Operation Warp Speed: The Good, the Bad, and the Deadly

Ihave been a strong supporter of Donald Trump since the first Super Tuesday primary in February 2016, when he trounced the competition in races held in the heart of the ‘Bible Belt.’ Those results convinced me that if any Republican had a prayer (excuse the pun) of winning the White House, he was the only game in town.

One of the key elements of the Trump administration’s response to the Covid pandemic was Operation Warp Speed (OWS). A unique feature of OWS was that it was used, respectively, by Trump’s supporters and detractors to laud or denigrate the initiative, depending almost solely on political party affiliation. This bifurcation even extended to the healthcare establishment, a clear indication that medical science had been eclipsed by political science. In so doing, the physician’s creed, “First, do no harm” was shredded. The impact on patient outcomes, not surprisingly, was devastating.

In an attempt to move the discussion away from political slogans and bumper stickers, and towards a more nuanced assessment, I will examine six major OWS initiatives:

• Ventilators
• Masks 
• Disinfectants
• Hospital Beds for NYC and Los Angeles
• Repurposed Therapeutics: Hydroxychloroquine
• mRNA Vaccine Development, Production, and Distribution

Ventilators

In preparing for airborne pandemics, it had been the consensus for several years that the number of ventilators available would be woefully inadequate. To meet this challenge, Trump pulled every emergency lever at his disposal in order to direct the nation’s manufacturing capabilities towards producing the number of ventilators required. This effort succeeded to the degree that the metrics for ventilator production were quickly exceeded, and a more than sufficient number was produced and distributed. 

Clearly, this was a logistical triumph…but there’s the rub. It was determined early on that almost all patients with Covid-induced respiratory failure who were placed on a ventilator succumbed. You’d think that someone in authority would have made the observation that ventilators caused harm whenever used, and use of this modality would have ceased. Well, if you thought that, you’d be mistaken. Ventilators were used for months after it was clear that they caused harm. So where does responsibility for this debacle reside? Was it with OWS for supplying too many ventilators or with the healthcare providers who, under cover of perverse incentives, continued to use them? 

Masks 

As with ventilators, there was great concern that supplies of masks would be inadequate. Given the fact that more than 100 years of public health policy and practice had demonstrated that mask use outside of healthcare settings was a useless exercise, pulling the trigger on OWS should never have been done. However, when it came to Covid, deliberately fanning the flames of fear overcame sound public health policy, and the trigger was pulled. Sadly, all of the predicted collateral damage that universal masking could cause came to pass (as has been well-documented elsewhere), with none of the purported benefits. An additional adverse consequence that has not been mentioned is to the environment. Between the masks and the plastic straws, I’m surprised there are any sea turtles left! 

Once again, where does responsibility for this debacle reside? Is it with OWS for supplying a huge number of masks or with the public health agencies that continued to push, and, in many cases, mandated a useless modality that could and did cause harm? 

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