Deborah Birx - Silent Invasion

More than two years ago, I first learned of a viral illness originating in China. Since then, the Covid-19 pandemic has greatly occupied our thoughts, has altered to one degree or another our way of life, and most regrettably, might have even cost the lives of people we cared about deeply. Whatever your experience has been, Im sorry for your loss and the catastrophic loss of life around the world.

Globally, humans have suffered great pandemics before. In some cases, weve learned the lessons from the previous one to reduce the damage in the future and bring about public health reforms. More often though, either we havent learned those lessons, or those lessons faded quickly with time, leaving us vulnerable to the next pandemicbecause as human history tells us, there will always be a next one. Thats the reason why I wrote this book.

In it, I share with you my insights while serving at the highest level of the Trump administrations response to the SARS-CoV-2 virus pandemic, and as a private citizen still working in the background as the Biden administration has overseen our public health efforts. As the White House Coronavirus Task Force Coordinator, it was my responsibility, as the job title says, to coordinate efforts across a broad range of federal agencies to deal with the enormously complex problems this pandemic brought about. This pandemic has presented greater challenges than any other in my lifetime, in your lifetime, and maybe even in all of human history. As society has evolved, as technology and medicine have advanced, weve done wonders. Yet, in the face of what some scientists refer to as organisms at the edge of life, many of us, as well as all of our advances, have been pushed to the edge.

Its tempting when faced with something as complex as a viral pandemic to find comfort in simplicity. By nature and by discipline, I dont do that. Im not tempted to do that here in this book, either, because that reductive approach doesnt reflect reality and will make it too easy to dismiss whats happened these past two years. That approach will not help us learn the lessons we need to, and would allow us to go into the next one as equally unprepared as we were for this one. I cant let that happen.

Pandemics dont lend themselves to simplicity. There are too many interwoven layers: the politics are too intrinsic, the science sometimes seems too difficult to convey, and the cost of mistakes is so high that determining who is accountable is cast in doubt. In short, pandemics are hard to get right, and more than two years into this one, we can safely say that no one got this one rightnot the Trump administration and not the Biden administration. Yet we are not alone in this track record. As you look around the globe, this imperfection has been replicated everywhere during the Covid-19 pandemic. No country has been completely right in its handling, and the few that have come close have only done so with extreme measures that are hard to implement in most places. The reality is that countries everywhere have experienced victories and also defeats against this virus. There have been moments of celebration as well as horror in equal measure as the virus has appeared to retreat and then returned with a whole new extreme of savagery.

This is not a book about Donald Trump alone. It is not a book that portrays the failures that occurred solely through the complexities of his character. In our imagination and our politics, Donald Trump looms large to be sure, but the scale of what occurred in 2020 was far greater than even him. Of course, he is a part of this story, but he is just thata part. There is no one scapegoat for the greater than 950,000 Americans deadas much as we might want there to be. That number is too vast, the damage far too great. To point the finger exclusively at any one group or individual misses the larger point: There is plenty of blame to go around. There have been lots of errors made by many people and institutions that have gotten us to this point. It may make you feel better to think of this as the result of one man, but youll still be infected with another figurative pathogen that will make it more difficult for all of us collectively to see, to understand, to evaluate, and to do better next time.

Conversely, this is also a story with heroes and victories, with people who, through their attempts to save the lives of those around them, ushered in a broader sense of what was possible, of what we need to do differently now and into the future. People quietly doing their own part in their corner of the country, changing their behaviors and caring for their neighbors and families. People who recognized this pandemic for what it was: an opportunity to provide help in all the ways it was neededhelp that continues to reverberate today.

The truth is, this is a story where multiple levels of behavior and decisionsboth good and badcompound one another. Here in 2022, we have seen how this virus has evolved, and our understanding of this pandemics history must evolve as well. As a people, weve made errors and weve made good choices. Our leaders have done the same. We must learn from all of these choices, so that in the future we can make different ones.

I believe that we have to continue to learn from what has worked and what hasnt. I believe that we should appreciate the successes and acknowledge the people and organizations who contributed to them. I also believe that we should hold accountable those groups and individuals who contributed to the problems that plagued the response and ensure corrective actions. Sometimes they exist on both sides of that ledger. In a rush to judgment, its too easy to forget this is frequently the case in all of life. That it is true in this situation, one of such historical significance, demands that we thoroughly examine both right and wrong, good and bad, and all the points in between those extremes.

My purpose isnt simply to condemn or commend, but to recommend. I am most frequently an optimist, sometimes a pessimist, but most consistently Im a data-driven realist and that is the perspective that is most reflected in the pages that follow. We have solutions to the problems this pandemic presents. I have recommendations for how we can be better prepared for the next one. In both cases, we have to break the cycle of dysfunction that has produced so much devastation. If there was one thread that ran through my experiences in the White House and in many of our states, it was that where a spirit of community and cooperation thrived, we achieved the most gains. Where and when this spirit did not exist, we lost the most ground. When minds and hearts worked together, we were better.

We have to do better. We can do better. So much depends on it, as we continue to face this crisis and, I hope, as we plan better for the next one.

Dr. Deborah Birx, February 2022