AIDS activist turned epidemiologist on Trump’s ‘genocide’ and Deborah Birx’s ‘horrific’ deadly compromise
No matter how much Donald Trump and his agents misrepresent, obfuscate, deny, distort, spin or outright lie about the coronavirus pandemic, a basic truth remains very clear.
Trump and his regime's response to the coronavirus has been worse than negligent. It is willfully malevolent.
More than 100,000 Americans have died from the coronavirus pandemic. At every opportunity Trump has made decisions — or refused to make them — which turned a manageable problem into a national and global tragedy.
Donald Trump shows no empathy for the sick or the dying, or the overall human cost of the coronavirus pandemic. He cares more about being re-elected in November than the health and safety of the American people.
Trump and his family, like other authoritarians, are manifestly corrupt and operate like a political crime syndicate. Trump, his family, political allies and other sycophants have used the pandemic to grow their personal fortunes. Serving the common good has never been their concern. For them, this pandemic is an opportunity for self-interested (and likely illegal) profiteering and other abuses of power.
Donald Trump is using the coronavirus crisis and the deaths of tens of thousands as a weapon to harm and otherwise punish those cities and states he views as "enemies". Why? Because the people who live there are unlikely to vote for him.
While many public voices and others have chosen to cower in fear before Donald Trump and his agents — thereby normalizing his authoritarian threats to democracy and human rights — Gregg Gonsalves, assistant professor in epidemiology (microbial diseases) at Yale and co-director of the university's Global Health Justice Partnership, has instead chosen to speak truth to power.
Several weeks ago, Gonsalves shared a series of questions on Twitter:
How many people will die this summer, before Election Day? What proportion of the deaths will be among African-Americans, Latinos, other people of color? This is getting awfully close to genocide by default. What else do you call mass death by public policy?
And I am being serious here: what is happening in the US is purposeful, considered negligence, omission, failure to act by our leaders. Can they be held responsible under international law?
So, what does it mean to let thousands die by negligence, omission, failure to act, in a legal sense under international law?
In this conversation, Gonsalves explains why he perceives the Trump administration's response to the coronavirus pandemic as an act of massive state-sponsored violence against the American people — especially vulnerable and marginalized communities — and likely as a crime against humanity.
Gonsalves also reflects on the need for a truth and reconciliation commission in the aftermath of the pandemic and Trump's eventual removal from office. He also shares his thoughts on why his longtime colleague Dr. Deborah Birx, who serves as White House coronavirus response coordinator, has seemingly abandoned her commitment to medical ethics by choosing to assist Donald Trump in spreading lies, disinformation and distortions about the coronavirus pandemic.
Finally, Gonsalves explains how he would try to convince Trump supporters and others who refuse to wear masks or maintain appropriate social distancing to change their dangerous behavior during the pandemic.
More than 100,000 Americans have died from the coronavirus. Many more will die. Donald Trump plays golf. He has shown that he does not really care about all this suffering and misery beyond how it impacts his re-election chances in November. In so many ways this has been a preventable national disaster. It did not have to be this way.
Yes, it did not have to be this way. But the scarier part is that it is very easy to say that this crisis is just Donald Trump's fault, as opposed to seeing how it is a function of how American society has organized itself for a long time. Even if Donald Trump were not president, the United States would not have been able to respond to the coronavirus pandemic as well as many other countries did and are.
The coronavirus pandemic, like other health crises, truly reveals what groups and communities the larger society deems valuable or not.
And that is overlaid on America's intersections of race and class. Correlation is not causation, but if one examines a map of slave states, the density of black human property around the time of the Civil War is closely related to life expectancy at present, more than 150 years later. That outcome is a result of how racial inequality is built into the health care system of the United States. White supremacy combined with the legacy of slavery was bound to create the type of crisis we are seeing with the coronavirus pandemic.
As an epidemiologist, how do you make sense of this crisis? What is a defining feature of this moment for you?
At present I am an epidemiologist. I was an AIDS activist for far longer than I have been a doctor. Infectious diseases will always be with us because they are a part of nature. But epidemics are made by human beings, and we sure made a horrible one with the coronavirus pandemic. Yes, the coronavirus came from a bat. The coronavirus jumped to a person somewhere in China and then spread around the world. Our failure to contain the coronavirus is a problem of medicine and epidemiology, but at its root the failure is a political one.
What has the coronavirus pandemic revealed about American society? What truths have been made more clear?
There is a myth of American generosity, can-do-ism and independent-mindedness. We love to think of ourselves as an exceptional country. "Make America Great Again" is the myth that President Trump would like to tell us, that somehow we inherently are a great country, whether that is in the past or not.
But the coronavirus is a type of revelation for many people that America's inherent greatness was indeed a myth. It was a joke. That joke was not funny to the people who suffered for decades and centuries under that myth and many others about America.
The response to the pandemic reveals, again, who is disposable in America.
For example, during the HIV epidemic in the 1980s and 1990s, the disposable people were gay men, people who used drugs, sex workers and communities of color.
Now the country's failure to protect everyone equally from the coronavirus pandemic is rooted in how decisions were made about what types of people are disposable and who is considered "valuable." There are two tiers of health outcomes in the United States. There are also multiple tiers of economic and other opportunities. The pandemic has further revealed the country's inequalities and injustices.
In a normal situation, how should the United States have responded to the coronavirus pandemic?
Other presidents, including Republicans, would have responded using traditional public health care strategies. These are the techniques that other countries such as New Zealand, South Korea, Germany and Denmark successfully applied against the pandemic. The United States' response to the pandemic would also have been much faster and more efficient. There would also have been much faster testing, contact tracing and isolation programs.
The Trump administration and other Republicans on the state level have responded to the coronavirus by lying to the public. This is another example of how truth and reality are under siege by Donald Trump and his authoritarian movement. For example, in Florida and Georgia public health data is reportedly being manipulated to hide the true number of infected and dying. Truth is the heart of science. How can the country defeat the pandemic if basic facts and data are being manipulated?
You keep saying that two plus two equals four. You bear witness. Donald Trump is never going to do the right thing. It is our job to tell the truth. Period. Every time Trump or someone in a position of power lies about the coronavirus pandemic, we must point out the truth.
Every time there's a lie, to say, "No, that's not the truth. This is the truth."
If you are someone who has the capability or the inclination or the luxury of personal safety and you can protest for people who are rotting away in jails and prisons in the United States — which are now factories of COVID-19 — do that too. You do what you can. You can do the right thing with your own body and your own mind and your own voice.
Is that enough to wash away the lies that Donald Trump is propagating after the failed coronavirus public health response that he is presiding over? No. But people should do what they can.
I'm staying at home. I could decide, "Let's go out to eat." No, I'm not going to do it. I'm going to stay at home as long as I can because I know other people don't have the luxury of that choice.
Doctors take an oath "to do no harm." How are you making sense of Dr. Deborah Birx's decision to be an agent for Trump and his administration's lies and propaganda about the coronavirus pandemic?
First, the good. There are many scientists who have spoken out. Scientists almost as a rule do not write op-eds for newspapers and magazines and the like, except when the subject is their very narrow field of research. Scientists are also speaking out on TV and other forums so that the public can learn more about what is really happening with the pandemic. It is very important and good that many scientists realize that what they are doing in the lab or on the computer or in a clinic is not enough in this moment of crisis with the pandemic.
But then there are people who have made different kinds of bargains. It's been interesting to watch Dr. Deborah Birx and Dr. Tony Fauci. I know both of them pretty well.
They have served under many different presidents and see their jobs as insiders where it is important for them to be at the table and included in decision-making at the highest levels.
Over the last few weeks, I have watched Deborah Birx morph into a vehicle for Donald Trump's fabrications. She tries to leaven and qualify his fabrications with statements such as, "Yes, we should all wear masks." But then she says, "I don't believe anything that comes out of the Centers for Disease Control."
I believe that Dr. Fauci has been sidelined a bit by the Trump administration because he is less eager to play along with Trump's fabrications. But Deborah Birx has become much more of an apologist than Fauci has.
Both of them are likely thinking that it is better for them to be in the room than out of the room in terms of Trump and his administration's response to the coronavirus.
There is something strange going on with Deborah Birx. This whole idea that she's angling for the State Department to be put in charge of pandemic preparedness and have that responsibility taken away from the U.S. Agency for International Development looks like a career move.
If that is true, then it is really horrific. Deborah Birx has been playing, weirdly, both sides of the street. I would not have thought that possible several months ago.
In a series of recent much-discussed tweets, you have truly spoken truth to power in your observations about Donald Trump and his administration's response to the coronavirus pandemic as being akin to "genocide." How did you arrive at the decision to use that language?
I saw the AIDS epidemic. I know what it did to my community. It wasn't visible to much of American society. Some people went to funerals every week. Some of us, like me, were at funerals every few months. I saw what happened when the United States government really didn't give a damn about you and could care less if you were dead.
Trump's pandemic response is not the same as Nazi Germany. It is not Rwanda. But Trump's response is something that is well beyond a policy mistake. One hundred thousand people are dead. There are likely to be 150,000 or perhaps even 200,000 dead from the coronavirus pandemic in the United States. The estimates are that two thirds or more of the deaths could have been prevented. A large amount of that death and dying could have been prevented.
Moreover, it was premeditated. There were people in the White House and elsewhere warning Donald Trump, "People are going to die. We need to do something about this." And the White House made a concerted policy decision to let people die. Their response to the coronavirus was death by public policy.
We can parse words about whether that is manslaughter or mass negligence. Part of me, in retrospect, feels like using the word "genocide" made it too easy for some critics to deny the reality of the situation. Perhaps I should have said that the Trump White House's response to the coronavirus was a monumental error and a monumental sin and a monumental human rights violation. What the Trump administration is doing in response to the coronavirus is something we have not seen in the United States in a long time, which is basically wiping out a whole group of people by public policy.
During a recent appearance on CNN, Trump's Health and Human Services Secretary Alex Azar said that "diversity" is making the coronavirus pandemic's impact on the U.S. even worse because of "co-morbidities" among blacks, Latinos and other nonwhite groups. Azar basically said that lazy, fat black people are to blame for the pandemic's great harm to the country. Trump and his administration — most notably people like Stephen Miller — have consistently shown themselves to be white supremacists. How can anyone fail to see the role of racism in how the Trump administration has responded to the pandemic? At this point they are saying the quiet part right out loud.
We did not need COVID to tell us that Donald Trump is a white supremacist. This administration, from the beginning, has been xenophobic and racist and misogynist.
Under Donald Trump, these values are now the policy of the United States government. That Alex Azar would dare say something about "co-morbidities" when Trump and his administration have spent the past three and a half years trying to strip health care from people is just disgusting.
A truth and reconciliation commission may well be needed to begin making a better America after the disaster of the Trump regime and now the pandemic. What questions do you think need to be asked in such hearings about this pandemic?
The commission needs to have subpoena power. Donald Trump, Mike Pence, Jerome Adams, Deborah Birx, Tony Fauci, Alex Azar, Robert Redfield and others will have to testify and tell the country and the world what they knew. Emails and phone conversations will have to be subpoenaed. Mitch McConnell should also testify. Corporations that put their workers in grave danger in meat processing plants, nursing homes and elsewhere must send representatives to testify as well.
For me this is not a question about vengeance but rather about truth and reconciliation. We cannot move on properly as a country after the coronavirus pandemic without some truth-telling. If people testify and continue to lie, then history will be their judge. But I do think we need to give them the chance to tell the truth before the American people.
There are many Trump supporters and others who refuse to wear masks or practice social distancing or do the other things necessary to save lives during the coronavirus pandemic. How would you explain to them the seriousness of this situation? What would you tell them about why they should wear masks and follow other public health guidelines?
I'm not a big believer in shame and anger, so I'd say, "Think of your grandmother. Think of your grandfather. Think of somebody you know who has had breast cancer or who lives with advanced diabetes. Think of a child who might have a blood disorder or leukemia but maybe it's cured. Think about those people and think about what this all means to them.
I don't care what it means to Donald Trump. I don't care what it means to me. I don't care what it means to anybody outside your own family. Think about what wearing a mask means in terms of, if you contract COVID, you're asymptomatic and you bring it home. What does it mean when your decision today has implications for those you care about? Not the people you do not care about — those people in faraway places who you think are telling you what to do. But what it means for your family and your friends and the people you care about."
I'd talk directly about the personal meaning. A lot of information gets trivialized in the United States, whether it's around vaccines or evolution or whatever.
I do not think you approach people who are not wearing masks, refusing to follow social distancing rules or are just in denial by using appeals to science or with political arguments. I believe that we should meet them with very human arguments about what their decisions mean in their own lives.
Maybe they're unwilling to listen, but I just find it hard to believe that somebody faced with the prospect of infecting their elderly mother or grandmother would really be willing to stake a claim on that being the right thing to do for themselves.
Maybe there are in fact people who are so far gone it does not matter to them. People can be convinced to do lots of bad things in the name of politics. We know that from history. But I do believe that people are fundamentally good, and you can try to make a personal challenge to them to do the right thing about their behavior during the pandemic.