In an editorial letter published Thursday, The New England Journal of Medicine lambasted the Trump presidency's handling of the COVID-19 pandemic and called U.S. political leaders' response to the virus "dangerously incompetent."

"This crisis has produced a test of leadership. With no good options to combat a novel pathogen, countries were forced to make hard choices about how to respond," read the letter, which was signed by all the NEJM editors, The New York Times reported.

"Here in the United States, our leaders have failed that test. They have taken a crisis and turned it into a tragedy," the letter continued.

"Reasonable people will certainly disagree about the many political positions taken by candidates. But truth is neither liberal nor conservative," the editors said.

Although the letter did not explicitly endorse former Vice President Joe Biden for president, it noted that this election "gives us the power to render judgment" of current leaders in the federal government.

"We should not abet them and enable the deaths of thousands more Americans by allowing them to keep their jobs," said the editors.

WHY IT MATTERS

This is the first time NEJM has supported or condemned a presidential candidate, noted the Times. But, the Journal said, the magnitude of U.S. leaders' coronavirus failure is "astonishing."

"COVID-19 is an overwhelming challenge, and many factors contribute to its severity. But the one we can control is how we behave. And in the United States we have consistently behaved poorly," wrote the NEJM editors. 

The editors critiqued the federal government's failure to implement effective testing measures and to provide personal protective equipment to healthcare workers. They called social distancing rules in many places "lackadaisical at best" and denounced leadership's politicization of mask wearing. 

And when it comes to vaccine development, they said, the government's rhetoric has "led to growing public distrust."

The NEJM editors noted that states, for all their respective strengths and weaknesses in responding to the virus, do not have the access to tools the federal government has undermined. They pointed to policy failures surrounding the Centers for Disease Control and Prevention, the National Institutes of Health and the Food and Drug Administration, saying that "our current leaders have undercut trust in science and in government, causing damage that will certainly outlast them."

"Instead of relying on expertise, the administration has turned to uninformed 'opinion leaders' and charlatans who obscure the truth and facilitate the promulgation of outright lies," they wrote.

The editors pointed to the disproportionate effect of the pandemic on communities of color, the children missing school at critical developmental periods, the discounted work of healthcare professionals, the wave of job losses, and the 200,000 U.S. deaths as evidence of "the cost of not taking even simple measures."

"Anyone else who recklessly squandered lives and money in this way would be suffering legal consequences," they wrote.

THE LARGER TREND

The Trump administration's handling of COVID-19 patient data has sown confusion among hospitals, with its directive this summer to bypass the CDC and send information directly to the U.S. Department of Health and Human Services sparking reports of "chaos."

And although hospital associations said their members had largely adjusted to the new rules within a month or so, the administration triggered new concerns with its announcement this week that facilities' Medicare and Medicaid reimbursements would be at stake if they were not compliant with reporting directives.

"Tying data reporting to participation in the Medicare program remains an overly heavy-handed approach that could jeopardize access to hospital care for all Americans," said American Hospital Association president and CEO Rick Pollack in a statement about the guidance.

ON THE RECORD

"Some deaths from COVID-19 were unavoidable. But, although it is impossible to project the precise number of additional American lives lost because of weak and inappropriate government policies, it is at least in the tens of thousands in a pandemic that has already killed more Americans than any conflict since World War II," wrote the editors.

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.