In 2016, the National Security Council published a playbook for early response to high-consequence emerging infectious disease threats. However, the playbook was never adopted by the incoming Trump administration. As a result, key positions in the pandemic response were left unfilled, leaving the White House without experienced personnel in public health.
Step-by-step explanation:
In 2016, the National Security Council (NSC) published Playbook for Early Response to High-Consequence Emerging Infectious Disease Threats and Biological Incidents, a 69-page document on responding to diseases spreading within and outside of the United States. On January 13, 2017, the joint transition teams of outgoing president Barack Obama and then president-elect Donald Trump performed a pandemic preparedness exercise based on the playbook; however, it was never adopted by the incoming administration. A year later, in February 2018, the Trump administration began to cut funding for the Prevention and Public Health Fund at the Centers for Disease Control and Prevention, leaving key positions unfilled. Other individuals who were fired or resigned in 2018 were the homeland security adviser, whose portfolio included global pandemics; the director for medical and biodefense preparedness; and the top official in charge of a pandemic response. None of them were replaced, leaving the White House with no senior person who had experience in public health. Experts voiced concerns, among them Luciana Borio, director of medical and biodefense preparedness at the NSC, who spoke at a symposium marking the centennial of the 1918 influenza pandemic in May 2018: "The threat of pandemic flu is the number one health security concern," she said. "Are we ready to respond? I fear the answer is no".