这10个追问，美国必须回答
Ten questions the US needs to
offer clear answers to the world
1.禽流感病毒改造去年突然重启，之后无声无息，为什么？
1.Regarding the restarted avian influenza virus modification experiment last year, why does the US release no more updates?
去年2月，据美国《科学》杂志网站披露，美国政府机构已“悄悄”批准曾引发巨大争议的禽流感病毒改造实验，这类被认为“危险”的实验在被禁多年后将很快重启。相关实验可将H5N1禽流感病毒改造得易于在哺乳动物间传播，被认为可能带来人际传播风险。美国为何在相关实验被暂停4年多后重启这类危险实验？又为何不见披露进展？
The Science reported in February 2019 that US authorities had quietly approved the avian influenza virus modification experiment. The research, aiming to transform the H5N1 virus to be more capable of infecting mammals, was controversial and considered extremely dangerous. Some experts believe that the modification may increase the risk of human-to-human transmission of the virus.
The question is why the US government decided to unfreeze the experiment 4 years after it was halted, and why there are no more updates regarding the experiment.
2.美军生物实验室一度关闭停产，真相是什么？
2.The United States Army Medical Research Institute of Infectious Diseases (USAMRIID) was previously closed.What is the truth behind ?
日前，据“全球生物防御”（globalbiodefence）网站报道，位于马里兰州德特里克堡的美国陆军传染病医学研究所（USAMRIID）已经全面恢复运行。去年7月，美国疾病控制与预防中心（CDC）正式向位于马里兰州德特里克堡的美国陆军传染病医学研究所（USAMRIID）发出“停产令”，要求其停止进行“特定生物制剂与毒素”研究。今年3月，白宫请愿网站出现一道特殊的请愿帖，要求美国政府公布去年7月“关闭”德特里克堡生物实验室的真正原因。USAMRIID神秘“关闭”和迅速重启引人关注。针对白宫请愿网站请愿帖上的要求，美国作何回应？
The Global Biodefence reported in April that the USAMRIID, US Army's primary institution and facility for biological research headquartered in Fort Detrick, Maryland, has resumed full operation. The institution was once ordered to halt the study of biological select agents and toxins (BSATs) last July. In March, there was a petition on the White House website demanding the clarification of the shutdown of USAMRIID. Given that these issues have become a primary public concern, what is the US government's response?
3.去年传染病演习情景今年真实上演，真的只是巧合？
3.The US Department of Health and Human Services ran a scenario last year that was similar to the COVID-19 outbreak. Is this just a coincidence?
今年3月《纽约时报》披露的一份美国官方秘密文件显示，2019年1月至8月16日举行，美国卫生与公共服务部（HHS）发起组织了一场代号为“赤色传染”（Crimson Contagion）的推演，演习以中国最早出现病毒为模拟情景。2019年10月，美国多个机构又组织了一次代号为“Event 201”的全球流行病演习。演练中的模型假设一种名为CAPS的冠状病毒，比SARS致命，又如感冒轻易传播，却未开发出疫苗，能迅速传播促成全球大流行。美国去年进行的传染病演习的设定与现实的吻合度如此之高是否只是巧合？既然有演练在前，新冠疫情发生后美国为何没有给予足够的关注和重视、宣称“尚在掌握之中”？
In March, the New York Times quoted a draft report obtained from the US government saying that from January to August 2019, the US Department of Health and Human Services ran a scenario called "Crimson Contagion" that simulated the fictional outbreak involving a group of tourists visiting China. They then became infected and flew to various countries, including the US.
Last October, a high-level pandemic exercise named Event 201 was hosted by a couple of US organizations. The drill simulated a scenario that a fictional virus called CAPS, which causes more severe symptoms than SARS and transmits via the respiratory route like the common flu, had caused a pandemic. Like COVID-19, there is no vaccine for CAPS.
Given the fact that the simulated virus is so much like COVID-19, is this just a coincidence? Another question is, why did it not take enough preventive measures at the early stages of the coronavirus outbreak since the US has predicted a similar pandemic?
4.提前预测疫情大流行又无视警告情报，为什么？
4.US intelligence officials warned of coronavirus crisis as early as last November. Why the warning was ignored?
今年4月，据美国广播公司（ABC）报道，有内部消息称，早在2019年11月下旬，美国情报官员就曾多次向国防情报局、五角大楼和白宫警告，一场传染病正在席卷中国武汉地区。美国国家医学情报中心（NCMI）去年11月出具了一份详细阐述病毒大流行情况的报告，也就是后来被确认的新型冠状病毒肺炎“COVID-19”。有分析人士认为武汉疫情爆发可能会演变成一场灾难性事件。据美国《华盛顿邮报》网站报道称在年初的2个多月时间里，特朗普获得了美国情报机构发出的关于新冠病毒的密集警告。美国政府为何一直拖到3月13日才宣布进入“国家紧急状态”？
In April, according to the American Broadcasting Corporation (ABC), it was said that, as early as late November 2019, US intelligence officials had warned the Defense Intelligence Agency, the Pentagon, and the White House that an infectious disease was sweeping through Wuhan, China.
Last November, the US National Center for Medical Intelligence (NCMI) issued a report detailing the coronavirus pandemic, which was later identified as "COVID-19". Some analysts believed that the outbreak in Wuhan might have evolved into a catastrophic event. According to the Washington Post, in more than two months from January to February, Trump had received intensive warnings from the US intelligence agencies about the coronavirus. Why did the US government not declare a "National Emergency" until March 13?
5.有多少流感患者感染的其实是新冠肺炎，能不能说清楚？
5.Among the reported influenza deaths in the US, can the US clarify how many cases are actually infected with COVID-19?
今年2月21日，日本朝日电视台报道的“美国1.4万名因流感致死的人中部分可能死于新冠肺炎”掀起热议。美疾控中心2月底发布的报告显示，今冬流感季美国估计已有至少3200万流感。3月11日在美国众议院，美国疾控中心主任罗伯特·雷德菲尔德（Robert Redfield）亲口承认，在美国，确实有一些“流感”死者实际感染的可能是新冠肺炎。美国流感感染者中，到底有多少新冠病例？美国有没有借流感来掩盖新冠肺炎的情况？美国何时才能公开美国流感病毒样本及基因序列信息，或者允许世卫组织或联合国派遣专家采样分析？
Japanese Asahi Television reported on February 21 that some of the 14,000 people reportedly killed by influenza in the US might have died from coronavirus, which became a hot topic soon after.
The US Centers for Disease Control and Prevention (CDC) released a report at the end of February, showing that there have been at least 32 million flu illnesses in the US that winter.
On March 11, at the House of Representatives, Robert Redfield, the director of the US CDC, admitted that some in the US who were previously thought to have been killed from the flu may have been infected with coronavirus.
Among the reported influenza deaths in the US, how many cases were infected with COVID-19? Did the US government cover up the spread of coronavirus with the flu? When will the US government make public the samples of the US influenza virus and its genetic sequence, or allow experts from the WHO or the United Nations to sample and analyze?
6.新冠病毒到底什么时候在美国出现？社区传播是否早已开始？
6.When did the novel coronavirus first appear in the US? Did community transmission of the coronavirus start sooner than it was reported?
今年4月下旬，美国加利福尼亚州圣克拉拉县政府公共卫生部门公布的最新检测报告显示，早在2月6日当地就有人死于新冠肺炎，这比美国此前公布的首例新冠死亡病例出现时间提前了20多天。据《洛杉矶时报》报道，圣克拉拉县的卫生官员萨拉·科迪表示，这些新发现的死亡病例说明，当时“已经有相当程度的社区传播”。圣克拉拉县行政长官杰弗里·史密斯表示，这表明新冠病毒早在1月、甚至更早就已经开始在加州传播。加州州长纽瑟姆已宣布将对去年12月以来疑似新冠死亡病例进行尸检。新冠病毒到底什么时候在美国出现？美国新冠疫情在社区的传播是否早已开始？
A report released in late April by local health authorities suggests that a 57-year-old woman from Santa Clara County of California died from COVID-19 on February 6, some 20 days earlier than the date the US announced its first death caused by the virus.
The Los Angeles Times quoted Santa Clara County health officer Sara Cody in a piece saying, "we presume that each of them represents community transmission and that there was some significant level of virus circulating in our community in early February."
County Executive Officer Jeffrey V. Smith said this is evidence that the coronavirus was circulating in California as early as January or even earlier.
California Gov. Gavin Newsom has ordered all counties in the state to review autopsies of suspected coronavirus deaths dating back to December.
When did the novel coronavirus first appear in the US? Did community transmission of the coronavirus start sooner than it was reported?
7.全球首个启动新冠疫苗人体试验，这么快是怎么拿到毒株的？
7.How did the US get the virus strains so soon to start the first human testing of a vaccine against COVID-19?
据《华尔街日报》报道，美国国立卫生研究院(National Institutes of Health)3月16日称，生物科技公司Moderna Inc. (MRNA)针对新型冠状病毒的试验性疫苗已开始首次人体测试。对于全球首次针对新型冠状病毒的疫苗人体试验在美国启动一事，专家表示，美国这一针实在太快了，除非很早就开始进行试验，更早的拿到了病毒株。美国疫苗人体试验为何进行得如此之快？美国是什么时候通过什么方式获得的毒株？
The Wall Street Journal on March 16 reported that the first human testing of Moderna Inc.'s experimental vaccine against the COVID-19 had already begun. Experts immediately raised questions about the speed of the vaccine development, saying that it would not be possible unless the US had obtained the virus strains from very early on. So how did the US start the first human testing of the vaccine so soon? When and how did they get the virus strains?
8.政府说疫情不严重，官员却在狂抛股票，为什么？
8.Why did the US government keep downplaying the pandemic while its officials privately dumped stocks?
据《华盛顿邮报》报道，大约在新冠肺炎疫情引发美股暴跌之前一周，美国国会参议院情报委员会主席理查德·伯尔密集出售了自己和夫人持有的33只股票，估价在62.8万美元到172万美元之间。为什么2月中旬美国政府对本国新冠肺炎疫情轻描淡写，而参议院情报委员会的多位官员却在那时抛售价值上百万的股票？难道政客们竟然一边利用内幕交易售卖股票，一边对公众隐瞒疫情？
According to the Washington Post, US Senate Intelligence Committee Chairman Richard Burr and his wife sold up to 1.7 million in 33 different stocks just one week before the market plunged. Why did these officials at the Committee act so quickly while the government was continually understating the pandemic?
Why is the vital information kept confidential to the public while the government officials were taking advantage to practice insider-trading?
9.不许美国专家学者随意公开谈论新冠病毒，是想干什么？
9.Why are US experts not allowed to discuss COVID-19 in public?
据美国《纽约时报》报道，在由副总统迈克·彭斯领导美国防疫工作之后，白宫于当地时间2月27日开始，加强了对新冠病毒信息“发声”的控制。包括美国国立卫生研究院（NIH）过敏和传染病研究所(NIAID)主任、美国疾控中心（CDC）顶级传染病专家安东尼·福西（Anthony S. Fauci）在内的众多科学家和政府卫生官员被要求：只有与美国副总统办公室协调商议后，才能发声明或公开露面谈论新冠病毒的相关话题。为什么号称言论自由的美国不允许专家学者自由公开讨论新冠病毒？是想隐瞒什么还是在害怕什么？
The New York Times reported that the White House began tightening controls for all coronavirus messaging from health officials on February 27 after Vice President Mike Pence led the nation's epidemic prevention and control efforts.
Several scientists and government health officials, including the nation's leading infectious disease expert Anthony S. Fauci, have been asked to make statements or make public appearances about the COVID-19 only after consultation with the US vice president's office.
Why does the United States, which claims free speech, not allow experts and scholars to discuss the novel coronavirus in public? Does the US want to hide something or fear of something?
10.海外生物实验室到底在做什么研究，为什么从不向外界透露？
10.What research is being done in the US overseas biological laboratories? Why does the US keep tight-lipped about it?
据俄罗斯卫星通讯社日前报道，俄罗斯国家杜马国际事务委员会副主席波克隆斯卡娅提议核查世界各地美国生物实验室的合法性。前不久，俄罗斯外交部发言人就美国在前苏联国家建立生物实验室表达关切。俄罗斯内政、外交和国防领域专家格里高利·特罗菲姆丘克表示，美国这些生物实验室所从事的工作从不向外界透露，并且这些实验室引发了大量的问题，在实验室所在地就曾爆发过大范围的麻疹等危险的传染类疾病。美国建立的这些生物实验室到底在进行什么研究？美国为何对这些生物实验室的功能、用途、安全系数等三缄其口？
Natalia Poklonskaya, deputy chairman of the State Duma Committee on Foreign Affairs, has proposed verifying the legitimacy of US biological laboratories around the world, according to Sputnik news agency.
Not long ago, a spokesman for the Russian Foreign Ministry expressed concern about the establishment of a biological laboratory in countries from the former Soviet Union.
Grigory Trofimchuk, a Russian expert in the field of internal affairs, foreign affairs, and national defense, said the work of these biological laboratories was never disclosed to the outside world, and that they had caused several problems, with widespread outbreaks of dangerous infectious diseases such as measles at the laboratory site.
What research is being done in these biological laboratories? Why does the US keep tight-lipped about the function, use, the safety of these biological laboratories?
Crimson Contagion.
Before Virus Outbreak, a Cascade of Warnings Went Unheeded.
Government exercises, including one last year, made clear that the U.S. was not ready for a pandemic like the coronavirus. But little was done.
The Department of Health and Human Services’ Covid-19 operations center in Washington. The department ran an extensive exercise last year simulating a pandemic.
Published March 19, 2020
Updated March 22, 2020
WASHINGTON — The outbreak of the respiratory virus began in China and was quickly spread around the world by air travelers, who ran high fevers. In the United States, it was first detected in Chicago, and 47 days later, the World Health Organization declared a pandemic. By then it was too late: 110 million Americans were expected to become ill, leading to 7.7 million hospitalized and 586,000 dead.
That scenario, code-named “Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration’s Department of Health and Human Services in a series of exercises that ran from last January to August.
The simulation’s sobering results — contained in a draft report dated October 2019 that has not previously been reported — drove home just how underfunded, underprepared and uncoordinated the federal government would be for a life-or-death battle with a virus for which no treatment existed.
The draft report, marked “not to be disclosed,” laid out in stark detail repeated cases of “confusion” in the exercise. Federal agencies jockeyed over who was in charge. State officials and hospitals struggled to figure out what kind of equipment was stockpiled or available. Cities and states went their own ways on school closings.
Many of the potentially deadly consequences of a failure to address the shortcomings are now playing out in all-too-real fashion across the country. And it was hardly the first warning for the nation’s leaders. Three times over the past four years the U.S. government, across two administrations, had grappled in depth with what a pandemic would look like, identifying likely shortcomings and in some cases recommending specific action.
In 2016, the Obama administration produced a comprehensive report on the lessons learned by the government from battling Ebola. In January 2017, outgoing Obama administration officials ran an extensive exercise on responding to a pandemic for incoming senior officials of the Trump administration.
The full story of the Trump administration’s response to the coronavirus is still playing out. Government officials, health professionals, journalists and historians will spend years looking back on the muddled messages and missed opportunities of the past three months, as President Trump moved from dismissing the coronavirus as a few cases that would soon be “under control” to his revisionist announcement on Monday that he had known all along that a pandemic was on the way.
What the scenario makes clear, however, is that his own administration had already modeled a similar pandemic and understood its potential trajectory.
The White House defended its record, saying it responded to the 2019 exercise with an executive order to improve the availability and quality of flu vaccines, and that it moved early this year to increase funding for the Department of Health and Human Services’ program that focuses on global pandemic threats.
“Any suggestion that President Trump did not take the threat of COVID-19 seriously is false,” said Judd Deere, a White House spokesman.
But officials have declined to say why the administration was so slow to roll out broad testing or to move faster, as the simulations all indicated it should, to urge social distancing and school closings.
Asked at his news briefing on Thursday about the government’s preparedness, Mr. Trump responded: “Nobody knew there would be a pandemic or epidemic of this proportion. Nobody has ever seen anything like this before.”
The work done over the past five years, however, demonstrates that the government had considerable knowledge about the risks of a pandemic and accurately predicted the very types of problems Mr. Trump is now scrambling belatedly to address.
Crimson Contagion, the exercise conducted last year in Washington and 12 states including New York and Illinois, showed that federal agencies under Mr. Trump continued the Obama-era effort to think ahead about a pandemic.
But the planning and thinking happened many layers down in the bureaucracy. The knowledge and sense of urgency about the peril appear never to have gotten sufficient attention at the highest level of the executive branch or from Congress, leaving the nation with funding shortfalls, equipment shortages and disorganization within and among various branches and levels of government.
The October 2019 report in particular documents that officials at the Departments of Homeland Security and Health and Human Services, and even at the White House’s National Security Council, were aware of the potential for a respiratory virus outbreak originating in China to spread quickly to the United States and overwhelm the nation.
“Nobody ever thought of numbers like this,’’ Mr. Trump said on Wednesday, at a news conference.
In fact, they had.
From Ebola, Lessons Learned
(Health workers entering a high-risk ward at an Ebola treatment center in 2014 in Monrovia, Liberia. The outbreak led the Obama administration to study U.S. preparedness for a pandemic.Credit...Daniel Berehulak for The New York Times)
As early as the George W. Bush administration, homeland security and health officials focused on big gaps in the American response to a biological attacks and the growing risk of pandemics. The first test came in April 2009, just a few months after the start of President Barack Obama’s first term. A 10-year-old California girl was diagnosed with a contagious disease that would be called swine flu or H1N1, the first flu pandemic in more than 40 years.
The Centers for Disease Control and Prevention estimates that ultimately there were about 60.8 million cases in the United States, along with 274,304 hospitalizations and 12,469 deaths associated with H1N1.
The virus turned out to be less deadly than first expected. But it was a warning shot that officials in the Obama administration said they took seriously, kicking off a planning effort that escalated in early 2014, with the outbreak of Ebola in West Africa and ensuing fear that it could spread to the United States.
Ebola was less contagious than the flu, but far more deadly. It killed 11,000 people in Africa. But it could have been far worse. The United States sent nearly 3,000 troops to Africa to help keep the disease from spreading. While the containment effort was considered a success, inside the White House, officials sensed that the United States had gotten lucky — and that the response had revealed gaps in preparedness.
Christopher Kirchhoff, a national security aide who moved from the Pentagon to the White House to deal with the Ebola crisis, was given the job of putting together a “lessons learned” report, with input from across the government.
The weaknesses Mr. Kirchhoff identified were early warning signals of what has unfolded in the past three months.
His report concluded that the United States assumed more ability on the part of the World Health Organization than the agency actually had.
The United States had its own issues. There was no airplane in the U.S. fleet capable of evacuating an American doctor who was infected while treating patients in Liberia. The Pentagon was largely unprepared for the intervention that Mr. Obama ordered.
While the United States rapidly developed a way to screen air passengers coming into the country — borrowing from intelligence tools developed after the Sept. 11, 2001, attacks to track possible terrorists — Mr. Kirchhoff found deficiencies in even measuring how fast the virus was spreading.
On the plus side, the Obama White House had created an Ebola Task Force, run by Ron Klain, Vice President Joseph R. Biden Jr.’s former chief of staff, before a single case emerged in the United States. Congress allocated $5.4 billion in emergency funding to pay for Ebola treatment and prevention efforts in the United States and West Africa.
The money helped fund a little-known agency inside the Department of Health and Human Services in charge of preparing for future contagious disease outbreaks, the same office that in 2019 ran the Crimson Contagion exercise and other similar events in the years since.
After a man named Thomas Duncan, a Liberian citizen, became the first person given a diagnosis of Ebola on American territory in September 2014, errors resulted in the infection of two nurses and fear of a wider spread in the United States. (Mr. Duncan died, but the two nurses recovered.)
What is striking in reading Mr. Kirchhoff’s account today, however, is how few of the major faults he found in the American response resulted in action — even though the report was filled with department-by-department recommendations.
There were deficiencies “in personal protective equipment use, disinfection” and “social services for those placed under quarantine.”
There was confusion over travel restrictions, and the need “for a smoother sliding scale of escalation of government response, from local authorities acting on their own to local authorities acting with some federal assistance” to the full activation of the federal government.
The report concluded that “a minimum planning benchmark might be an epidemic an order of magnitude or two more difficult than that presented by the outbreak of Ebola in West Africa, with much more significant domestic spread.
But one big change did come out of the study: The creation of a dedicated office at the National Security Council to coordinate responses and raise the alarm early.
“What I learned most is that we had to stand up a global biosecurity and health directorate, and get it enshrined for the next administration,” said Lisa Monaco, Mr. Obama’s homeland security adviser.
Getting the Trump Team’s Attention.
(John F. Kelly and Rex W. Tillerson were part of a high-level pandemic exercise, but both men left the administration before the Covid-19 outbreak.Credit...Al Drago for The New York Times)
After Mr. Trump’s election, Ms. Monaco arranged an extensive exercise for high-level incoming officials — including Rex W. Tillerson, the nominee for secretary of state; John F. Kelly, designated to become homeland security secretary; and Rick Perry, who would become energy secretary — gaming out the response to a deadly flu outbreak.
She asked Tom Bossert, who was preparing to come in as Mr. Trump’s homeland security adviser, to run the event alongside her.
“We modeled a new strain of flu in the exercise precisely because it’s so communicable,” Ms. Monaco said. “There is no vaccine, and you would get issues like nursing homes being particularly vulnerable, shortages of ventilators.”
Ms. Monaco was impressed by how seriously Mr. Bossert, her successor, appeared to take the threat, as did many of the 30 or so Trump team members who participated in the exercise, details of which were reported by Politico.
But by the time the current crisis hit, almost all of the leaders at the table — Mr. Tillerson, Mr. Kelly and Mr. Perry among them — had been fired or moved on.
In 2018, Mr. Trump’s national security adviser at the time, John R. Bolton, ousted Mr. Bossert and eliminated the National Security Council directorate, folding it into an office dedicated to weapons of mass destruction in what Trump officials called a logical consolidation.
Asked about that shift on March 13, Mr. Trump told a reporter that it was “a nasty question,” before adding: “I don’t know anything about it.” Writing on Twitter the next day, Mr. Bolton lashed out at critics who said the shift had reflected disregard for pandemic threats.
“Claims that streamlining NSC structures impaired our nation’s bio defense are false,” Mr. Bolton tweeted. “Global health remained a top NSC priority.”
In a statement, the National Security Council said it “has directors and staff whose full-time job it is to monitor, plan for, and respond to pandemics, including an infectious disease epidemiologist and a virologist.”
But in testimony to Congress last week, Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases, suggested that ending the stand-alone directorate was ill-advised. “It would be nice if the office was still there,” he said.
On Feb. 10, nearly three weeks after the first coronavirus case was diagnosed in the United States, Mr. Trump submitted a 2021 budget proposal that called for a $693.3 million reduction in funding for the C.D.C., or about 9 percent, although there was a modest increase for the division that combats global pandemics.
‘Crimson Contagion’
The Crimson Contagion planning exercise run last year by the Department of Health and Human Services involved officials from 12 states and at least a dozen federal agencies. They included the Pentagon, the Department of Veterans Affairs and the National Security Council. Groups like the American Red Cross and American Nurses Association were invited to join, as were health insurance companies and major hospitals like the Mayo Clinic.
The war game-like exercise was overseen by Robert P. Kadlec, a former Air Force physician who has spent decades focused on biodefense issues. After stints on the Bush administration’s Homeland Security Council and the staff of the Senate Intelligence Committee, he was appointed assistant secretary of Health and Human Services for Preparedness and Response.
“He recognized early that we have a big problem and we needed much bigger budgets to prepare,” said Richard Danzig, the secretary of the Navy in the Clinton administration, who had worked with Mr. Kadlec.
The exercise played out in four separate stages, starting in January 2019.
The events were supposedly unspooling in real time — with the worst-case scenario underway as of Aug. 13, 2019 — when, according to the script, 12,100 cases had already been reported in the United States, with the largest number in Chicago, which had 1,400.
The fictional outbreak involved a pandemic flu, which the Department of Health and Human Services says was “very different than the novel coronavirus.” The staged outbreak had started when a group of 35 tourists visiting China were infected and then flew home to Australia, Kuwait, Malaysia, Thailand, Britain and Spain, as well as to the United States, with some developing respiratory symptoms and fevers en route.
A 52-year-old man from Chicago, who was on the tour, had “low energy and a dry cough” upon his return home. His 17-year-old son on that same day went out to a large public event in Chicago, and the chain of illnesses in the United States started.
Many of the moments during the tabletop exercise are now chillingly familiar.
In the fictional pandemic, as the virus spread quickly across the United States, the C.D.C. issued guidelines for social distancing, and many employees were told to work from home.
But federal and state officials struggled to identify which employees were essential and what equipment was needed to effectively work from home.
There also was confusion over how to handle school children. The C.D.C. recommended that states delay school openings — the exercise took place toward the end of the summer. But some school districts decided to go ahead with the start of school while others followed the federal advice, causing the same types of confusion and discrepancies that have marked the response to the coronavirus.
The exercise from last year then went on to predict how the situation on the ground in the United States would worsen as the weeks passed.
Confusion emerged as state governments began to turn in large numbers to Washington for help to address shortages of antiviral medications, personal protective equipment and ventilators. Then states started to submit requests to different branches of the federal government, leading to bureaucratic chaos.
Friction also emerged between the Federal Emergency Management Agency, which is traditionally in charge of disaster response, and the Department of Health and Human Services, another scenario playing out now.
But the problems were larger than bureaucratic snags. The United States, the organizers realized, did not have the means to quickly manufacture more essential medical equipment, supplies or medicines, including antiviral medications, needles, syringes, N95 respirators and ventilators, the agency concluded.
Congress was briefed in December on some of these findings, including the inability to quickly replenish certain medical supplies, given that much of the product comes from overseas.
These concerns turned more urgent at a hearing last Thursday on Capitol Hill, as lawmakers peppered officials with the Department of Health and Human Services with questions that sounded almost as if they had read the script from the fictional exercise, reflecting the shortage of respirators and protective gear.
Senator Mitt Romney, Republican of Utah, said last week that he blamed Congress and prior administrations for not increasing stockpiles of this type of equipment.
“That is an area we ought to consider making an investment in,” he added, making a point, apparently unknown to him, that the administration’s own simulation had made clear five months earlier.
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Ten questions the US needs to
offer clear answers to the world
1.禽流感病毒改造去年突然重启，之后无声无息，为什么？
1.Regarding the restarted avian influenza virus modification experiment last year, why does the US release no more updates?
去年2月，据美国《科学》杂志网站披露，美国政府机构已“悄悄”批准曾引发巨大争议的禽流感病毒改造实验，这类被认为“危险”的实验在被禁多年后将很快重启。相关实验可将H5N1禽流感病毒改造得易于在哺乳动物间传播，被认为可能带来人际传播风险。美国为何在相关实验被暂停4年多后重启这类危险实验？又为何不见披露进展？
The Science reported in February 2019 that US authorities had quietly approved the avian influenza virus modification experiment. The research, aiming to transform the H5N1 virus to be more capable of infecting mammals, was controversial and considered extremely dangerous. Some experts believe that the modification may increase the risk of human-to-human transmission of the virus.
The question is why the US government decided to unfreeze the experiment 4 years after it was halted, and why there are no more updates regarding the experiment.
2.美军生物实验室一度关闭停产，真相是什么？
2.The United States Army Medical Research Institute of Infectious Diseases (USAMRIID) was previously closed.What is the truth behind ?
日前，据“全球生物防御”（globalbiodefence）网站报道，位于马里兰州德特里克堡的美国陆军传染病医学研究所（USAMRIID）已经全面恢复运行。去年7月，美国疾病控制与预防中心（CDC）正式向位于马里兰州德特里克堡的美国陆军传染病医学研究所（USAMRIID）发出“停产令”，要求其停止进行“特定生物制剂与毒素”研究。今年3月，白宫请愿网站出现一道特殊的请愿帖，要求美国政府公布去年7月“关闭”德特里克堡生物实验室的真正原因。USAMRIID神秘“关闭”和迅速重启引人关注。针对白宫请愿网站请愿帖上的要求，美国作何回应？
The Global Biodefence reported in April that the USAMRIID, US Army's primary institution and facility for biological research headquartered in Fort Detrick, Maryland, has resumed full operation. The institution was once ordered to halt the study of biological select agents and toxins (BSATs) last July. In March, there was a petition on the White House website demanding the clarification of the shutdown of USAMRIID. Given that these issues have become a primary public concern, what is the US government's response?
3.去年传染病演习情景今年真实上演，真的只是巧合？
3.The US Department of Health and Human Services ran a scenario last year that was similar to the COVID-19 outbreak. Is this just a coincidence?
今年3月《纽约时报》披露的一份美国官方秘密文件显示，2019年1月至8月16日举行，美国卫生与公共服务部（HHS）发起组织了一场代号为“赤色传染”（Crimson Contagion）的推演，演习以中国最早出现病毒为模拟情景。2019年10月，美国多个机构又组织了一次代号为“Event 201”的全球流行病演习。演练中的模型假设一种名为CAPS的冠状病毒，比SARS致命，又如感冒轻易传播，却未开发出疫苗，能迅速传播促成全球大流行。美国去年进行的传染病演习的设定与现实的吻合度如此之高是否只是巧合？既然有演练在前，新冠疫情发生后美国为何没有给予足够的关注和重视、宣称“尚在掌握之中”？
In March, the New York Times quoted a draft report obtained from the US government saying that from January to August 2019, the US Department of Health and Human Services ran a scenario called "Crimson Contagion" that simulated the fictional outbreak involving a group of tourists visiting China. They then became infected and flew to various countries, including the US.
Last October, a high-level pandemic exercise named Event 201 was hosted by a couple of US organizations. The drill simulated a scenario that a fictional virus called CAPS, which causes more severe symptoms than SARS and transmits via the respiratory route like the common flu, had caused a pandemic. Like COVID-19, there is no vaccine for CAPS.
Given the fact that the simulated virus is so much like COVID-19, is this just a coincidence? Another question is, why did it not take enough preventive measures at the early stages of the coronavirus outbreak since the US has predicted a similar pandemic?
4.提前预测疫情大流行又无视警告情报，为什么？
4.US intelligence officials warned of coronavirus crisis as early as last November. Why the warning was ignored?
今年4月，据美国广播公司（ABC）报道，有内部消息称，早在2019年11月下旬，美国情报官员就曾多次向国防情报局、五角大楼和白宫警告，一场传染病正在席卷中国武汉地区。美国国家医学情报中心（NCMI）去年11月出具了一份详细阐述病毒大流行情况的报告，也就是后来被确认的新型冠状病毒肺炎“COVID-19”。有分析人士认为武汉疫情爆发可能会演变成一场灾难性事件。据美国《华盛顿邮报》网站报道称在年初的2个多月时间里，特朗普获得了美国情报机构发出的关于新冠病毒的密集警告。美国政府为何一直拖到3月13日才宣布进入“国家紧急状态”？
In April, according to the American Broadcasting Corporation (ABC), it was said that, as early as late November 2019, US intelligence officials had warned the Defense Intelligence Agency, the Pentagon, and the White House that an infectious disease was sweeping through Wuhan, China.
Last November, the US National Center for Medical Intelligence (NCMI) issued a report detailing the coronavirus pandemic, which was later identified as "COVID-19". Some analysts believed that the outbreak in Wuhan might have evolved into a catastrophic event. According to the Washington Post, in more than two months from January to February, Trump had received intensive warnings from the US intelligence agencies about the coronavirus. Why did the US government not declare a "National Emergency" until March 13?
5.有多少流感患者感染的其实是新冠肺炎，能不能说清楚？
5.Among the reported influenza deaths in the US, can the US clarify how many cases are actually infected with COVID-19?
今年2月21日，日本朝日电视台报道的“美国1.4万名因流感致死的人中部分可能死于新冠肺炎”掀起热议。美疾控中心2月底发布的报告显示，今冬流感季美国估计已有至少3200万流感。3月11日在美国众议院，美国疾控中心主任罗伯特·雷德菲尔德（Robert Redfield）亲口承认，在美国，确实有一些“流感”死者实际感染的可能是新冠肺炎。美国流感感染者中，到底有多少新冠病例？美国有没有借流感来掩盖新冠肺炎的情况？美国何时才能公开美国流感病毒样本及基因序列信息，或者允许世卫组织或联合国派遣专家采样分析？
Japanese Asahi Television reported on February 21 that some of the 14,000 people reportedly killed by influenza in the US might have died from coronavirus, which became a hot topic soon after.
The US Centers for Disease Control and Prevention (CDC) released a report at the end of February, showing that there have been at least 32 million flu illnesses in the US that winter.
On March 11, at the House of Representatives, Robert Redfield, the director of the US CDC, admitted that some in the US who were previously thought to have been killed from the flu may have been infected with coronavirus.
Among the reported influenza deaths in the US, how many cases were infected with COVID-19? Did the US government cover up the spread of coronavirus with the flu? When will the US government make public the samples of the US influenza virus and its genetic sequence, or allow experts from the WHO or the United Nations to sample and analyze?
6.新冠病毒到底什么时候在美国出现？社区传播是否早已开始？
6.When did the novel coronavirus first appear in the US? Did community transmission of the coronavirus start sooner than it was reported?
今年4月下旬，美国加利福尼亚州圣克拉拉县政府公共卫生部门公布的最新检测报告显示，早在2月6日当地就有人死于新冠肺炎，这比美国此前公布的首例新冠死亡病例出现时间提前了20多天。据《洛杉矶时报》报道，圣克拉拉县的卫生官员萨拉·科迪表示，这些新发现的死亡病例说明，当时“已经有相当程度的社区传播”。圣克拉拉县行政长官杰弗里·史密斯表示，这表明新冠病毒早在1月、甚至更早就已经开始在加州传播。加州州长纽瑟姆已宣布将对去年12月以来疑似新冠死亡病例进行尸检。新冠病毒到底什么时候在美国出现？美国新冠疫情在社区的传播是否早已开始？
A report released in late April by local health authorities suggests that a 57-year-old woman from Santa Clara County of California died from COVID-19 on February 6, some 20 days earlier than the date the US announced its first death caused by the virus.
The Los Angeles Times quoted Santa Clara County health officer Sara Cody in a piece saying, "we presume that each of them represents community transmission and that there was some significant level of virus circulating in our community in early February."
County Executive Officer Jeffrey V. Smith said this is evidence that the coronavirus was circulating in California as early as January or even earlier.
California Gov. Gavin Newsom has ordered all counties in the state to review autopsies of suspected coronavirus deaths dating back to December.
When did the novel coronavirus first appear in the US? Did community transmission of the coronavirus start sooner than it was reported?
7.全球首个启动新冠疫苗人体试验，这么快是怎么拿到毒株的？
7.How did the US get the virus strains so soon to start the first human testing of a vaccine against COVID-19?
据《华尔街日报》报道，美国国立卫生研究院(National Institutes of Health)3月16日称，生物科技公司Moderna Inc. (MRNA)针对新型冠状病毒的试验性疫苗已开始首次人体测试。对于全球首次针对新型冠状病毒的疫苗人体试验在美国启动一事，专家表示，美国这一针实在太快了，除非很早就开始进行试验，更早的拿到了病毒株。美国疫苗人体试验为何进行得如此之快？美国是什么时候通过什么方式获得的毒株？
The Wall Street Journal on March 16 reported that the first human testing of Moderna Inc.'s experimental vaccine against the COVID-19 had already begun. Experts immediately raised questions about the speed of the vaccine development, saying that it would not be possible unless the US had obtained the virus strains from very early on. So how did the US start the first human testing of the vaccine so soon? When and how did they get the virus strains?
8.政府说疫情不严重，官员却在狂抛股票，为什么？
8.Why did the US government keep downplaying the pandemic while its officials privately dumped stocks?
据《华盛顿邮报》报道，大约在新冠肺炎疫情引发美股暴跌之前一周，美国国会参议院情报委员会主席理查德·伯尔密集出售了自己和夫人持有的33只股票，估价在62.8万美元到172万美元之间。为什么2月中旬美国政府对本国新冠肺炎疫情轻描淡写，而参议院情报委员会的多位官员却在那时抛售价值上百万的股票？难道政客们竟然一边利用内幕交易售卖股票，一边对公众隐瞒疫情？
According to the Washington Post, US Senate Intelligence Committee Chairman Richard Burr and his wife sold up to 1.7 million in 33 different stocks just one week before the market plunged. Why did these officials at the Committee act so quickly while the government was continually understating the pandemic?
Why is the vital information kept confidential to the public while the government officials were taking advantage to practice insider-trading?
9.不许美国专家学者随意公开谈论新冠病毒，是想干什么？
9.Why are US experts not allowed to discuss COVID-19 in public?
据美国《纽约时报》报道，在由副总统迈克·彭斯领导美国防疫工作之后，白宫于当地时间2月27日开始，加强了对新冠病毒信息“发声”的控制。包括美国国立卫生研究院（NIH）过敏和传染病研究所(NIAID)主任、美国疾控中心（CDC）顶级传染病专家安东尼·福西（Anthony S. Fauci）在内的众多科学家和政府卫生官员被要求：只有与美国副总统办公室协调商议后，才能发声明或公开露面谈论新冠病毒的相关话题。为什么号称言论自由的美国不允许专家学者自由公开讨论新冠病毒？是想隐瞒什么还是在害怕什么？
The New York Times reported that the White House began tightening controls for all coronavirus messaging from health officials on February 27 after Vice President Mike Pence led the nation's epidemic prevention and control efforts.
Several scientists and government health officials, including the nation's leading infectious disease expert Anthony S. Fauci, have been asked to make statements or make public appearances about the COVID-19 only after consultation with the US vice president's office.
Why does the United States, which claims free speech, not allow experts and scholars to discuss the novel coronavirus in public? Does the US want to hide something or fear of something?
10.海外生物实验室到底在做什么研究，为什么从不向外界透露？
10.What research is being done in the US overseas biological laboratories? Why does the US keep tight-lipped about it?
据俄罗斯卫星通讯社日前报道，俄罗斯国家杜马国际事务委员会副主席波克隆斯卡娅提议核查世界各地美国生物实验室的合法性。前不久，俄罗斯外交部发言人就美国在前苏联国家建立生物实验室表达关切。俄罗斯内政、外交和国防领域专家格里高利·特罗菲姆丘克表示，美国这些生物实验室所从事的工作从不向外界透露，并且这些实验室引发了大量的问题，在实验室所在地就曾爆发过大范围的麻疹等危险的传染类疾病。美国建立的这些生物实验室到底在进行什么研究？美国为何对这些生物实验室的功能、用途、安全系数等三缄其口？
Natalia Poklonskaya, deputy chairman of the State Duma Committee on Foreign Affairs, has proposed verifying the legitimacy of US biological laboratories around the world, according to Sputnik news agency.
Not long ago, a spokesman for the Russian Foreign Ministry expressed concern about the establishment of a biological laboratory in countries from the former Soviet Union.
Grigory Trofimchuk, a Russian expert in the field of internal affairs, foreign affairs, and national defense, said the work of these biological laboratories was never disclosed to the outside world, and that they had caused several problems, with widespread outbreaks of dangerous infectious diseases such as measles at the laboratory site.
What research is being done in these biological laboratories? Why does the US keep tight-lipped about the function, use, the safety of these biological laboratories?
Crimson Contagion.
Before Virus Outbreak, a Cascade of Warnings Went Unheeded.
Government exercises, including one last year, made clear that the U.S. was not ready for a pandemic like the coronavirus. But little was done.
The Department of Health and Human Services’ Covid-19 operations center in Washington. The department ran an extensive exercise last year simulating a pandemic.
Published March 19, 2020
Updated March 22, 2020
WASHINGTON — The outbreak of the respiratory virus began in China and was quickly spread around the world by air travelers, who ran high fevers. In the United States, it was first detected in Chicago, and 47 days later, the World Health Organization declared a pandemic. By then it was too late: 110 million Americans were expected to become ill, leading to 7.7 million hospitalized and 586,000 dead.
That scenario, code-named “Crimson Contagion” and imagining an influenza pandemic, was simulated by the Trump administration’s Department of Health and Human Services in a series of exercises that ran from last January to August.
The simulation’s sobering results — contained in a draft report dated October 2019 that has not previously been reported — drove home just how underfunded, underprepared and uncoordinated the federal government would be for a life-or-death battle with a virus for which no treatment existed.
The draft report, marked “not to be disclosed,” laid out in stark detail repeated cases of “confusion” in the exercise. Federal agencies jockeyed over who was in charge. State officials and hospitals struggled to figure out what kind of equipment was stockpiled or available. Cities and states went their own ways on school closings.
Many of the potentially deadly consequences of a failure to address the shortcomings are now playing out in all-too-real fashion across the country. And it was hardly the first warning for the nation’s leaders. Three times over the past four years the U.S. government, across two administrations, had grappled in depth with what a pandemic would look like, identifying likely shortcomings and in some cases recommending specific action.
In 2016, the Obama administration produced a comprehensive report on the lessons learned by the government from battling Ebola. In January 2017, outgoing Obama administration officials ran an extensive exercise on responding to a pandemic for incoming senior officials of the Trump administration.
The full story of the Trump administration’s response to the coronavirus is still playing out. Government officials, health professionals, journalists and historians will spend years looking back on the muddled messages and missed opportunities of the past three months, as President Trump moved from dismissing the coronavirus as a few cases that would soon be “under control” to his revisionist announcement on Monday that he had known all along that a pandemic was on the way.
What the scenario makes clear, however, is that his own administration had already modeled a similar pandemic and understood its potential trajectory.
The White House defended its record, saying it responded to the 2019 exercise with an executive order to improve the availability and quality of flu vaccines, and that it moved early this year to increase funding for the Department of Health and Human Services’ program that focuses on global pandemic threats.
“Any suggestion that President Trump did not take the threat of COVID-19 seriously is false,” said Judd Deere, a White House spokesman.
But officials have declined to say why the administration was so slow to roll out broad testing or to move faster, as the simulations all indicated it should, to urge social distancing and school closings.
Asked at his news briefing on Thursday about the government’s preparedness, Mr. Trump responded: “Nobody knew there would be a pandemic or epidemic of this proportion. Nobody has ever seen anything like this before.”
The work done over the past five years, however, demonstrates that the government had considerable knowledge about the risks of a pandemic and accurately predicted the very types of problems Mr. Trump is now scrambling belatedly to address.
Crimson Contagion, the exercise conducted last year in Washington and 12 states including New York and Illinois, showed that federal agencies under Mr. Trump continued the Obama-era effort to think ahead about a pandemic.
But the planning and thinking happened many layers down in the bureaucracy. The knowledge and sense of urgency about the peril appear never to have gotten sufficient attention at the highest level of the executive branch or from Congress, leaving the nation with funding shortfalls, equipment shortages and disorganization within and among various branches and levels of government.
The October 2019 report in particular documents that officials at the Departments of Homeland Security and Health and Human Services, and even at the White House’s National Security Council, were aware of the potential for a respiratory virus outbreak originating in China to spread quickly to the United States and overwhelm the nation.
“Nobody ever thought of numbers like this,’’ Mr. Trump said on Wednesday, at a news conference.
In fact, they had.
From Ebola, Lessons Learned
(Health workers entering a high-risk ward at an Ebola treatment center in 2014 in Monrovia, Liberia. The outbreak led the Obama administration to study U.S. preparedness for a pandemic.Credit...Daniel Berehulak for The New York Times)
As early as the George W. Bush administration, homeland security and health officials focused on big gaps in the American response to a biological attacks and the growing risk of pandemics. The first test came in April 2009, just a few months after the start of President Barack Obama’s first term. A 10-year-old California girl was diagnosed with a contagious disease that would be called swine flu or H1N1, the first flu pandemic in more than 40 years.
The Centers for Disease Control and Prevention estimates that ultimately there were about 60.8 million cases in the United States, along with 274,304 hospitalizations and 12,469 deaths associated with H1N1.
The virus turned out to be less deadly than first expected. But it was a warning shot that officials in the Obama administration said they took seriously, kicking off a planning effort that escalated in early 2014, with the outbreak of Ebola in West Africa and ensuing fear that it could spread to the United States.
Ebola was less contagious than the flu, but far more deadly. It killed 11,000 people in Africa. But it could have been far worse. The United States sent nearly 3,000 troops to Africa to help keep the disease from spreading. While the containment effort was considered a success, inside the White House, officials sensed that the United States had gotten lucky — and that the response had revealed gaps in preparedness.
Christopher Kirchhoff, a national security aide who moved from the Pentagon to the White House to deal with the Ebola crisis, was given the job of putting together a “lessons learned” report, with input from across the government.
The weaknesses Mr. Kirchhoff identified were early warning signals of what has unfolded in the past three months.
His report concluded that the United States assumed more ability on the part of the World Health Organization than the agency actually had.
The United States had its own issues. There was no airplane in the U.S. fleet capable of evacuating an American doctor who was infected while treating patients in Liberia. The Pentagon was largely unprepared for the intervention that Mr. Obama ordered.
While the United States rapidly developed a way to screen air passengers coming into the country — borrowing from intelligence tools developed after the Sept. 11, 2001, attacks to track possible terrorists — Mr. Kirchhoff found deficiencies in even measuring how fast the virus was spreading.
On the plus side, the Obama White House had created an Ebola Task Force, run by Ron Klain, Vice President Joseph R. Biden Jr.’s former chief of staff, before a single case emerged in the United States. Congress allocated $5.4 billion in emergency funding to pay for Ebola treatment and prevention efforts in the United States and West Africa.
The money helped fund a little-known agency inside the Department of Health and Human Services in charge of preparing for future contagious disease outbreaks, the same office that in 2019 ran the Crimson Contagion exercise and other similar events in the years since.
After a man named Thomas Duncan, a Liberian citizen, became the first person given a diagnosis of Ebola on American territory in September 2014, errors resulted in the infection of two nurses and fear of a wider spread in the United States. (Mr. Duncan died, but the two nurses recovered.)
What is striking in reading Mr. Kirchhoff’s account today, however, is how few of the major faults he found in the American response resulted in action — even though the report was filled with department-by-department recommendations.
There were deficiencies “in personal protective equipment use, disinfection” and “social services for those placed under quarantine.”
There was confusion over travel restrictions, and the need “for a smoother sliding scale of escalation of government response, from local authorities acting on their own to local authorities acting with some federal assistance” to the full activation of the federal government.
The report concluded that “a minimum planning benchmark might be an epidemic an order of magnitude or two more difficult than that presented by the outbreak of Ebola in West Africa, with much more significant domestic spread.
But one big change did come out of the study: The creation of a dedicated office at the National Security Council to coordinate responses and raise the alarm early.
“What I learned most is that we had to stand up a global biosecurity and health directorate, and get it enshrined for the next administration,” said Lisa Monaco, Mr. Obama’s homeland security adviser.
Getting the Trump Team’s Attention.
(John F. Kelly and Rex W. Tillerson were part of a high-level pandemic exercise, but both men left the administration before the Covid-19 outbreak.Credit...Al Drago for The New York Times)
After Mr. Trump’s election, Ms. Monaco arranged an extensive exercise for high-level incoming officials — including Rex W. Tillerson, the nominee for secretary of state; John F. Kelly, designated to become homeland security secretary; and Rick Perry, who would become energy secretary — gaming out the response to a deadly flu outbreak.
She asked Tom Bossert, who was preparing to come in as Mr. Trump’s homeland security adviser, to run the event alongside her.
“We modeled a new strain of flu in the exercise precisely because it’s so communicable,” Ms. Monaco said. “There is no vaccine, and you would get issues like nursing homes being particularly vulnerable, shortages of ventilators.”
Ms. Monaco was impressed by how seriously Mr. Bossert, her successor, appeared to take the threat, as did many of the 30 or so Trump team members who participated in the exercise, details of which were reported by Politico.
But by the time the current crisis hit, almost all of the leaders at the table — Mr. Tillerson, Mr. Kelly and Mr. Perry among them — had been fired or moved on.
In 2018, Mr. Trump’s national security adviser at the time, John R. Bolton, ousted Mr. Bossert and eliminated the National Security Council directorate, folding it into an office dedicated to weapons of mass destruction in what Trump officials called a logical consolidation.
Asked about that shift on March 13, Mr. Trump told a reporter that it was “a nasty question,” before adding: “I don’t know anything about it.” Writing on Twitter the next day, Mr. Bolton lashed out at critics who said the shift had reflected disregard for pandemic threats.
“Claims that streamlining NSC structures impaired our nation’s bio defense are false,” Mr. Bolton tweeted. “Global health remained a top NSC priority.”
In a statement, the National Security Council said it “has directors and staff whose full-time job it is to monitor, plan for, and respond to pandemics, including an infectious disease epidemiologist and a virologist.”
But in testimony to Congress last week, Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases, suggested that ending the stand-alone directorate was ill-advised. “It would be nice if the office was still there,” he said.
On Feb. 10, nearly three weeks after the first coronavirus case was diagnosed in the United States, Mr. Trump submitted a 2021 budget proposal that called for a $693.3 million reduction in funding for the C.D.C., or about 9 percent, although there was a modest increase for the division that combats global pandemics.
‘Crimson Contagion’
The Crimson Contagion planning exercise run last year by the Department of Health and Human Services involved officials from 12 states and at least a dozen federal agencies. They included the Pentagon, the Department of Veterans Affairs and the National Security Council. Groups like the American Red Cross and American Nurses Association were invited to join, as were health insurance companies and major hospitals like the Mayo Clinic.
The war game-like exercise was overseen by Robert P. Kadlec, a former Air Force physician who has spent decades focused on biodefense issues. After stints on the Bush administration’s Homeland Security Council and the staff of the Senate Intelligence Committee, he was appointed assistant secretary of Health and Human Services for Preparedness and Response.
“He recognized early that we have a big problem and we needed much bigger budgets to prepare,” said Richard Danzig, the secretary of the Navy in the Clinton administration, who had worked with Mr. Kadlec.
The exercise played out in four separate stages, starting in January 2019.
The events were supposedly unspooling in real time — with the worst-case scenario underway as of Aug. 13, 2019 — when, according to the script, 12,100 cases had already been reported in the United States, with the largest number in Chicago, which had 1,400.
The fictional outbreak involved a pandemic flu, which the Department of Health and Human Services says was “very different than the novel coronavirus.” The staged outbreak had started when a group of 35 tourists visiting China were infected and then flew home to Australia, Kuwait, Malaysia, Thailand, Britain and Spain, as well as to the United States, with some developing respiratory symptoms and fevers en route.
A 52-year-old man from Chicago, who was on the tour, had “low energy and a dry cough” upon his return home. His 17-year-old son on that same day went out to a large public event in Chicago, and the chain of illnesses in the United States started.
Many of the moments during the tabletop exercise are now chillingly familiar.
In the fictional pandemic, as the virus spread quickly across the United States, the C.D.C. issued guidelines for social distancing, and many employees were told to work from home.
But federal and state officials struggled to identify which employees were essential and what equipment was needed to effectively work from home.
There also was confusion over how to handle school children. The C.D.C. recommended that states delay school openings — the exercise took place toward the end of the summer. But some school districts decided to go ahead with the start of school while others followed the federal advice, causing the same types of confusion and discrepancies that have marked the response to the coronavirus.
The exercise from last year then went on to predict how the situation on the ground in the United States would worsen as the weeks passed.
Confusion emerged as state governments began to turn in large numbers to Washington for help to address shortages of antiviral medications, personal protective equipment and ventilators. Then states started to submit requests to different branches of the federal government, leading to bureaucratic chaos.
Friction also emerged between the Federal Emergency Management Agency, which is traditionally in charge of disaster response, and the Department of Health and Human Services, another scenario playing out now.
But the problems were larger than bureaucratic snags. The United States, the organizers realized, did not have the means to quickly manufacture more essential medical equipment, supplies or medicines, including antiviral medications, needles, syringes, N95 respirators and ventilators, the agency concluded.
Congress was briefed in December on some of these findings, including the inability to quickly replenish certain medical supplies, given that much of the product comes from overseas.
These concerns turned more urgent at a hearing last Thursday on Capitol Hill, as lawmakers peppered officials with the Department of Health and Human Services with questions that sounded almost as if they had read the script from the fictional exercise, reflecting the shortage of respirators and protective gear.
Senator Mitt Romney, Republican of Utah, said last week that he blamed Congress and prior administrations for not increasing stockpiles of this type of equipment.
“That is an area we ought to consider making an investment in,” he added, making a point, apparently unknown to him, that the administration’s own simulation had made clear five months earlier.
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