[This is the third and final blog of a three-part series focused on what is happening in our democratic republic in terms of repression and regression and what should be done in response to these conditions. In the first blog, we examined the areas of repression. In the second, we examined the areas of regression. In this blog, we present and discuss plans for protecting and preserving our democracy.]
Make no little plans, they have no magic to stir men’s blood and probably themselves will not be realized. Make big plans; aim high in hope and work, remembering that a noble, logical diagram once recorded will never die, but long after we are gone be a living thing, asserting itself with insistency.
– Daniel Burnham, American architect and urban planner
In an April 10 White House coronavirus briefing, President Trump was asked by a reporter what metrics he would use to determine when to reopen the country. Trump pointed to his head and replied, “The metrics right here. That’s my metrics. That’s all I can do.”
That gesture and those words confirmed that the United States was in terrible trouble with this planning averse President who lives inside his own head in charge during this time of crisis. This is the case because inside that head there is little-to-no room for data, evidence, expert knowledge, intelligence, or analytical reasoning.
There is no vacuum at the top. But it would be nice to have a vacuum cleaner that could be used to get rid of the flotsam and jetsam floating around in the mind of our feckless leader. Or perhaps all we need is the sun or a little bit of bleach for the President to ingest.
A mind is a terrible thing to waste. But you have to have one to waste one.
Seriously, because of who he was and is, this is the best that can be expected of Trump — our commander-in-chief. He may be our “war-time” President. The war he continues to wage, unfortunately, is not on the coronavirus pandemic, but a divisive re-election and cultural war focused on mobilizing his base to go into combat on his behalf.
This is a tragic for the United States and destructive of our American democracy. Fortunately, while the coronavirus has shown us the worst of Donald Trump, it has brought out the best in many citizens who have leapt into the breach to fight for the common good and to breathe life back into the American idea.
Our democracy is not on life support and ventilators like those citizens with Covid-19 in hospitals across the nation, but it is definitely at risk. As we said in our two earlier blogs in this series, we are living in an era of repression and regression.
The repression has been going on for some time, but intensified with the presidential political campaign of 2016 and has intensified even more-so under the Trump administration. The scope of the regression is broad and encompassing and has been affecting many areas for decades before the pandemic.
The coronavirus pandemic has multiplied the impact of these repressive and regressive forces. As a result, it will be totally insufficient to only address the near-term health and economic consequences of the pandemic.
What will be required to win this war completely on behalf of the American citizens and to preserve our democracy is an integrated set of four plans. They are:
Health Care Stabilization Plan
Country Reopening Plan
Economic Recovery Plan (Short Term)
Democracy Renewal Plan (Long Term)
In earlier times, the federal government would have taken the lead in helping to develop and ensure those plans were put into place and implemented effectively. In these times, for the time being, the federal government is providing “guidance” and leaving it up to states and cities to chart their own course on the first two plans.
While the federal government (with a few notable exceptions such as FEMA, the CDC and the National Guard) has been more hands-off, citizens and organizations have heard the call to arms and been hands-on, providing input and ideas that can be used to develop all four of those plans. They have done so with classic American industriousness, ingenuity, and inventiveness.
We will identify some of that creative input and ideas in our discussion of the plans that follow. Let us begin, however, with an overriding recommendation, which is to establish an American Renewal Commission as the group to lead the development of these plans.
American Renewal Commission (ARC or Commission)
Kyle Cheney of Politicoreported on April 6 that there were four proposals circulating in the U.S. House of Representatives to establish a 9/11 type commission to investigate the government’s response to the coronavirus pandemic.
The ARC we recommend would have a much broader scope and charge than the coronavirus investigative 9/11-type commission proposals currently being floated in the House. The Commission would be responsible for preparing the drafts of each of the four plans identified and ensuring they are an integrated set.
As an integrated set they should be comprehensive, coordinated, and citizen-oriented. The overriding vision for the set should be:
To provide the strategic and proactive framework for creating a more inclusive and equitable American democracy.
In combination, these plans should resemble but go well beyond the scope and thrust of the acclaimed Marshall Plan, which the U.S. put together to finance the rebuilding of Europe after the devastation of World War II. There should be a preamble to the plan that defines the parameters of a new social contract, similar to the one Nobel Prize-winning economist Joseph Stiglitz proposes, “between voters and elected officials, between workers and corporations, between rich and poor, and between those with jobs and those who are un- or under-employed.”
The charge to the Commission should be to conduct a thorough and in-depth SWOT analysis and situational assessment of the United States’ current position in each plan area. Based upon those findings, at a minimum each draft plan should clearly spell out goals, strategies, strategic action programs, implementation requirements, facilitating factors, potential obstacles or barriers, and critical success factors. Each plan should include a budget and cost benefit analysis for its implementation.
The Commission will not have to start from scratch. Groups of all stripes and persuasions have already weighed in, and many more will undoubtedly be doing so in the months ahead. This full body of work should be reviewed and considered as input by the Commission in the analysis phase of its planning.
In terms of its composition, the ARC should be nonpartisan rather than bipartisan. Its members should be drawn from national leaders with expertise and experience in business, politics, government, civic and community service, and academia. The Commission should be headed by representatives from the business, civic/community, and governmental sectors. While it should include a few former elected officials, they should be a minority of the membership.
The ARC’s membership will be pivotal to its success. According to Karen Tumulty of the Washington Post, former New Jersey governor Tom Kean, who headed the 9/11 commission, told her that “the first and most important challenge for any commission would be making sure the right people are on it. Ideally, he said, they should be figures who are respected across party lines and who are not likely to seek political office in the future.”
It will not be just the appointed members of the ARC who matter. Of equal importance will be the management team and staff of the Commission. These individuals should have content knowledge and expertise in health care, government, economics, social policy and programs, have done major management studies, and created and contributed to the successful implementation of turnaround and/or transformation plans.
To avoid being seen as political, the Commission should be established and begin its work in the first quarter of 2021. Sufficient time should be spent to do the planning right which means 24 months for all four plans.
The plans should be developed in three phases: The Health Care Stabilization Plan and the Country Reopening Plan should be prepared and available within 12 months. The Economic Recovery Plan within 18 months and the Democracy Renewal Plan within 24 months.
The Commission should present its plans to representative stakeholder groups for review and comment. The final plans should be provided to the President and U.S. Congress for consideration and action.
The Commission should be paid for by a mix of public and private funds. It should also solicit volunteer-contributed time to assist in the research and analysis from organizations such as businesses, consulting firms, universities, and civic organizations.
One might argue that our elected officials at the federal level are already doing this planning when they write laws or develop policy. Unfortunately, nothing could be further from the truth. A law is not a plan. A policy is not a plan.
Moreover, Congress, over the past decade, has become increasingly more dysfunctional. It is also understaffed and frequently has to depend on lobbyists and think tanks to do its primary and secondary research. Those groups have agendas. They are hired guns for their cause, as they should be.
When it comes to an issue as critical as the future of this great nation and our American democracy, we adamantly believe that we need more objective and neutral data. We need real strategic planning and foresight.
The Commission would provide that. As Martin Luther King famously said, “The arc of the moral universe is long, but it bends toward justice.” This ARC would help to bend the United States toward more justice and opportunity and equality for all and it would do that first in its health care stabilization plan.
Health Care Stabilization Plan (Stabilization Plan)
Since it was established on January 29, The White House Coronavirus Task Force has been the group that “coordinates and oversees the Administration’s effort to monitor, prevent, contain and mitigate the spread” of coronavirus (Covid-19). The Task Force and the White House have been criticized for being slow to issue, and not directive enough, in its guidance, and for the lack of national testing plan and program.
As a result, a number of groups and individuals stepped up and put forward plans and recommendations. Three common elements among most of the proposals were: ramp-up testing, do extensive contact tracing, and treatment and quarantine of all those who are identified with the virus.
Because of his extensive involvement in addressing health issues through the Bill and Melinda Gates Foundation, Bill Gates has become a very knowledgeable and one of the most influential people on what to do to combat this pandemic. On March 31, in a Washington Post op-ed, he outlined a plan to make up for lost time in dealing with the coronavirus.
Gates’ plan had three steps: (1) Implement a consistent nationwide approach to shutting down; (2) Have the federal government step up testing; (3) Implement a data-based approach to developing treatments and a vaccine.
On April 26, the Rockefeller Foundation issued a National Covid-19 Testing Action Plan. This Action Plan was created by the Foundation bringing together experts and leaders from science, industry, academia, public policy and the government.
It has three major objectives: (1) Launch a plan to expand from the current 1 million tests/week to 3 million within 8 weeks, and 30 million within six months. (2) Launch a Covid Community Healthcare Corps to do testing and contact tracing nationally. (3) Create a Covid-19 data commons and digital platform to create a national system to track the Covid-19 status and to find data-driven ways to improve diagnosis and treatment.
At about the same time that the Rockefeller Foundation put out its plan, Andy Slavitt, director of Medicare and Medicaid in the Obama administration, and Scott Gottlieb, former head of the Food and Drug Administration for President Trump, advanced a $46.5 billion coronavirus package. They did this because the U.S public health system lacks the capacity to address the needs presented by Covid-19.
Their $46.5 billion package would allocate funds as follows: (1) $12 billion to expand the contact tracing workforce by 180,000 until a vaccine is on the market; (2) $4.5 billion to use vacant hotels to house infected and exposed people; (3) $30 billion to offer 18 months of income support for those voluntarily self-isolating.
The White House has made some modest progress in having tests manufactured and distributed over the past month or so. And, on April 30, Dr. Anthony Fauci said that “if things fall in the right place,” meaning that the coronavirus vaccine, which is currently in Phase I trial, works, and is safe, the vaccine might be available for wide use nationally as early as January 2021. It remains the case that there is still not a national plan for managing and controlling the response to the coronavirus.
And, there will not be such a plan. This will be so even though President Trump said the Coronavirus Task Force will stay in place “indefinitely” on Wednesday, May 6, reversing his statement of a day earlier that the Task Force would be winding up its work by around Memorial Day.
The task force may be there but it will be, as it has been since its inception, a toothless tiger. And not all task force members of this “tiger” will be present in person for a while. On May 9, Dr. Anthony Fauci, director of NIH, Dr. Robert Redfield, director of CDC, and Dr. Stephen Hahn, commissioner of FDA announced they would be self-quarantining, due to contact with a person who has tested positive for Covid-19.
On May 12, the Senate Health, Education and Labor Benefits Committee held a hearing on the coronavirus briefing with Drs Fauci, Redfield, Hahn and Admiral Brett Giroir, assistant secretary of Health at HHS as witnesses.
During the hearing, CNN reports, Committee Chair Lamar Alexander (R-TN) stated, “All roads back to work and school run through testing. And that what our country has done so far on testing is impressive but not nearly enough.”
Senator Patty Murray (D-WA) agreed with Alexander on the need for more testing, but she was much more critical of its current availability. She asserted: “We need dramatically more testing. It’s unacceptable we still don’t have a national strategic plan to make sure testing is free, fast and everywhere.”
Even though Senator Murray called for a national strategic plan for testing, there will never be one from this administration. This war has already been won. Trump declared victory on May 12 in front of those testing banners when he said, “We have met the moment and we have prevailed.”
This means when the American Renewal Commission convenes in January 2021 it will have the plans and proposals discussed here and many others to consider in drafting the Health Care Stabilization Plan after it completes an exhaustive assessment of the status of the coronavirus at that time. In conducting this analysis and decision-making the ARC should determine what has been accomplished since the coronavirus was identified, what has not and why.
This absolutely must not be done as a blame game or a finger-pointing exercise, however. It must be a search for the truth which will set America and Americans free from the effects of this pandemic and be to fully prepared for the next pandemic which will come inevitably.
One of the documents that the ARC should look at carefully as part of its inquiry is the Global Health Security Index (GHSI or Index). The Index was released in October 2019 as a joint project of the Nuclear Threat Initiative, the John Hopkins Center for Health Security, and The Economist Intelligence Unit. The GHSI ranks countries based on the preparedness to face a pandemic.
The United States ranked first out of 195 on the Index, with an overall value of 83.5. Tellingly, however, it fell short in some critical indicator areas, including: access to health care, where it ranked 175 out of 195; socio-economic resilience, with a ranking of 59; and exercising response plans, with a ranking of 54.
The deficiencies in these areas, in conjunction with the lack of presidential and federal leadership, may help to explain why the U.S. has stumbled in responding to the Covid-19 onslaught. The ARC can make this determination based upon the facts and data it collects.
As noted earlier, the ARC should have the Health Care Stabilization Plan drafted, reviewed, commented upon and delivered to the President and Congress for action within 12 months.
One concern should be mentioned. This timeline assumes that when there is a second round of Covid-19 beginning in the Fall of 2020 — as most medical experts project there will be — this round will be mild in comparison to the first one. If, on the other hand, the second round is a wave comparable to, or worse, than the first round, as many medical experts predict, the ARC should compress its time frame for completion to the shortest period in which a quality job can be done in preparing the Stabilization Plan.
The Stabilization Plan should be focused solely on pandemic preparedness and management. As Bernie Sanders, Elizabeth Warren, all of the Democratic candidates for President, and numerous others have highlighted, the United States public health care system is “sick”. The ARC should provide the answers to dealing with the illness of the health care system as part of the Democracy Renewal Plan.
Country Reopening Plan
As with the Stabilization Plan, the ARC should have the Country Reopening Plan drafted, reviewed commented upon and delivered to the President and Congress for action within 12 months. Also, in this area, as in the area of health care, there was not, and will not be, any national plan for country re-opening.
The White House did issue Opening Up America Again Guidelines on April 16 for states to follow. These guidelines stated that there should be a 14-day period of “downward trajectory of influenza-like illnesses” and a “downward trajectory of documented cases” before re-opening.
CNBC reported that by April 30, none of the states had met the guidelines. Nevertheless, as reported in the New York Timesby May 7, more than half of all of the states had re-opened partially, and the bulk of the states that had not reopened or had serious restrictions were primarily in the Northeast, the Midwest Great Lakes, and the West Coast. Even in many of those states, people were being allowed to walk on beaches, parks, and other open space areas.
With a few exceptions such as Georgia, the states have not acted precipitously and have developed well-designed phased plans for re-opening slowly. The plans tend to resemble each other and generally follow the phased approach set out in the White House Guidelines.
For example, New Jersey which has been the second hardest hit state with coronavirus cases and deaths announced a six-point “Road Back Plan” on Monday, April 27. NJ Governor Phil Murphy opened beaches and parks on May 2, but stated it was premature to open any businesses.
Florida ranks eighth in coronavirus cases and deaths. FL Governor Ron DeSantis announced his “Safe. Smart. Step-by-Step.” Plan for FL on April 29. Many beaches were already open. His plan called for re-opening selected businesses on a reduced scale on May 4 in all counties except for Broward, Miami-Dade, and Palm Beach, where the preponderance of Florida cases existed.
Most governors and city mayors have demonstrated strong leadership and the ability to cooperate in creating innovative and collaborative approaches to confront and combat the coronavirus pandemic. These collaborations for reopening planning extend across state lines. There is an eight-state coalition in the Northeast and a four-state coalition on the West Coast.
These responsible actions and coalition-building have been essential because of the contrasting signals and messages sent from the White House regarding reopening America. The Guidelines issued by the White House speak for themselves.
Unfortunately, they do not speak to the President. On May 2, the Washington Post ran a revelatory article describing the President’s “desperate attempts to reopen America,” guided not by science or epidemiologists but wishful thinking and an econometric model which forecast a peak in cases in mid-April and a much lower death count than has occurred.
The President has exacerbated his desperate attempts by tweeting approvingly in support of those who have come out in states across the country to protest and demonstrate against business closures and stay at home orders. These tweets and his public comments rationalizing and encouraging that aberrant behavior have been extremely divisive. They have moved the U.S to the precipice of anarchy.
On Chis Wallace’s show on Sunday, May 3, Coronavirus Task Force member Dr. Deborah Birx called protesters storming the Michigan Capitol not wearing masks and jammed together and not social distancing “devastatingly worrisome” because it increases the potential for new coronavirus cases and more deaths.
Dr. Birx also reinforced that the medical community’s projections for Covid-19 deaths have been over 100,000. That is much higher than the 60,0000 that President Trump had been claiming would be the peak. By that Sunday night, May 2, President Trump himself was adjusting his numbers from 60,000 to closer to 100,000.
The chaotic and nationally uncoordinated reopening process, combined with the President’s cognitive dissonance, make the American Renewal Commission’s development of a Country Reopening Plan especially critical. The country will have reopened in some shape and form by January 2021. But the impact of that reopening because of the lack of a uniform and consistent approach will be variable.
In this planning area, as in all of the others, the ARC will have solid data to draw upon as the basis for creating its plan. Although not done deliberately, the states provide a Whitman’s sampler, or an uncontrolled experiment, of data that can be analyzed to see what was done and the results achieved. ARC should create an index to evaluate and rank the effectiveness of states responses to determine what to recommend going forward to ensure the best possible outcomes across the country.
Additional reference points, among others, include the original reopening plan put together by FEMA and the CDC; the May 1 Morbidity and Mortality Weekly Report (MMWR) put together by the CDC; and the 17 page CDC report, “Guidance for Implementing the Opening Up America Again Framework” (Guidance Framework) which provides step-by-step directions on how and when to reopen restaurants and other public facilities. Jason Dearen and Mike Stoppe of the AP report that this Guidance Framework was to have been issued on Friday, May 1 but the White House has shelved it.
The review of the original FEMA/CDC reopening plan should identify deviations from it in the White House reopening plan. The May 1 MMWR highlighted four factors contributing to accelerated spread: travel-associated importations, large gatherings, introductions in the workplace and densely populated areas, and “cryptic transmissions resulting from limited testing and asymptomatic and pre-symptomatic spread.” These factors should be used to assess whether they were adequately addressed in the federal government’s guidelines and the states reopening plans. The Guidance Framework should be reviewed and the ARC should conduct interviews to ascertain why it was not issued or used to facilitate the opening up process.
The analysis in this area should determine best practices that can be highlighted in the Country Reopening Plan. That plan can be used to extend and enhance the reopening across the nation or to revamp the re-opening process if the reopening that began in late April and early May led to shutdowns due to reaccelerating the expansion of Covid-19 in the Fall of this year.