US President Donald Trump holds up a paper displaying a news story about ventilators during the daily briefing on the novel coronavirus, in April 2020. -- first opinion coverage from STAT
President Trump displaying a news story about ventilators during a briefing on the novel coronavirus in April 2020.MANDEL NGAN/AFP via Getty Images

“We did a phenomenal job with the pandemic,” former President Donald Trump claimed during his recent debate with Vice President Kamala Harris.

As the former director of the Biomedical Advanced Research and Development Authority (BARDA), I know just how absurd that statement is.

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I witnessed firsthand the Trump administration’s mishandling of the pandemic. In early 2020, I repeatedly warned about critical shortages in medical supplies and the need for a coordinated national response. For raising these concerns and opposing the promotion of unproven, potentially dangerous treatments like hydroxychloroquine — which later studies showed was not only ineffective, but may also have contributed to unnecessary deaths — I faced retaliation and was ultimately removed from my position. My experience underscores the administration’s pattern of sidelining scientific expertise in favor of political opportunism and disinformation, an approach that not only had devastating consequences for the American people but also severely eroded public trust in science and public health institutions.

Yet Trump has attempted to recast his administration’s handling of the Covid-19 pandemic as a success story. A closer examination of the facts, however, reveals a pattern of failures and denials that led to delayed actions, misinformation, and missed opportunities that cost American lives. Trump’s revisionist statements not only distort reality but also present a clear danger should he return to office.

“We did a phenomenal job with the pandemic,” Trump claimed. Yet, by the time he left office in January 2021, more than 400,000 Americans had died from Covid-19, a death toll higher than any other country at that time.  The United States, despite its wealth and advanced health care infrastructure, experienced one of the highest per capita death rates among developed nations.

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This wasn’t inevitable. Early, decisive action could have significantly mitigated the impact of the virus. A Columbia University study estimated that if the U.S. had implemented comprehensive early response strategies just one week earlier in March 2020, approximately 36,000 lives could have been saved. Instead of heeding expert warnings and preparing robust public health measures, Trump downplayed the threat for months.

Trump’s administration failed to deliver a coordinated national strategy, particularly in testing, that allowed the virus to spread undetected for weeks. In January 2020, the World Health Organization developed a coronavirus test and offered it to countries worldwide. Trump’s HHS refused to allow importation, opted to create its own test, and blocked others in the U.S. from making one. This decision proved disastrous when the CDC-developed tests were found to be flawed, causing a significant delay in testing capabilities. Perhaps that was not Trump’s personal decision, but it was his HHS that allowed it to happen.

By early March 2020, when South Korea was conducting more than 15,000 tests per day, the U.S. had performed fewer than 10,000 tests in total. This testing shortage persisted for months. Again, it may not have been Trump’s fault initially, but he failed to practice the kind of leadership that might have changed the situation. He even denied reality,  infamously stating on March 6, 2020, “Anybody that wants a test can get a test,” despite widespread reports of testing unavailability. The lack of adequate and rapid testing made it impossible to implement effective contact tracing and targeted isolation measures, allowing the virus to spread unchecked.

Trump’s claim at the debate with Harris that “We made ventilators for the entire world” is not something he should be bragging about. While U.S. hospitals faced critical shortages, thousands of ventilators were exported from January to March 2020. States competed for scarce resources as government reports revealed widespread price gouging and egregious contracting failures. In March 2020, hospitals reported having to reuse N95 masks designed for single use, and some resorted to using swim goggles and garbage bags as makeshift PPE. This systemic failure put health care workers and patients at unnecessary risk, and over 3,200 health care workers died from Covid-19 in the first year of the pandemic. The subsequent burnout has left the country with dangerous physician and nursing shortages.

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The situation in nursing homes was equally dire. Despite early evidence that the elderly were particularly vulnerable to Covid-19, the Trump administration failed to prioritize protection for nursing home residents. In September 2020, Time magazine reported, “so far, the Trump Administration has talked a big talk [on supporting nursing homes]—and mostly failed to deliver.” By December 2020, more than 100,000 residents and workers had died in long-term care facilities, accounting for about 40% of all U.S. coronavirus deaths at that time. The administration’s delayed response in providing testing and PPE to these facilities contributed to this high death toll. In fact, the Trump administration didn’t make testing in nursing homes a requirement until August 2020, months into the pandemic. This delay in action left many of the most vulnerable Americans exposed to the virus in settings where it could spread rapidly.

Operation Warp Speed, initiated under Trump’s administration, did achieve the rapid development of Covid-19 vaccines, a notable success. However, the vaccine rollout was chaotic, and its effectiveness was severely undermined by Trump’s own actions. Despite promises of 40 million doses by the end of December 2020, fewer than 32 million doses had been delivered by mid-January 2021, with less than half administered. Trump officials repeatedly overpromised on dose availability, and mixed messaging about a nonexistent vaccine reserve left states unprepared and confused.

More critically, Trump’s persistent spread of disinformation about Covid-19 and his politicization of public health measures eroded public trust in the vaccines. His messaging was inconsistent: He downplayed the need for vaccines and suggested they might be unsafe. Instead of releasing an image of himself getting vaccinated, as President Obama did with H1N1 in 2009, Trump received his Covid shot “quietly,” as the New York Times reported, and “never publicly encouraged people to take it while he was in office.”

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All of this contributed to vaccine hesitancy among his supporters. A study found that counties that voted heavily for Trump had lower vaccination rates and higher Covid-19 death rates. Thus, while Operation Warp Speed succeeded in developing vaccines quickly, Trump’s rhetoric significantly hampered the crucial task of getting those vaccines into arms.

Perhaps the most dangerous aspect of Trump’s pandemic response was his role in spreading misinformation. A Cornell University study identified Trump as the single largest driver of Covid-19 misinformation during the pandemic. His promotion of hydroxychloroquine as a “game changer” led many to misuse the drug, despite the lack of scientific evidence, and appears to have led to unnecessary deaths.

As we approach another election, it’s crucial to remember these facts. Trump’s attempts to rewrite the history of his administration’s Covid-19 response must be met with rigorous scrutiny. His leadership failures — marked by denials, disorganization, and misinformation — had deadly consequences. Far from delivering a “phenomenal” response, Trump’s actions and inactions contributed to one of the worst public health disasters in American history.

Allowing this revisionist narrative to go unchallenged not only dishonors the memory of the hundreds of thousands of Americans who died but also poses a direct threat to the nation’s future.

Rick Bright is the chief executive of Bright Global Health, a global strategic advisory organization that focuses on improving responses to public health emergencies.