In the early days of the coronavirus pandemic, as White House officials debated whether to bring infected Americans home for care, President Donald Trump suggested his own plan for where to send them, eager to suppress the numbers on U.S. soil.
“Don’t we have an island that we own?” the president reportedly asked those assembled in the Situation Room in February 2020, before the U.S. outbreak would explode. “What about Guantánamo?”
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“We import goods,” Trump specified, lecturing his staff. “We are not going to import a virus.”
Aides were stunned, and when Trump brought it up a second time, they quickly scuttled the idea, worried about a backlash over quarantining American tourists on the same Caribbean base where the United States holds terrorism suspects.
Such insider conversations are among the revelations in “Nightmare Scenario: Inside the Trump Administration’s Response to the Pandemic That Changed History,” a new book by Washington Post journalists Yasmeen Abutaleb and Damian Paletta that captures the dysfunctional response to the unfolding pandemic.
The book – which draws on interviews with more than 180 people, including multiple White House senior staff members and government health leaders – offers new insights into last year’s chaotic and often-bungled response, portraying the power struggles over the leadership of the White House coronavirus task force, the unrelenting feuds that hampered cooperation and the enormous efforts made to prevent Trump from acting on his worst instincts. The Washington Post obtained a copy of the book ahead of its June 29 publication.
The book offers new insights about Trump as the president careened between embracing miracle coronavirus cures in his quest for good news, grappling with his own illness – which was far more serious than officials acknowledged – and fretting about the outbreak’s implications for his reelection bid.
“Testing is killing me!” Trump reportedly exclaimed in a phone call to then-Health and Human Services Secretary Alex Azar on March 18, yelling so loudly that Azar’s aides overheard every word. “I’m going to lose the election because of testing! What idiot had the federal government do testing?”
“Uh, do you mean Jared?” Azar responded, citing the president’s senior adviser and son-in-law, Jared Kushner. Just five days earlier, Kushner had vowed to take charge of a national testing strategy with the help of the private sector, Abutaleb and Paletta write.
Trump countered that the U.S. government never should have become involved in testing, arguing with his health secretary over why the Centers for Disease Control and Prevention was seeking to track infections at all. “This was gross incompetence to let CDC develop a test,” Trump reportedly said as he berated Azar.
Public health experts contend it was inadequate testing that allowed the novel coronavirus to spread largely undetected across the United States in early 2020, making contact tracing and isolation all but impossible in the early days of the outbreak and fueling the first staggering wave of infections, hospitalizations and deaths.
Trump’s rages frequently distracted senior officials and slowed the national response, the authors found, with the president touting his hunches and eventually turning to handpicked advisers including the radiologist Scott Atlas, who had no infectious-disease or public health experience. But the book also depicts the president as ineffectual and out of touch while his health and national security officials tried to manage the worsening outbreak.
Despite his famous reality TV catchphrase “You’re fired,” Trump proved markedly ineffective at removing staffers during the pandemic, Abutaleb and Paletta write, boxed in by deputies who worried about political fallout and the implications of undermining public health.
For instance, Trump repeatedly told his aides in February to fire a senior State Department official who allowed 14 coronavirus-infected Americans on the Diamond Princess cruise ship to return home. The decision “doubles my numbers overnight,” the president complained to Azar, as the number of official U.S. coronavirus cases rose to 28.
But senior officials balked at firing the diplomat, and Trump and then-acting White House chief of staff Mick Mulvaney eventually “gave up,” Abutaleb and Paletta write, adding that the official’s decision to bring the sick Americans back to the United States may have saved their lives, given there were no later flights they could take.
Trump also would call for firing Robert Kadlec, the HHS emergency preparedness chief who signed off on the Diamond Princess evacuation. Later, he would push to replace Food and Drug Administration Commissioner Stephen Hahn when the agency chief refused to expedite vaccine approvals before the election and deferred to career FDA officials instead.
Both men would stay on for the duration of Trump’s presidency, along with Anthony S. Fauci – the longtime infectious-disease expert who became a top target of Trump and his allies but whose public popularity helped insulate him. Rather than fire Fauci, White House officials increasingly tuned out the advice from him and other top health officials, the book says, with Trump instead leaning on Kushner, an array of economic advisers and other trusted allies who lacked infectious-disease expertise.
Trump’s top deputies adopted a similar strategy of issuing threats or isolating their rivals, undermining efforts to manage the outbreak, Abutaleb and Paletta write.
Kadlec, who had overseen the purchase of 600 million masks, took the plan in late March to Kushner – who exploded in anger, throwing his pen against the wall in frustration when he learned the masks would not arrive until June.
“You f—ing moron,” Kushner reportedly said. “We’ll all be dead by June.”
Mark Meadows, whom Trump abruptly installed as White House chief of staff with little warning to Mulvaney, also berated Kadlec as the federal government struggled to distribute a new antiviral treatment called remdesivir, whose use the FDA had just authorized.
“I’m going to fire your a– if you can’t fix this!” Meadows reportedly yelled at Kadlec in a surprise phone call as the remdesivir rollout sputtered when scarce supplies were wrongly delivered to hospitals without eligible patients or appropriate refrigeration and the White House’s hopes for positive headlines slipped away.
“That was what the response had turned into: a toxic environment in which no matter where you turned, someone was ready to rip your head off or threatening to fire you,” Abutaleb and Paletta write.
“Nightmare Scenario” also captures the tensions as then-Vice President Mike Pence was installed as the new head of the coronavirus task force at the end of February 2020, replacing Azar. In subsequent days, Pence and his chief of staff, Marc Short, focused on the political and economic implications of the coronavirus response and approached many public health decisions by considering how they would be perceived.
For instance, Short complained that Trump was overreacting by listening to public health experts and opting to extend an economic pause through Easter 2020, characterizing the move as a gift to Democratic governors, the authors write. Short also pushed back against an HHS effort to send free masks to every American household in the response’s early days, a step that some public health experts think would have depoliticized mask-wearing but which Short believed would unnecessarily alarm people. Several senior officials also compared masks to “underwear on your face,” with one remarking that they looked like a “training bra.”
The book details smaller episodes that reveal the personalities at the heart of the Trump administration’s response that would play out in sometimes dysfunctional ways, including in the White House’s February 2020 announcement that “Ambassador Debbie Birx [would] serve as the White House Coronavirus Response Coordinator.” But Birx, a longtime infectious-disease expert, actually goes by “Debbi” – a point that Birx, a former military officer who was “ever respectful of the chain of command,” never sought to correct, even as the mistake was repeated. Birx would subsequently be pilloried for failing to correct Trump’s frequent misstatements, including an episode where she sat by as Trump riffed about injecting bleach to fight the virus – a comment that was tied to a subsequent reported spike in calls to emergency poison lines.
As Fauci’s popularity rose and public trust in other administration doctors plummeted, allies of Birx and CDC Director Robert Redfield chafed that Fauci was not being punished by the public for his own missteps, including advising Americans early in the outbreak that they did not need to wear masks before reversing course several weeks later.
The authors also look back for lessons that could inform the government’s response to future crises.
“One of the biggest flaws in the Trump administration’s response is that no one was in charge of the response,” Abutaleb and Paletta write. “Was it Birx, the task force coordinator? Was it Pence, head of the task force? Was it Trump, the boss? Was it Kushner, running the shadow task force until he wasn’t? Was it Marc Short or Mark Meadows, often at odds, rarely in sync?”
“Ultimately, there was no accountability, and the response was rudderless,” they conclude.