The politics of COVID-19: Fact and fiction - Part 3 - Who is right, the President or the medical expert(s)?
“I apologize when I’m wrong” - Donald Trump1
In part one, a simple but demanding general model was described - the “Lean Startup”. It requires project managers to engage early in empirical testing of their key assumptions. A primary value is placed on modifying those assumptions as product performance is better understood through empirical analysis of market response. This data-driven dynamic model, identical to that of empirical science, was contrasted with the value-driven typical model of politics, and in part two we saw a perfect case study of this contrast: the developing relationship between President Donald Trump and physician-immunologist Dr. Anthony Fauci, member of the White House Coronavirus Task Force and director of the National Institute of Allergy and Infectious Diseases since 1984.
As Dr. Fauci continues to follow the Lean-Startup/empirical-science model, and Trump diverges to a public-relations “staging” political model, their initial collaboration disintegrates. Below is a continuation of the timeline in part two, from when the US declared a national emergency in March to Fauci’s careful statement in mid-July.
Event timeline - Late January to March 2020
March 24, 2020: President Trump works for the country to open by April 12, to which Fauci responds by suggesting caution and advising a more flexible approach.2
April 12, 2020: Fauci acknowledges that earlier mitigation could have saved lives.5
April 24, 2020: Trump says he doesn’t agree with Fauci.5
May 12, 2020: Dr Fauci testifies against avoidable suffering in relation to the idea of opening of schools. He responds to Trump’s desires to relaunch the economy by stating that the government is attempting to reopen too soon. May 13th, Trump states that Dr Fauci’s response is unacceptable.58
May 25, 2020: The death of George Floyd becomes one too many black men killed while under police restraint. A concern about racism in American society takes center stage as the Black Lives Matter movement galvanizes many people, against the backdrop of the pandemic. The United States is soon witnessing and participating in a national conversation about race not seen since the civil rights movement of the 1960s.9
June 1, 2020: The White House states that the pandemic task force is no longer holding daily meetings, and Fauci confirms that meetings have dramatically decreased.10
June 23, 2020: Fauci warns of disturbing surges of infection, while Trump states that the virus is going away.11
July 7, 2020: Trump says that he disagrees with Fauci’s outlook on the virus.12
July 9, 2020: Fauci states the US is not doing very well in responding to the pandemic, and Trump states that Fauci has made a lot of mistakes.13
July 15, 2020: Dr Fauci acknowledges that the advice he has provided has shifted over time, but he insists that his recommendations have always been based on the latest science.14
The Lean Startup approach, it may be recalled, focuses on information gathering, measured outcomes, and assumption adjustments to determine the next steps to be taken in a product-launch. It requires the management team to learn, and to pivot or abandon their assumptions in order to achieve their goals. In managing our national response to the COVID-19 pandemic, lives depended upon the method used. Fauci continued to focus on data and to learn and to modify his advice. Trump diverged from a focus on the pandemic to a primary concern for US economy. In doing so, he separated himself strikingly from Fauci and the White House Coronavirus Task Force.
The Lean Startup approach is non-emotional, non-discriminatory, and non-political in its design. It removes the egoism and vanity that plagues many projects by focusing on testing assumptions to assess their actual value. Politics by its very nature is egoistic and emotional. For a project to succeed, these two approaches cannot co-exist.
Lean Startup project management relies upon assembling a group of people willing to build trust for each other and to support the project’s goals. It strives to find out what actually works, and not to persist in acting on what is merely assumed will work. As the pandemic launched itself and then rapidly progressed, trust eroded between Trump and Fauci. At a critical time in the process, Trump’s divergence gave clear evidence of this loss of trust.
Lean Startup methods require accountability based upon real-time data analysis and a reallocation of resources, time, and effort driven by what is learned from this analysis. As the US began to bring the virus under control and efforts to flatten the infection rate curve started to show positive results, Trump moved away from the pandemic as a focal problem, pulling necessary resources and attention elsewhere. He separated from Fauci, the World Health Organization (WHO) and the CDC because their narrative did not align with his political strategy. In Trump’s mind, that strategy took precedence over a virus about which there was still a lot to learn.
Trump’s method vs Fauci’s ^
As a successful businessman, it was said during his original election campaign, Trump’s business skills would work to bring greater success to the country. However (and this is a crucial distinction), what he has relied upon was not business acumen but public relations acumen - the same method a realtor uses to “stage” a property in presenting to a prospective buyer.
Communicating a story to a targeted audience to elicit a particular response is the cornerstone of public relations and marketing. This has been Trump’s go-to strategy and Twitter his go-to tool. The problem is that this method did not reconcile facts learned with election strategy. It contrasted with Fauci’s approach, and actually undermined reelection confidence.
Once Trump decided to reopen the country, the White House pandemic management and reelection teams were no longer working in sync. George Floyd’s death and the subsequent national demonstrations gave Trump the public relations target he needed to redirect attention to getting the country back on track by reopening it. He used unrest, riots, looting, and other alleged acts to justify shifting focus from the pandemic to reopening the country.15
His shift in priorities led to clashes between the president and Dr Fauci, and to conflicts with the WHO and the CDC. Dr Fauci has said that the top priority must be controlling the spread of the virus. Trump’s reopening efforts were a setback for this national effort. As a result, more than three thousand health officials publicly defended Dr Fauci’s position.16
Lessons from recent national experience ^
Night after night, from May 25th to today, demonstrations about racism have been launched in the streets of major US cities. Interestingly there is no evidence that these demonstrations exacerbate the pandemic. Why?
Viral spread has failed to occur in any meaningful way because most demonstrators have been compliant with Fauci’s recommendations: they wore masks, used some manner of social distancing, and practiced appropriate personal hygiene. They were also in the open air rather than in confined spaces. Tracing and testing were available and attended to. These standard epidemic management strategies achieved what was promised.17
Under the Lean Startup method, this is all important information. It confirms Fauci’s urgings that the use of reasonable social distancing, masks, testing, and tracing have crucial value. Furthermore, recent evidence supports the assertion that when states reopened earlier than was deemed prudent by medical experts the pandemic was not in fact under control. The virus responded by infecting more people.18
Additionally, where it had been thought that the population under forty years of age were safer than the older population, better data revealed that younger age cohorts also had real risks to manage. Contract tracing found that infection occurred at beaches, in public pools, in crowded bars, and inside restaurants where younger people congregated in large groups and did not use recommended methods to prevent viral spread. All of this was critical information, and none of it supported the narrative Trump insisted upon.19
Fauci’s narrative was, and continues to be, based upon an evolution of learned facts that were acquired through monitoring and measurement. The facts attest to the fundamental superiority of his approach. Trump’s narrative was based upon public relations practices and concepts. Public relations efforts, by design, manipulate emotions. Lean Startup methods eliminate emotions, preferring an evolving, learned response developed over a short period of time.20 Recent national experience has shown which method is superior.
“…The US agency charged with tracking and investigating public health trends. A part of the US Public Health Services (PHS) under the Department of Health and Human Services (HHS), the CDC is based in Atlanta, Georgia. It publishes key health information, including weekly data on all deaths and diseases reported in the US and travelers’ health advisories. The CDC also fields special rapid-response teams to halt epidemic diseases.” Retrieved from https://www.medicinenet.com/script/main/art.asp?articlekey=2655 ^
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