most incompetent administration in memory, but it's all too depressing.

Finally, for Trump the buck never stops at his desk. Trump has tried labelling the virus "the China virus" the "Wuhan virus' and even the "kung flu."

But these diversionary efforts are increasingly falling flat. A poll released two days ago by the Associated Press-NORC found that Trump's approval rating on his handling of the virus has fallen to an all-time low of 32%.

Inside Trump’s failure:

the rush to abandon

leadership role on the virus

Michael D. Shear, Noah Weiland, Eric Lipton,

Maggie Haberman and David E. Sanger

Published July 18, 2020

Updated July 28, 2020

The roots of the nation’s current inability to control the pandemic can be traced to mid-April, when the White House embraced overly rosy projections to proclaim victory and move on.

Each morning at 8 as the coronavirus crisis was raging in April, Mark Meadows, the White House chief of staff, convened a small group of aides to steer the administration through what had become a public health, economic and political disaster.

Seated around Mr. Meadows’s conference table and on a couch in his office down the hall from the Oval Office, they saw their immediate role as practical problem solvers. Produce more ventilators. Find more personal protective equipment. Provide more testing.

But their ultimate goal was to shift responsibility for leading the fight against the pandemic from the White House to the states. They referred to this as “state authority handoff,” and it was at the heart of what would become at once a catastrophic policy blunder and an attempt to escape blame for a crisis that had engulfed the country — perhaps one of the greatest failures of presidential leadership in generations.

Over a critical period beginning in mid-April, President Trump and his team convinced themselves that the outbreak was fading, that they had given state governments all the resources they needed to contain its remaining “embers” and that it was time to ease up on the lockdown.

In doing so, he was ignoring warnings that the numbers would continue to drop only if social distancing was kept in place, rushing instead to restart the economy and tend to his battered re-election hopes.

Casting the decision in ideological terms, Mr. Meadows would tell people: “Only in Washington, D.C., do they think that they have the answer for all of America.”

For scientific affirmation, they turned to Dr. Deborah L. Birx, the sole public health professional in the Meadows group. A highly regarded infectious diseases expert, she was a constant source of upbeat news for the president and his aides, walking the halls with charts emphasizing that outbreaks were gradually easing. The country, she insisted, was likely to resemble Italy, where virus cases declined steadily from frightening heights.

On April 11, she told the coronavirus task force in the Situation Room that the nation was in good shape. Boston and Chicago are two weeks away from the peak, she cautioned, but the numbers in Detroit and other hard-hit cities are heading down.

A sharp pivot soon followed, with consequences that continue to plague the country today as the virus surges anew.

Even as a chorus of state officials and health experts warned that the pandemic was far from under control, Mr. Trump went, in a matter of days, from proclaiming that he alone had the authority to decide when the economy would reopen to pushing that responsibility onto the states. The government issued detailed reopening guidelines, but almost immediately, Mr. Trump began criticizing Democratic governors who did not “liberate” their states.

Mr. Trump’s bet that the crisis would fade away proved wrong. But an examination of the shift in April and its aftermath shows that the approach he embraced was not just a misjudgment. Instead, it was a deliberate strategy that he would stick doggedly to as evidence mounted that, in the absence of strong leadership from the White House, the virus would continue to infect and kill large numbers of Americans.

He and his top aides would openly disdain the scientific research into the disease and the advice of experts on how to contain it, seek to muzzle more authoritative voices like Dr. Anthony S. Fauci and continue to distort reality even as it became clear that his hopes for a rapid rebound in the economy and his electoral prospects were not materializing.

Mr. Trump had missed or dismissed mounting signals of the impending crisis in the early months of the year. Now, interviews with more than two dozen officials inside the administration and in the states, and a review of emails and documents, reveal previously unreported details about how the White House put the nation on its current course during a fateful period this spring.

• Key elements of the administration’s strategy were formulated out of sight in Mr. Meadows’s daily meetings, by aides who for the most part had no experience with public health emergencies and were taking their cues from the president. Officials in the West Wing saw the better-known White House coronavirus task force as dysfunctional, came to view Dr. Fauci as a purveyor of dire warnings but no solutions and blamed officials from the Centers for Disease Control and Prevention for mishandling the early stages of the virus.

   

• Dr. Birx was more central than publicly known to the judgment inside the West Wing that the virus was on a downward path. Colleagues described her as dedicated to public health and working herself to exhaustion to get the data right, but her model-based assessment nonetheless failed to account for a vital variable: how Mr. Trump’s rush to urge a return to normal would help undercut the social distancing and other measures that were holding down the numbers.

   

• The president quickly came to feel trapped by his own reopening guidelines. States needed declining cases to reopen, or at least a declining rate of positive tests. But more testing meant overall cases were destined to go up, undercutting the president’s push to crank up the economy. The result was to intensify Mr. Trump’s remarkable public campaign against testing, a vivid example of how he often waged war with science and his own administration’s experts and stated policies.

   

• Mr. Trump’s bizarre public statements, his refusal to wear a mask and his pressure on states to get their economies going again left governors and other state officials scrambling to deal with a leadership vacuum. At one stage, Gov. Gavin Newsom of California was told that if he wanted the federal government to help obtain the swabs needed to test for the virus, he would have to ask Mr. Trump himself — and thank him.

   

• Not until early June did White House officials even begin to recognize that their assumptions about the course of the pandemic had proved wrong. Even now there are internal divisions over how far to go in having officials publicly acknowledge the reality of the situation.

   

Judd Deere, a White House spokesman, said the president had imposed travel restrictions on China early in the pandemic, signed economic relief measures that have provided Americans with critical assistance and dealt with other issues including supplies of personal protective equipment, testing capacity and vaccine development.

“President Trump and his bold actions from the very beginning of this pandemic stand in stark contrast to the do-nothing Democrats and radical left who just complain, criticize and condemn anything this president does to preserve this nation,” he  said.

At a briefing on April 10, Mr. Trump predicted that the number of deaths in the United States from the pandemic would be “substantially” fewer than 100,000. As of Saturday, the death toll stood at 139,186, the pace of new deaths was rising again and the country, logging a seven-day average of 65,790 new cases a day, had more confirmed cases per capita than any other major industrial nation.

Trump’s Choice

The president had a decision to make.

It was the end of March and his initial, 15-day effort to slow the spread of the virus by essentially shutting down the country was expiring in days. Sitting in front of the Resolute Desk in the Oval Office were Drs. Fauci and Birx, along with other top officials. Days earlier, Mr. Trump had said he envisioned the country being “opened up and raring to go” by Easter, but now he was on the verge of announcing that he would keep the country shut down for another 30 days.

“Do you really think we need to do this?” the president asked Dr. Fauci. “Yeah, we really do need to do it,” Dr. Fauci replied, explaining again the federal government’s role in making sure the virus did not explode across the country.

Mr. Trump’s willingness to go along — driven in part by grim television images of bodies piling up at Elmhurst Hospital Center in New York City — was a concession that federal responsibility was crucial to defeating a virus that did not respect state boundaries. In a later Rose Garden appearance, he appeared resigned to continuing the battle.

“Nothing would be worse than declaring victory before the victory is won,” Mr. Trump said.

But even as the president was acknowledging the need for tough decisions, he and his aides would soon be looking to do the opposite — build a public case that the federal government had completed its job and unshackle the president from ownership of the response.

The hub of the activity was the working group assembled by Mr. Meadows, who had just taken over as chief of staff.

Joe Grogan, the domestic policy adviser, had come around to Mr. Trump’s view that the reaction to the virus was overblown, a position shared at that point by Marc Short, Vice President Mike Pence’s chief of staff and a frequent participant in the meetings. Russell T. Vought, the president’s acting budget director, was there to address the pandemic’s mounting costs.

Chris Liddell, a deputy chief of staff, and Jared Kushner, the president’s senior adviser and son-in-law, acted as the group’s procurement and supply-chain experts.

Hope Hicks, the protector of Mr. Trump’s brand, was a regular participant. Kevin A. Hassett, a top economic adviser, came at times to help assess the numbers and also participated in a 9 a.m. meeting three times a week with Mr. Meadows and Treasury Secretary Steven Mnuchin on the economic aspects of the pandemic.

Then there was Dr. Birx, the response coordinator of the coronavirus task force. Unlike Dr. Fauci, who only stopped by the White House to attend meetings, she was given an office near the Situation Room and freely roamed the West Wing, fully embracing her role as a member of the president’s team.

By mid-April, Mr. Trump had grown publicly impatient with the stay-at-home recommendations he had reluctantly endorsed. Weekly unemployment claims made clear the economy was cratering and polling was showing his campaign bleeding support. Republican governors were agitating to lift the lockdown and the conservative political machinery was mobilizing to oppose what it saw as constraints on individual freedom.

At the meetings in Mr. Meadows’s office, the issue was clear: How much longer do we keep this up?

To answer that, they focused on two more questions: Had the virus peaked? And had the government given the states the tools they needed to manage the remaining problems?

On the first question, Dr. Birx and Mr. Hassett were optimistic: Mitigation was working, they insisted, even as many outside experts were warning that the nation would remain at great risk if it let up on social distancing and moved prematurely to reopen.

Mr. Meadows thought of himself as a data-driven decision maker, and in addition to models and infection numbers from the states and the C.D.C., they looked at traffic on the New Jersey Turnpike (the volume of cars coming in and out of New York City was down by 95.2 percent); payroll and credit card data, and the number of people who were reporting to have self-quarantined.

If the point was to sustain a monthlong lockdown, the numbers told them, the administration succeeded. If it was to squelch the virus to containable levels, later events would show the officials were oblivious to how widely it was already spreading.

The members of his group believed they had succeeded on the second question, too, although shortages of protective gear continued in some places (and would flare again months later).

A one-time anticipated shortage of more than 100,000 ventilators had been overcome; now there was enough of a surplus that the United States could lend them to other countries. A ban on elective surgeries meant there was plenty of bed space — and no more need for the Navy’s hospital ships.

The group thought governors should no longer have trouble getting what they needed for hospitals, doctors and first responders. And they grew increasingly frustrated by what they saw as politically motivated complaining about a lack of federal help and the inability of some states to make effective use of the supplies they were receiving.

Enraged by criticism from New York’s Democratic politicians about not being able to find a shipment of ventilators from the federal government, Mr. Grogan, the domestic policy chief, angrily told Mr. Kushner that they should put more ventilators on eighteen-wheelers, drive them into New York City and invite news helicopters to record it all — just to embarrass Gov. Andrew Cuomo and Mayor Bill de Blasio.

On April 14, the country passed what the group saw as a milestone, administering its three millionth test. Inside the West Wing, Mr. Kushner was insistent on that point: Given their assumption that infections would not surge again until the fall, there was enough testing ability out there.

Those outside experts who disagreed were largely brushed off. In mid-April, Dr. Ashish K. Jha, director of the Harvard Global Health Institute, urged a top administration official to embrace his call for conducting 500,000 coronavirus tests a day — far more than was happening at the time.

The official, Adm. Brett P. Giroir, the administration’s testing czar, who had been delivering upbeat descriptions of the nation’s growing testing capacity, eventually conceded to Dr. Jha that his plan seemed to be needed. But he made clear the federal government was not prepared to get there quickly.

“At some point down the road,” is what Dr. Jha said Admiral Giroir told him.

“My take is that Jared Kushner believes that this is not something that the White House should get too involved in,” Dr. Jha recalled. “And then the president believes that it is better left up to the states.”

Their critics notwithstanding, White House officials came to feel that they had in fact accomplished their job: giving governors the tools they needed to deal with remaining outbreaks as infections ebbed.

The wind down of the federal government’s response would play out over the next several weeks. The daily briefings with Mr. Trump ended on April 24. The Meadows team started barring Dr. Fauci from making most television appearances, lest he go off message and suggest continued high risk from the virus.

By the beginning of May, word leaked that the daily meetings of the task force itself would be ended, though Mr. Trump, who had not been told, backpedaled after the coverage caused an uproar.

On testing, Mr. Trump shifted from stressing that the nation was already doing more than any other country to deriding its importance. By June the president was regularly making nonsensical statements like, “If we stop testing right now, we’d have very few cases, if any.”

But during the middle weeks of April the president’s decision to largely walk away from an active leadership role — and give many states permission to believe the worst of the crisis was behind them — came abruptly into public view.

On April 10, Mr. Trump declared that, in his role as something akin to a “wartime president,” it would be his decision about whether to reopen the country. “That’s my metrics,”he told reporters, pointing to his own head. “I would say without question it’s the biggest decision I’ve ever had to make.”

Three days later, he reiterated his responsibility. “When somebody is the president of the United States, the authority is total and that’s the way it’s got to be,” he said.

The next day, Dr. Birx and Dr. Fauci presented Mr. Trump with a plan for issuing guidelines to start reopening the country at the end of the month. Developed largely by Dr. Birx and held closely by her until being presented to the president — most task force members did not see them beforehand — the guidelines laid out broad, voluntary standards for states considering how fast to come out of the lockdown.

In political terms, the document’s message was that responsibility for dealing with the pandemic was shifting from Mr. Trump to the states.

On April 16, when Mr. Trump publicly announced the guidelines, he made the message to the governors explicit.

“You’re going to call your own shots,” he said.

Birx’s Influence

Dr. Birx showing a projected model of national deaths during a coronavirus task force briefing at the White House in March. Inside the White House, Dr. Birx was the chief evangelist for the idea that the threat from the virus was fading.

Unlike Dr. Fauci, Dr. Birx is a strong believer in models that forecast the course of an outbreak. Dr. Fauci has cautioned that “models are only models” and that real-world outcomes depend on how people respond to calls for changes in behavior — to stay home, for example, or wear masks in public — sacrifices that required a sense of shared national responsibility.

In his decades of responding to outbreaks, Dr. Fauci, a voracious reader of political histories, learned to rely on reports from the ground. Late at night in his home office this spring, Dr. Fauci, who declined to comment for this article, dialed health officials in New Orleans, New York and Chicago, where he heard desperation unrecognizable in the more sanguine White House meetings.

Dr. Fauci had his own critics, who said he relied on anecdotes and experience rather than data, and who felt he was not sufficiently attuned to the devastating economic and social consequences of a national lockdown.

As the pandemic worsened, Dr. Fauci’s darker view of the circumstances was countered by the reassurances ostensibly offered by Dr. Birx’s data.

A renowned AIDS researcher who holds the title of “ambassador” as the State Department’s special representative for global health diplomacy, she had assembled a team of analysts who worked late nights in the White House complex, feeding her a constant stream of updated data, packaged in Power Point slides emailed to senior officials each day.

There were warnings that the models she studied might not be accurate, especially in predicting the course of the virus against a backdrop of evolving political, economic and social factors. Among the models Dr. Birx relied on most was one produced by researchers at the University of Washington. But when Mr. Hassett reviewed its performance by looking back on its predictions from three weeks earlier, it turned out to be hit or miss.

The authors of the University of Washington model spoke to Dr. Birx or members of her team almost daily, they said, and often cautioned that their work was only supposed to offer a snapshot based on key assumptions, like people continuing to abide by social distancing until June 1.

“We made clear that to get the epidemic under control and bring it down to effectively zero transmission required the social distancing mandates to be in place,” said Christopher J. L. Murray, the director of the modeling program. “April 22 — somewhere around that period. That’s when the tone shifted. They started to ask questions about what will be the trajectory and where with the lifting of mandates?”

Some state officials were also alarmed by the administration’s use of the University of Washington model.

Colorado health officials wrote to the administration on April 9, pleading that the White House not use the model to allocate supplies to the state, saying its predictions were rosier than the grim reality they were encountering. (When those concerns were relayed to her, Dr. Birx replied that decisions on allocating equipment were based on factors beyond the one model.)

Dr. Birx declined to be interviewed. A task force official said that she had only used the University of Washington model in a limited way and that the White House used “real data, not modeled data, to understand the pandemic in the United States.”

The official said the White House “immediately reacted to the early signs of community spread” by working with governors in the affected states.

But despite the outside warnings and evidence by early May that new infections, while down, remained higher than anticipated, the White House never fundamentally re-examined the course it had set in mid-April.

Dr. Fauci, a friend of Dr. Birx’s for 30 years, would describe her as more political than him, a “different species.” More pessimistic by nature, Dr. Fauci privately warned that the virus was going to be difficult to control, often commenting that he was the “skunk at the garden party.”

By contrast, Dr. Birx regularly delivered what the new team was hoping for.

“All metros are stabilizing,” she would tell them, describing the virus as having hit its “peak” around mid-April. The New York area accounted for half of the total cases in the country, she said. The slope was heading in the right direction. “We’re behind the worst of it.” She endorsed the idea that the death counts and hospitalization numbers could be inflated.

For Dr. Birx, Italy’s experience was a particularly telling — and positive — comparison. She routinely told colleagues that the United States was on the same trajectory as Italy, which had huge spikes before infections and deaths flattened to close to zero.

“She said we were basically going to track Italy,” one senior adviser later recalled.

Dr. Birx would roam the halls of the White House, talking to Mr. Kushner, Ms. Hicks and others, sometimes passing out diagrams to bolster her case. “We’ve hit our peak,” she would say, and that message would find its way back to Mr. Trump.

Dr. Birx began using versions of the phrase “putting out the embers,” wording that was later picked up by the press secretary, Kayleigh McEnany, and by Mr. Trump himself.

By the middle of May, the task force believed that another resurgence was not likely until the fall, senior administration officials said.

The New York region appeared well on its way to driving new infections down to levels it could handle — it was the one area of the country that did resemble the Italian model. But the models and analysis embraced by the West Wing failed to account for the weakening adherence to the lockdowns across the country that began even before Mr. Trump started urging governors to “liberate” their residents from the methodical guidelines his own government had established.

Later, it was clear that states that rushed to reopen before meeting the criteria in the guidelines — like Arizona, Texas and Alabama — would have among the worst surges in new cases.

Dr. Birx’s belief that the United States would mirror Italy turned out to be disastrously wrong. The Italians had been almost entirely compliant with stay-at-home orders and social distancing, squelching new infections to negligible levels before the country slowly reopened. Americans, by contrast, began backing away by late April from what social distancing efforts they had been making, egged on by Mr. Trump.

The difference was critical. As communities across the United States raced to reopen, the daily number of new cases barely dropped below 20,000 in early May. The virus was still circulating across the country.

Italy’s recovery curve, it turned out, looked nothing like the American one.

The Consequences

The real-world consequences of Mr. Trump’s abdication of responsibility rippled across the country.

During a briefing on April 20, Mr. Trump mocked Gov. Larry Hogan of Maryland, a fellow Republican, for the state’s inability to find enough testing. Dr. Birx displayed maps with dozens of dots indicating labs that could help.

“He really didn’t know about the federal laboratories,” Mr. Trump told reporters with mock astonishment. “He didn’t know about it.”

But when Frances B. Phillips, the state’s deputy health secretary, reached out to one of those dots — a National Institutes of Health facility in Maryland — she was told that they were suffering from the same shortages as state labs and were not in a position to help.

“It was clear that we were on our own and we need to develop our own strategy, which is very unlike the kind of federal response in the past public health emergencies,” Ms. Phillips recalled.

In California, Mr. Newsom had already experienced firsthand the complexities of getting help from Washington.

After offering to help acquire 350,000 testing swabs during an early morning conversation with one of Mr. Newsom’s advisers, Mr. Kushner made it clear that the federal help would hinge on the governor doing him a favor.

“The governor of California, Gavin Newsom, had to call Donald Trump, and ask him for the swabs” recalled the adviser, Bob Kocher, an Obama-era White House health care official.

Mr. Newsom made the call as requested and then praised Mr. Trump that same day during a news conference where he announced the commitment, giving Mr. Trump credit for the “substantial increase in supply” headed to California.

Mayor Francis X. Suarez of Miami, a Republican, said that the White House approach had only one focus: reopening businesses, instead of anticipating how cities and states should respond if cases surged again.

“It was all predicated on reduction, open, reduction, open more, reduction, open,” he said. “There was never what happens if there is an increase after you reopen?”

Other nations had moved aggressively to employ an array of techniques that Mr. Trump never mobilized on a federal level, including national testing strategies and contact tracing to track down and isolate people who had interacted with newly diagnosed patients.

“These things were done in Germany, in Italy, in Greece, Vietnam, in Singapore, in New Zealand and in China,” said Andy Slavitt, a former federal health care official who had been advising the White House.

“They were not secret,” he said. “Not mysterious. And these were not all wealthy countries. They just took accountability for getting it done. But we did not do that here. There was zero chance here that we would ever have been in a situation where we would be dealing with ‘embers.’ ”

A New Surge

By early June, it was clear that the White House had gotten it wrong.

In task force meetings, officials discussed a spike in cases across the South and whether any bumps in caseloads were caused by crowded protests over the killing of George Floyd. They briefly considered if it was a fleeting side effect of Memorial Day gatherings.

They soon realized there was more at play.

Digging into new data from Dr. Birx, they concluded the virus was in fact spreading with invisible ferocity during the weeks in May when states were opening up with Mr. Trump’s encouragement and many were all but declaring victory.

With the benefit of hindsight, the head of the Centers for Disease Control and Prevention, Dr. Robert R. Redfield, acknowledged this week in a conversation with the Journal of the American Medical Association that administration officials — himself included — severely underestimated infections in April and May. He estimated they were missing as many as 10 cases each day for every one they were confirming.

The number of new cases has now surged far higher than the previous peak of more than 36,000 a day in mid-April. On Thursday, there were more than 75,000 confirmed new cases, a record.

Mr. Trump’s disdain for testing continues to affect the country. By the middle of June, lines stretched for blocks in Phoenix and in Austin, Texas. And getting results could take a week to 10 days, officials in Texas said — effectively inviting the virus to spread uncontrollably.

Dr. Mandy K. Cohen, the top health official in North Carolina, contacted the Trump administration after a surge in June, asking the government to quickly open 100 new testing sites in her state, in addition to the 13 it was then operating.

“We will keep those 13 open for another month — you are welcome,” Dr. Cohen said, mocking the response she received.

It was a devastating situation, said Mayor Steve Adler of Austin, who watched as the Covid-19 cases at intensive care units at area hospitals jumped from three in mid-May to 185 by early July. Mr. Adler had a simple plea for the White House.

“When we were trying to get people to wear masks, they would point to the president and say, well, not something that we need to do,” he said.

Mr. Suarez expressed similar frustrations with Mr. Trump’s dismissive approach to mask wearing. “People follow leaders,” he said, before rephrasing his remarks. “People follow the people who are supposed to be leaders.”

He could have seen what was coming: behind Trump’s failure on the virus

Eric Lipton, David E. Sanger, Maggie Haberman, Michael D. Shear, Mark Mazzetti and Julian E. Barnes 

April 11, 2020

An examination reveals the president was warned about the potential for a pandemic but that internal divisions, lack of planning and his faith in his own instincts led to a halting response.

“Nobody knew there would be a pandemic or epidemic of this proportion,” President Trump said last month. He has repeatedly said that no one could have seen the effects of the coronavirus coming.

“Any way you cut it, this is going to be bad,” a senior medical adviser at the Department of Veterans Affairs, Dr. Carter Mecher, wrote on the night of Jan. 28, in an email to a group of public health experts scattered around the government and universities. “The projected size of the outbreak already seems hard to believe.”

A week after the first coronavirus case had been identified in the United States, and six long weeks before President Trump finally took aggressive action to confront the danger the nation was facing — a pandemic that is now forecast to take tens of thousands of American lives — Dr. Mecher was urging the upper ranks of the nation’s public health bureaucracy to wake up and prepare for the possibility of far more drastic action.

“You guys made fun of me screaming to close the schools,” he wrote to the group, which called itself “Red Dawn,” an inside joke based on the 1984 movie about a band of Americans trying to save the country after a foreign invasion. “Now I’m screaming, close the colleges and universities.”

His was hardly a lone voice. Throughout January, as Mr. Trump repeatedly played down the seriousness of the virus and focused on other issues, an array of figures inside his government — from top White House advisers to experts deep in the cabinet departments and intelligence agencies — identified the threat, sounded alarms and made clear the need for aggressive action.

The president, though, was slow to absorb the scale of the risk and to act accordingly, focusing instead on controlling the message, protecting gains in the economy and batting away warnings from senior officials. It was a problem, he said, that had come out of nowhere and could not have been foreseen.

Even after Mr. Trump took his first concrete action at the end of January — limiting travel from China — public health often had to compete with economic and political considerations in internal debates, slowing the path toward belated decisions to seek more money from Congress, obtain necessary supplies, address shortfalls in testing and ultimately move to keep much of the nation at home.

Unfolding as it did in the wake of his impeachment by the House and in the midst of his Senate trial, Mr. Trump’s response was colored by his suspicion of and disdain for what he viewed as the “Deep State” — the very people in his government whose expertise and long experience might have guided him more quickly toward steps that would slow the virus, and likely save lives.

Decision-making was also complicated by a long-running dispute inside the administration over how to deal with China. The virus at first took a back seat to a desire not to upset Beijing during trade talks, but later the impulse to score points against Beijing left the world’s two leading powers further divided as they confronted one of the first truly global threats of the 21st century.

The shortcomings of Mr. Trump’s performance have played out with remarkable transparency as part of his daily effort to dominate television screens and the national conversation.

But dozens of interviews with current and former officials and a review of emails and other records revealed many previously unreported details and a fuller picture of the roots and extent of his halting response as the deadly virus spread:

• The National Security Council office responsible for tracking pandemics received intelligence reports in early January predicting the spread of the virus to the United States, and within weeks was raising options like keeping Americans home from work and shutting down cities the size of Chicago. Mr. Trump would avoid such steps until March.

• Despite Mr. Trump’s denial weeks later, he was told at the time about a Jan. 29 memo produced by his trade adviser, Peter Navarro, laying out in striking detail the potential risks of a coronavirus pandemic: as many as half a million deaths and trillions of dollars in economic losses.

• The health and human services secretary, Alex M. Azar II, directly warned Mr. Trump of the possibility of a pandemic during a call on Jan. 30, the second warning he delivered to the president about the virus in two weeks. The president, who was on Air Force One while traveling for appearances in the Midwest, responded that Mr. Azar was being alarmist.

• Mr. Azar publicly announced in February that the government was establishing a “surveillance” system in five American cities to measure the spread of the virus and enable experts to project the next hot spots. It was delayed for weeks. The slow start of that plan, on top of the well-documented failures to develop the nation’s testing capacity, left administration officials with almost no insight into how rapidly the virus was spreading. “We were flying the plane with no instruments,” one official said.

• By the third week in February, the administration’s top public health experts concluded they should recommend to Mr. Trump a new approach that would include warning the American people of the risks and urging steps like social distancing and staying home from work. But the White House focused instead on messaging and crucial additional weeks went by before their views were reluctantly accepted by the president — time when the virus spread largely unimpeded.

When Mr. Trump finally agreed in mid-March to recommend social distancing across the country, effectively bringing much of the economy to a halt, he seemed shellshocked and deflated to some of his closest associates. One described him as “subdued” and “baffled” by how the crisis had played out. An economy that he had wagered his re-election on was suddenly in shambles.

He only regained his swagger, the associate said, from conducting his daily White House briefings, at which he often seeks to rewrite the history of the past several months. He declared at one point that he “felt it was a pandemic long before it was called a pandemic,” and insisted at another that he had to be a “cheerleader for the country,” as if that explained why he failed to prepare the public for what was coming.

Mr. Trump’s allies and some administration officials say the criticism has been unfair. The Chinese government misled other governments, they say. And they insist that the president was either not getting proper information, or the people around him weren’t conveying the urgency of the threat. In some cases, they argue, the specific officials he was hearing from had been discredited in his eyes, but once the right information got to him through other channels, he made the right calls.

“While the media and Democrats refused to seriously acknowledge this virus in January and February, President Trump took bold action to protect Americans and unleash the full power of the federal government to curb the spread of the virus, expand testing capacities and expedite vaccine development even when we had no true idea the level of transmission or asymptomatic spread,” said Judd Deere, a White House spokesman.

There were key turning points along the way, opportunities for Mr. Trump to get ahead of the virus rather than just chase it. There were internal debates that presented him with stark choices, and moments when he could have chosen to ask deeper questions and learn more. How he handled them may shape his re-election campaign. They will certainly shape his legacy.

The Containment Illusion

By the last week of February, it was clear to the administration’s public health team that schools and businesses in hot spots would have to close. But in the turbulence of the Trump White House, it took three more weeks to persuade the president that failure to act quickly to control the spread of the virus would have dire consequences.

When Dr. Robert Kadlec, the top disaster response official at the Health and Human Services Department, convened the White House coronavirus task force on Feb. 21, his agenda was urgent. There were deep cracks in the administration’s strategy for keeping the virus out of the United States. They were going to have to lock down the country to prevent it from spreading. The question was: When?

Dr. Robert Kadlec with the Department of Health and Human Services ran an exercise with the White House Task Force in February that helped convince some in the administration to push for taking more urgent action against the virus.

There had already been an alarming spike in new cases around the world and the virus was spreading across the Middle East. It was becoming apparent that the administration had botched the rollout of testing to track the virus at home, and a smaller-scale surveillance program intended to piggyback on a federal flu tracking system had also been stillborn.

In Washington, the president was not worried, predicting that by April, “when it gets a little warmer, it miraculously goes away.” His White House had yet to ask Congress for additional funding to prepare for the potential cost of wide-scale infection across the country, and health care providers were growing increasingly nervous about the availability of masks, ventilators and other equipment.

What Mr. Trump decided to do next could dramatically shape the course of the pandemic — and how many people would get sick and die.

With that in mind, the task force had gathered for a tabletop exercise — a real-time version of a full-scale war gaming of a flu pandemic the administration had run the previous year. That earlier exercise, also conducted by Mr. Kadlec and called “Crimson Contagion,” predicted 110 million infections, 7.7 million hospitalizations and 586,000 deaths following a hypothetical outbreak that started in China.

Facing the likelihood of a real pandemic, the group needed to decide when to abandon “containment” — the effort to keep the virus outside the U.S. and to isolate anyone who gets infected — and embrace “mitigation” to thwart the spread of the virus inside the country until a vaccine becomes available.

Among the questions on the agenda, which was reviewed by The New York Times, was when the department’s secretary, Mr. Azar, should recommend that Mr. Trump take textbook mitigation measures “such as school dismissals and cancellations of mass gatherings,” which had been identified as the next appropriate step in a Bush-era pandemic plan.

The exercise was sobering. The group — including Dr. Anthony S. Fauci of the National Institutes of Health; Dr. Robert R. Redfield of the Centers for Disease Control and Prevention, and Mr. Azar, who at that stage was leading the White House Task Force — concluded they would soon need to move toward aggressive social distancing, even at the risk of severe disruption to the nation’s economy and the daily lives of millions of Americans.

If Dr. Kadlec had any doubts, they were erased two days later, when he stumbled upon an email from a researcher at the Georgia Institute of Technology, who was among the group of academics, government physicians and infectious diseases doctors who had spent weeks tracking the outbreak in the Red Dawn email chain.

A 20-year-old Chinese woman had infected five relatives with the virus even though she never displayed any symptoms herself. The implication was grave — apparently healthy people could be unknowingly spreading the virus — and supported the need to move quickly to mitigation.

“Is this true?!” Dr. Kadlec wrote back to the researcher. “If so we have a huge whole on our screening and quarantine effort,” including a typo where he meant hole. Her response was blunt: “People are carrying the virus everywhere.”

The following day, Dr. Kadlec and the others decided to present Mr. Trump with a plan titled “Four Steps to Mitigation,” telling the president that they needed to begin preparing Americans for a step rarely taken in United States history.

But over the next several days, a presidential blowup and internal turf fights would sidetrack such a move. The focus would shift to messaging and confident predictions of success rather than publicly calling for a shift to mitigation.

These final days of February, perhaps more than any other moment during his tenure in the White House, illustrated Mr. Trump’s inability or unwillingness to absorb warnings coming at him. He instead reverted to his traditional political playbook in the midst of a public health calamity, squandering vital time as the coronavirus spread silently across the country.

Dr. Kadlec’s group wanted to meet with the president right away, but Mr. Trump was on a trip to India, so they agreed to make the case to him in person as soon as he returned two days later. If they could convince him of the need to shift strategy, they could immediately begin a national education campaign aimed at preparing the public for the new reality.

A memo dated Feb. 14, prepared in coordination with the National Security Council and titled “U.S. Government Response to the 2019 Novel Coronavirus,” documented what more drastic measures would look like, including: “significantly limiting public gatherings and cancellation of almost all sporting events, performances, and public and private meetings that cannot be convened by phone. Consider school closures. Widespread ‘stay at home’ directives from public and private organizations with nearly 100% telework for some.”

The memo did not advocate an immediate national shutdown, but said the targeted use of “quarantine and isolation measures” could be used to slow the spread in places where “sustained human-to-human transmission” is evident.

Within 24 hours, before they got a chance to make their presentation to the president, the plan went awry.

Mr. Trump was walking up the steps of Air Force One to head home from India on Feb. 25 when Dr. Nancy Messonnier, the director of the National Center for Immunization and Respiratory Diseases, publicly issued the blunt warning they had all agreed was necessary.

But Dr. Messonnier had jumped the gun. They had not told the president yet, much less gotten his consent.

On the 18-hour plane ride home, Mr. Trump fumed as he watched the  stock market crash after Dr. Messonnier’s comments. Furious, he called Mr. Azar when he landed at around 6 a.m. on Feb. 26, raging that Dr. Messonnier had scared people unnecessarily. Already on thin ice with the president over a variety of issues and having overseen the failure to quickly produce an effective and widely available test, Mr. Azar would soon find his authority reduced.

The meeting that evening with Mr. Trump to advocate social distancing was canceled, replaced by a news conference in which the president announced that the White House response would be put under the command of Vice President Mike Pence.

The push to convince Mr. Trump of the need for more assertive action stalled. With Mr. Pence and his staff in charge, the focus was clear: no more alarmist messages. Statements and media appearances by health officials like Dr. Fauci and Dr. Redfield would be coordinated through Mr. Pence’s office. It would be more than three weeks before Mr. Trump would announce serious social distancing efforts, a lost period during which the spread of the virus accelerated rapidly.

Over nearly three weeks from Feb. 26 to March 16, the number of confirmed coronavirus cases in the United States grew from 15 to 4,226. Since then, nearly half a million Americans have tested positive for the virus and authorities say hundreds of thousands more are likely infected.

The China Factor

The earliest warnings about coronavirus got caught in the crosscurrents of the administration’s internal disputes over China. It was the China hawks who pushed earliest for a travel ban. But their animosity toward China also undercut hopes for a more cooperative approach by the world’s two leading powers to a global crisis.

It was early January, and the call with a Hong Kong epidemiologist left Matthew Pottinger rattled.

Mr. Pottinger, the deputy national security adviser and a hawk on China, took a blunt warning away from the call with the doctor, a longtime friend: A ferocious, new outbreak that on the surface appeared similar to the SARS epidemic of 2003 had emerged in China. It had spread far more quickly than the government was admitting to, and it wouldn’t be long before it reached other parts of the world.

Mr. Pottinger had worked as a Wall Street Journal correspondent in Hong Kong during the SARS epidemic, and was still scarred by his experience documenting the death spread by that highly contagious virus.

Now, seventeen years later, his friend had a blunt message: You need to be ready. The virus, he warned, which originated in the city of Wuhan, was being transmitted by people who were showing no symptoms — an insight that American health officials had not yet accepted. Mr. Pottinger declined through a spokesman to comment.

It was one of the earliest warnings to the White House, and it echoed the intelligence reports making their way to the National Security Council. While most of the early assessments from the C.I.A. had little more information than was available publicly, some of the more specialized corners of the intelligence world were producing sophisticated and chilling warnings.

In a report to the director of national intelligence, the State Department’s epidemiologist wrote in early January that the virus was likely to spread across the globe, and warned that the coronavirus could develop into a pandemic. Working independently, a small outpost of the Defense Intelligence Agency, the National Center for Medical Intelligence, came to the same conclusion. Within weeks after getting initial information about the virus early in the year, biodefense experts inside the National Security Council, looking at what was happening in Wuhan, started urging officials to think about what would be needed to quarantine a city the size of Chicago.

By mid-January there was growing evidence of the virus spreading outside China. Mr. Pottinger began convening daily meetings about the coronavirus. He alerted his boss, Robert C. O’Brien, the national security adviser.

The early alarms sounded by Mr. Pottinger and other China hawks were freighted with ideology — including a push to publicly blame China that critics in the administration say was a distraction as the coronavirus spread to Western Europe and eventually the United States.

And they ran into opposition from Mr. Trump’s economic advisers, who worried a tough approach toward China could scuttle a trade deal that was a pillar of Mr. Trump’s re-election campaign.

With his skeptical — some might even say conspiratorial — view of China’s ruling Communist Party, Mr. Pottinger initially suspected that President Xi Jinping’s government was keeping a dark secret: that the virus may have originated in one of the laboratories in Wuhan studying deadly pathogens. In his view, it might have even been a deadly accident unleashed on an unsuspecting Chinese population.

During meetings and telephone calls, Mr. Pottinger asked intelligence agencies — including officers at the C.I.A. working on Asia and on weapons of mass destruction — to search for evidence that might bolster his theory.

They didn’t have any evidence. Intelligence agencies did not detect any alarm inside the Chinese government that analysts presumed would accompany the accidental leak of a deadly virus from a government laboratory. But Mr. Pottinger continued to believe the coronavirus problem was far worse than the Chinese were acknowledging. Inside the West Wing, the director of the Domestic Policy Council, Joe Grogan, also tried to sound alarms that the threat from China was growing.

Mr. Pottinger, backed by Mr. O’Brien, became one of the driving forces of a campaign in the final weeks of January to convince Mr. Trump to impose limits on travel from China — the first substantive step taken to impede the spread of the virus and one that the president has repeatedly cited as evidence that he was on top of the problem.

In addition to the opposition from the economic team, Mr. Pottinger and his allies among the China hawks had to overcome initial skepticism from the administration’s public health experts.

Travel restrictions were usually counterproductive to managing biological outbreaks because they prevented doctors and other much-needed medical help from easily getting to the affected areas, the health officials said. And such bans often cause infected people to flee, spreading the disease further.

But on the morning of Jan. 30, Mr. Azar got a call from Dr. Fauci, Dr. Redfield and others saying they had changed their minds. The World Health Organization had declared a global public health emergency and American officials had discovered the first confirmed case of person-to-person transmission inside the United States.

The economic team, led by Treasury Secretary Steven Mnuchin, continued to argue that there were big risks in taking a provocative step toward China and moving to curb global travel. After a debate, Mr. Trump came down on the side of the hawks and the public health team. The limits on travel from China were publicly announced on Jan. 31.

Still, Mr. Trump and other senior officials were wary of further upsetting Beijing. Besides the concerns about the impact on the trade deal, they knew that an escalating confrontation was risky because the United States relies heavily on China for pharmaceuticals and the kinds of protective equipment most needed to combat the coronavirus.

But the hawks kept pushing in February to take a critical stance toward China amid the growing crisis. Mr. Pottinger and others — including aides to Secretary of State Mike Pompeo — pressed for government statements to use the term “Wuhan Virus.”

Mr. Pompeo tried to hammer the anti-China message at every turn, eventually even urging leaders of the Group of 7 industrialized countries to use “Wuhan virus” in a joint statement.

Others, including aides to Mr. Pence, resisted taking a hard public line, believing that angering Beijing might lead the Chinese government to withhold medical supplies, pharmaceuticals and any scientific research that might ultimately lead to a vaccine.

Mr. Trump took a conciliatory approach through the middle of March, praising the job Mr. Xi was doing.

That changed abruptly, when aides informed Mr. Trump that a Chinese Foreign Ministry spokesman had publicly spun a new conspiracy about the origins of Covid-19: that it was brought to China by U.S. Army personnel who visited the country last October.

Mr. Trump was furious, and he took to his favorite platform to broadcast a new message. On March 16, he wrote on Twitter that “the United States will be powerfully supporting those industries, like Airlines and others, that are particularly affected by the Chinese Virus.”

Mr. Trump’s decision to escalate the war of words undercut any remaining possibility of broad cooperation between the governments to address a global threat. It remains to be seen whether that mutual suspicion will spill over into efforts to develop treatments or vaccines, both areas where the two nations are now competing.

One immediate result was a free-for-all across the United States, with state and local governments and hospitals bidding on the open market for scarce but essential Chinese-made products. When the state of Massachusetts managed to procure 1.2 million masks, it fell to the owner of the New England Patriots, Robert K. Kraft, a Trump ally, to cut through extensive red tape on both sides of the Pacific to send his own plane to pick them up.

The Consequences of Chaos

The chaotic culture of the Trump White House contributed to the crisis. A lack of planning and a failure to execute, combined with the president’s focus on the news cycle and his preference for following his gut rather than the data cost time, and perhaps lives.

Inside the West Wing, Mr. Navarro, Mr. Trump’s trade adviser, was widely seen as quick-tempered, self-important and prone to butting in. He is among the most outspoken of China hawks and in late January was clashing with the administration’s health experts over limiting travel from China.

Peter Navarro, Mr. Trump’s trade adviser, warned that a pandemic could cost the United States trillions of dollars and put millions of Americans at risk of illness or death.

So it elicited eye rolls when, after initially being prevented from joining the coronavirus task force, he circulated a memo on Jan. 29 urging Mr. Trump to impose the travel limits, arguing that failing to confront the outbreak aggressively could be catastrophic, leading to hundreds of thousands of deaths and trillions of dollars in economic losses.

The uninvited message could not have conflicted more with the president’s approach at the time of playing down the severity of the threat. And when aides raised it with Mr. Trump, he responded that he was unhappy that Mr. Navarro had put his warning in writing.

From the time the virus was first identified as a concern, the administration’s response was plagued by the rivalries and factionalism that routinely swirl around Mr. Trump and, along with the president’s impulsiveness, undercut decision making and policy development.

Faced with the relentless march of a deadly pathogen, the disagreements and a lack of long-term planning had significant consequences. They slowed the president’s response and resulted in problems with execution and planning, including delays in seeking money from Capitol Hill and a failure to begin broad surveillance testing.

The efforts to shape Mr. Trump’s view of the virus began early in January, when his focus was elsewhere: the fallout from his decision to kill Maj. Gen. Qassim Suleimani, Iran’s security mastermind; his push for an initial trade deal with China; and his Senate impeachment trial, which was about to begin.

Even after Mr. Azar first briefed him about the potential seriousness of the virus during a phone call on Jan. 18 while the president was at his Mar-a-Lago resort in Florida, Mr. Trump projected confidence that it would be a passing problem.

“We have it totally under control,” he told an interviewer a few days later while attending the World Economic Forum in Switzerland. “It’s going to be just fine.”

Back in Washington, voices outside of the White House peppered Mr. Trump with competing assessments about what he should do and how quickly he should act.

Traders at the New York Stock Exchange on March 9, when stocks suffered their worst single-day decline in more than a decade. Two days later, Mr. Trump announced restrictions on travel from Europe.

The efforts to sort out policy behind closed doors were contentious and sometimes only loosely organized.

That was the case when the National Security Council convened a meeting on short notice on the afternoon of Jan. 27. The Situation Room was standing room only, packed with top White House advisers, low-level staffers, Mr. Trump’s social media guru, and several cabinet secretaries. There was no checklist about the preparations for a possible pandemic, which would require intensive testing, rapid acquisition of protective gear, and perhaps serious limitations on Americans’ movements.

Instead, after a 20-minute description by Mr. Azar of his department’s capabilities, the meeting was jolted when Stephen E. Biegun, the newly installed deputy secretary of state, announced plans to issue a “level four” travel warning, strongly discouraging Americans from traveling to China. The room erupted into bickering.

A few days later, on the evening of Jan. 30, Mick Mulvaney, the acting White House chief of staff at the time, and Mr. Azar called Air Force One as the president was making the final decision to go ahead with the restrictions on China travel. Mr. Azar was blunt, warning that the virus could develop into a pandemic and arguing that China should be criticized for failing to be transparent.

Mr. Trump rejected the idea of criticizing China, saying the country had enough to deal with. And if the president’s decision on the travel restrictions suggested that he fully grasped the seriousness of the situation, his response to Mr. Azar indicated otherwise.

Stop panicking, Mr. Trump told him.

That sentiment was present throughout February, as the president’s top aides reached for a consistent message but took few concrete steps to prepare for the possibility of a major public health crisis.

During a briefing on Capitol Hill on Feb. 5, senators urged administration officials to take the threat more seriously. Several asked if the administration needed additional money to help local and state health departments prepare.

Derek Kan, a senior official from the Office of Management and Budget, replied that the administration had all the money it needed, at least at that point, to stop the virus, two senators who attended the briefing said.

“Just left the Administration briefing on Coronavirus,” Senator Christopher S. Murphy, Democrat of Connecticut, wrote in a tweet shortly after. “Bottom line: they aren’t taking this seriously enough.”

The administration also struggled to carry out plans it did agree on. In mid-February, with the effort to roll out widespread testing stalled, Mr. Azar announced a plan to repurpose a flu-surveillance system in five major cities to help track the virus among the general population. The effort all but collapsed even before it got started as Mr. Azar struggled to win approval for $100 million in funding and the C.D.C. failed to make reliable tests available.

The number of infections in the United States started to surge through February and early March, but the Trump administration did not move to place large-scale orders for masks and other protective equipment, or critical hospital equipment, such as ventilators. The Pentagon sat on standby, awaiting any orders to help provide temporary hospitals or other assistance.

Dr. Carter Mecher with the Department of Veterans Affairs argued to colleagues in late February for so-called targeted layered containment (TLC) and non-pharmaceutical interventions (NPIs), which are measures like closing schools and businesses, to limit the spread of the virus. Mr. Azar and other public health officials came to the same conclusion around that time.

As February gave way to March, the president continued to be surrounded by divided factions even as it became clearer that avoiding more aggressive steps was not tenable.

Mr. Trump had agreed to give an Oval Office address on the evening of March 11 announcing restrictions on travel from Europe, where the virus was ravaging Italy. But responding to the views of his business friends and others, he continued to resist calls for social distancing, school closures and other steps that would imperil the economy.

Pandemic experts, including Mr. Trump’s own former homeland security adviser, Thomas Bossert, compare notes via the Red Dawn email group, after Mr. Trump’s March 11 announcement that he is limiting travel from Europe.

But the virus was already multiplying across the country — and hospitals were at risk of buckling under the looming wave of severely ill people, lacking masks and other protective equipment, ventilators and sufficient intensive care beds. The question loomed over the president and his aides after weeks of stalling and inaction: What were they going to do?

The approach that Mr. Azar and others had planned to bring to him weeks earlier moved to the top of the agenda. Even then, and even by Trump White House standards, the debate over whether to shut down much of the country to slow the spread was especially fierce.

Always attuned to anything that could trigger a stock market decline or an economic slowdown that could hamper his re-election effort, Mr. Trump also reached out to prominent investors like Stephen A. Schwarzman, the chief executive of Blackstone Group, a private equity firm.

“Everybody questioned it for a while, not everybody, but a good portion questioned it,” Mr. Trump said earlier this month. “They said, let’s keep it open. Let’s ride it.”

In a tense Oval Office meeting, when Mr. Mnuchin again stressed that the economy would be ravaged, Mr. O’Brien, the national security adviser, who had been worried about the virus for weeks, sounded exasperated as he told Mr. Mnuchin that the economy would be destroyed regardless if officials did nothing.

Soon after the Oval Office address, Dr. Scott Gottlieb, the former commissioner of the Food and Drug Administration and a trusted sounding board inside the White House, visited Mr. Trump, partly at the urging of Jared Kushner, the president’s son-in-law. Dr. Gottlieb’s role was to impress upon the president how serious the crisis could become. Mr. Pence, by then in charge of the task force, also played a key role at that point in getting through to the president about the seriousness of the moment in a way that Mr. Azar had not.

But in the end, aides said, it was Dr. Deborah L. Birx, the veteran AIDS researcher who had joined the task force, who helped to persuade Mr. Trump. Soft-spoken and fond of the kind of charts and graphs Mr. Trump prefers, Dr. Birx did not have the rough edges that could irritate the president. He often told people he thought she was elegant.

On Monday, March 16, Mr. Trump announced new social distancing guidelines, saying they would be in place for two weeks. The subsequent economic disruptions were so severe that the president repeatedly suggested that he wanted to lift even those temporary restrictions. He frequently asked aides why his administration was still being blamed in news coverage for the widespread failures involving testing, insisting the responsibility had shifted to the states.

During the last week in March, Kellyanne Conway, a senior White House adviser involved in task force meetings, gave voice to concerns other aides had. She warned Mr. Trump that his wished-for date of Easter to reopen the country likely couldn’t be accomplished. Among other things, she told him, he would end up being blamed by critics for every subsequent death caused by the virus.

Within days, he watched images on television of a calamitous situation at Elmhurst Hospital Center, miles from his childhood home in Queens, N.Y., where 13 people had died from the coronavirus in 24 hours.

He left the restrictions in place.