Paper 1 -10 Pages
Paper 2- Write a five page reflection paper. discussing the purpose of the article, the problem it is addressing, its findings and recommendations, its contributions to our understanding of public sector governance, and what you think is critical about that piece for our collective understanding of improving public health initiatives.
This project is intended to allow for a maximum of independent thinking. The purpose of this project is to select (choose) an organization and conduct an analysis of the operation from the perspective of how an operations manager would approach the analysis. If a firm is growing or declining, you might examine the reasons why.
Can choose any organization, public or private, production or service industry, to study. The only restriction is that the chosen organization is relatively small and fairly “local”. No global giants are allowed, no automakers, no Amazon, Google, Apple, etc. They are just too big and complex.
1. Length: No more than 10 typed, double-spaced pages with references and citations.
1. Organization selected can be a public sector or a private sector organization.
2. To remind : organization selected should be a small to midsized firm, department or organization, which is geographically contained and local so it can be analyzed more easily.
American Review of Public Administration 2020, Vol. 50(6-7) 614 –620
© The Author(s) 2020 Article reuse guidelines:
sagepub.com/journals-permissions DOI: 10.1177/0275074020941734
Bureaucratic Failures from a Comparative Lens
Starting in November 2019, a novel coronavirus began spreading in Wuhan, China (World Health Organization [WHO], 2020). The virus causes a deadly respiratory disease that has been termed COVID-19. During the first months of 2020, the virus moved across the globe. The spread of the virus led the WHO to label the outbreak as a pandemic (WHO, 2020). As of April 2020, the virus has infected mil- lions worldwide, including close to a million individuals in the United States (“Coronavirus in the United States,” 2020), causing a public health threat that the world has not dealt with since the 1918 flu pandemic. Nations have struggled to respond to the crisis. Some nations, like Italy, the United States, and the United Kingdom, initially were slow to respond to the threat, which has led to outbreaks in these countries. Others, such as New Zealand and South Korea, were quick to respond through expert-based practices, such as widespread testing for the virus and community surveil- lance. The pandemic has highlighted the need for public administration to incorporate public health into our scholar- ship and practice, the importance of leadership from profes- sional bureaucracy that follows evidence-based policies, and the danger of political leadership that is not equipped to deal with such a crisis and/or actively tries to mislead the public.
In addition, the pandemic highlights how tension between a country’s leader and the bureaucracy can harm that nation’s response to the crisis. This commentary addresses how mis- leading communications by a nation’s leader can have
disastrous effects on the bureaucracy’s response to a health crisis. During valuable weeks that could have been dedicated to fighting the outbreak in the United States, President Trump denied the danger of the virus and misled the public about the problem, the policies and procedures surrounding the prob- lem, and the politics needed to solve the problem. This lack of transparency in communication from the nation’s highest office restricted the ability of the bureaucracy at all levels— federal, state, and local—to respond to the crisis. The failures of the United States in addressing the pandemic are not fail- ures of bureaucracy but rather failures of communication by President Trump.
Building on my earlier research on how President Trump communicates health-related issues, this commentary exam- ines his communication during the early months of the pan- demic. Since 2016, I have researched how President Trump communicates issues of public health. This research has pro- duced two main studies. In an editorial for the American Journal of Public Health (2018), a coauthor and I reported an analysis of how the major candidates, Donald Trump and Hillary Clinton, talked about public health during the 2016
941734ARPXXX10.1177/0275074020941734The American Review of Public AdministrationHatcher research-article2020
1Augusta University, GA, USA
Corresponding Author: William Hatcher, Augusta University, Augusta, GA 30912, USA. Email: [email protected]
A Failure of Political Communication Not a Failure of Bureaucracy: The Danger of Presidential Misinformation During the COVID-19 Pandemic
Abstract President Trump’s communications during the novel coronavirus (COVID-19) pandemic violate principles of public health, such as practicing transparency and deferring to medical experts. Moreover, the president’s communications are dangerous and misleading, and his lack of leadership during the crisis limits the nation’s response to the problem, increases political polarization around public health issues of social distancing, and spreads incorrect information about health-related policies and medical procedures. To correct the dangerous path that the nation is on, the administration needs to adopt a more expert-centered approach to the crisis, and President Trump needs to practice compassion, empathy, and transparency in his communications.
Keywords COVID-19, public health, President Trump
presidential campaign. From this analysis, we found that both candidates dedicate little communication space to pub- lic health, but when Trump did discuss health-related issues, he often misled his audiences. Recently, in a research article in the Journal of Public Health (2019), I analyzed the health- related communication in The Washington Post’s database of over 10,000 misleading statements by President Trump. The analysis found that Trump has problems factually discussing health care policies, politics, and procedures.
This practice of misinformation has continued, and even increased in intensity, throughout the COVID-19 crisis. President Trump has misled the public about the seriousness of the pandemic. He has provided untested medical advice. And he has engaged in petty politics against the nation’s gov- ernors, who are trying to respond to the crisis. These behav- iors have spread throughout the nation’s federal system, leading to some governors mimicking the misleading com- munications of the president.
Politics affects how individuals view public health prob- lems, how problems are discussed, and what solutions are developed to advance public health (Oliver, 2006). Transparency in communication is a key principle of public health, especially during a crisis like the COVID-19 pan- demic (O’Malley et al., 2009), and the communications used by political leaders can have widespread effects on the health of a nation by affecting the health-related behavior of indi- viduals and decisions of policy makers. In addition, clear communication from political elites regarding health-related issues will affect the implementation efficacy of the bureau- cracy (Thompson, 2013). Thus, how leaders talk about pub- lic health issues matter, and communication is a powerful tool in public health. When the tool is misused or even abused, then public health efforts become faultier.
The case of the United States emphasizes just how dan- gerous it is to have political leaders who do not recognize the importance of the crisis, fail to follow expert-based advice, and, at times, actively misled the public. Even with a robust public health bureaucracy, with agencies like the Centers for Disease Control and Prevention, the leadership of President Trump has made the problem more pronounced, and, most worrisomely, he has actively misled the public, breaking one of the cornerstones of effective public health, the need for transparency and truth, when responding to a health crisis.
In this commentary, I apply my earlier research on public health communication to the COVID-19 crisis. I do this by discussing how President Trump has communicated the pan- demic and by identifying some of the public health problems caused by this failure of leadership. Running throughout this commentary is a focus on how the bureaucracy has not failed us during this pandemic. Rather, our political leadership has failed us, and after the immediate crisis, public administra- tion needs to explore institutional reforms that focus on more bureaucracy and less democracy (Meier, 1997) in public health while emphasizing the importance of transparency, compassion, empathy, and evidence.
President Trump’s Communications During the Pandemic
Political elites affect public health through the language that they use in their communications of health-related issues (Hatcher, 2019; Lezine & Reed, 2007; Zaller, 1992). The communications of political elites can diffuse throughout the political system because other elites and their supporters adopt similar language in describing policy problems (Mooney, 2001). In the United States, the current Republican Party closely follows and mimics the communication used by President Trump, even at times when his ideological posi- tions are not in line with conservative views (Barber & Pope, 2019). Alarmingly, supporters, who have a “feeling of one- ness” or psychology fusion with the ideas of President Trump, are more likely to be willing to abuse the rights of Muslims, challenge election results, and hold negative views of immigration (Kunst et al., 2019). In addition, social pres- sures and networks affect political behavior and mobilization (Bond et al., 2012). The spreading of misleading informa- tion, through inciting social pressures, hampers public health campaigns. Public health campaigns are not able to break through the misinformation to promote evidence-based behaviors, removing the efficacy of social pressure efforts. Research shows that social pressure is one of the most impor- tant tools available to public health experts in improving health-related features of communities (Christakis & Fowler, 2008). Thus, when political elites, especially the president, actively seek to mislead the public, this harms the work of public health experts.
Before the pandemic, President Trump did not discuss public health matters in great detail, and when he did, the president often misinformed the public. During the 2016 presidential campaign, the then candidate Trump dedicated only a small amount of his campaign speeches, campaign advertisements, and interviews to issues of public health (Hatcher & Vick, 2018). Trump, and for that matter Hillary Clinton, did not discuss major public health topics, such as wellness and diet, disease prevention, substance abuse, workplace standards, and vaccinations. After become presi- dent, Trump still dedicated only small amounts of his com- munications to public health matters, focusing mostly on discussions surrounding the Republican Party’s efforts to repeal the Affordable Care Act (Hatcher, 2019).
According to The Washington Post, from his inauguration on January 20, 2017 to April 27, 2019, President Trump made 10,000 misleading statements (Hatcher, 2019). Of these statements, only 6.6% (662 statements) dealt with health-related issues. From my analysis of these statements, I identified seven main types: misleading statements about the stability and cost of Obamacare, misleading statements about Obamacare repeal, misleading statements about veter- an’s health care, misleading statements about health care coverage for preexisting conditions, misleading statements about Medicare-for-All, misleading statements about
616 American Review of Public Administration 50(6-7)
prescription drugs, and misleading statements about abortion (Hatcher, 2019).
While the number of misleading health-related statements were small, compared with Trump’s overall misleading state- ments, the president did make some striking and at times dangerous comments about health-related matters. He mis- led the public about the cost of insurance under Obamacare, stating that the law was “in a death spiral” (Hatcher, 2019). Such statements may have discouraged individuals for seek- ing health insurance due to a perception that it was not affordable for them. Even more striking is how Trump dis- cussed abortion. In a series of statements, he referred to par- tial birth abortion, stating “The Governor [of Virginia] stated that he would even allow a newborn baby, wrap the baby up, make the baby comfortable, to be executed after birth” (Hatcher, 2019, p. 4). Trump also made incorrect statements about other procedures and drugs. Such statements may dis- courage patients from following the advice of experts (i.e., their doctors) and harming their health.
Since the onset of the current crisis, the president’s mis- leading health statements have increased. Those statements can be organized into three areas, which follow Kingdon’s streams theory of agenda-setting (Kingdon, 2010). First, communications that focus on the problem. These include the reluctance to acknowledge the pandemic during the early weeks of 2020, in particular the months of January and February where early action could have improved the nation’s public health response. Second, communications that focus on policy and procedures, such as misleading the public about the efficacy of anti-malaria medication. Finally, communications that focus on politics, such as making petty statements about the governors who disagree with him and trying to shift blame to former President Obama and other political opponents who are not responsible for the adminis- tration’s poor response to the COVID-19 crisis (Yamey & Gonsalves, 2020). Table 1 presents examples for each of these three areas and the possible negative effects that these
communications may have on public health. In the following paragraphs, I discuss how Trump has communicated the problem of the pandemic, the politics of the crisis, and the policies and medical procedures surrounding COVID-19.
During the early weeks of 2020, when a more effective response could have been mustered by the United States, Trump repeated downplayed the seriousness of the pan- demic, even making statements referring to the problem as one that is “going to disappearing” and calling the media’s attempt to educate the public about the problem as a “demo- cratic hoax” (Goldberg, 2020). He constantly confused the public by referring to the problem as being less of a threat than seasonal flu (Goldberg, 2020). As late as March 9, Trump was downplaying COVID-19 by comparing it with the deaths caused by the flu, or as he tweeted, “So last year 37,000 Americans died from the common Flu. It averages between 27,000 and 70,000 per year. Nothing is shut down, life & the economy go on” (Goldberg, 2020).
Trump’s communications spread throughout the U.S. political system, leading to host and guest on Fox News and other media outlets friendly to the president repeating the president’s false claims. In addition, the downplaying of the problem was also mimicked by Republican governors, lead- ing to slow responses in key states and making it more diffi- cult for the decentralized U.S. political system to respond to the crisis. The muddling of the water over the nature of the problem has led to COVID-19 being a political issue, and to some actors in our political system, viewing the problem as a hoax. This has complicated the efforts of public health offi- cials and experts in building scientific models trying to pre- dict the spread of the virus because their work is being characterized as being a “hoax” (Wan & Blake, 2020).
His communications on the problem has harmed public health efforts by making it difficult for public leaders, health
Table 1. President Trump’s Misleading Statements About the Pandemic.
Categories Types of statements Possible negative health effects
Problem The problem “is going to disappear” The problem is a “Democratic hoax” False comparisons of coronavirus with the flu
Led to the political system to be slow to respond to the problem
Increased politization in U.S. politics Made it less likely that people will follow public health
guidance of social distancing Politics Rewarding “loyal” governors and calling other
governors, “complainers” Speaking out against governors in a petty manner,
such as calling Governor Inslee a “snake” Inappropriately describing the role of the federal
Caused division in the U.S. federal system Made it difficult for governors to address the crisis Made it difficult for a nationwide response to the crisis
Policy and procedures
Being unclear about the efficacy of tested public health guidelines, such as stay-at-home orders and social distancing
Promoting untested drugs and medical procedures
Made it difficult for public health officials and the bureaucracy to promote effective public health behaviors for individuals
Encouraged individuals to engage in unhealthy behavior
officials, and the media to educate the public. The communi- cation is influencing the public’s behavior, making it likely that some will not follow public health guidance, in particu- lar social distancing and staying at home, because their favorite politician, President Trump, was telling them that the problem is not that dangerous.
The politization of the American political system can also help explain the action of political elites toward the pan- demic. In late March, the few states that were the holdouts on issuing stay-at-home orders were led by governors who are strong supporters of the president, in particular DeSantis in Florida, Kemp in Georgia, and McMaster in South Carolina. The South, a bastion of support for Trump, was the region that was the slowest to address the problem, leading to, as of early April, spreading of the virus in the region and many of the emerging hotspots of COVID-19.
The politics of Trump’s communications regarding the pandemic also produced divisions in our federal system. Some of Trump’s statements were simply petty, such as his statement calling Jay Inslee, Democratic governor of Washington, “a snake” (Choi, 2020). Trump also told staff and Vice President Pence to not provide assistance to the governor of Michigan by saying “Don’t call the woman in Michigan” (Rupar, 2020). And he has consistently told gov- ernors that they need to be appreciative of his help, that the federal government is a “backup,” and that they are over- playing the need for testing, personal protective equipments (PPEs), and ventilators. At times, Trump described the gov- ernors as “complainers” (Yglesias, 2020). And toward the end of April, small groups of protestors started defying stay- at-home orders, leading to Trump tweeting that the Democratic governors of states with distancing requirements should be “liberated.”
Instead of using his communications to lead the nation’s response, which is needed in our decentralized system of 50 states and more than 90,000 local governments, Trump caused division, which makes it more difficult for the admin- istrative state—federal, state, and local—to respond to the crisis. In addition, his communications about the crisis has contributed to the nation’s toxic political discourse and has influenced politicians, in particular governors in southern states, to rally around Trump by supporting policies that may be dangerous to public health, such as lifting stay-at-home orders early.
Policies and Procedures
Throughout the crisis, Trump has misled the public about the efficacy of policies, such as the efficacy of social distancing, and he has spread confusion by not supporting the Centers for Disease Control’s guidance about wearing cloth masks in public and by advocating for untested medical procedures
and medicines. The president has stated that he will not be wearing a mask, weakening the work of public health offi- cials by not demonstrating the importance of the guidance and possibly making it less likely that some citizens will fol- low the expert-based prescription.
Perhaps most concerning, Trump has pushed untested drugs and other procedures, in particular an anti-malaria drug, hydroxychloroquine (Grady et al., 2020). Early studies show that the drugs are not effective treatments and have a host of negative side effects, including the possibility of seri- ous heart problems (Hopkins, 2020). When promoting these questionable medications and advocating against evidence- based policies for public health, Trump has claimed, “I’m not a doctor . . . But I have common sense” (Samuels, 2020). This type of language has influenced behavior causing peo- ple to engage in possible dangerous health-related behaviors and downplay the need for expert advice. Common sense is not effective for medical and public health practice.
Trump’s promotion of the anti-malaria drug and other questionable medical practices has spread throughout the federal bureaucracy. In late April, the head of the office responsible for vaccination development, Dr. Rick Bright, was reassigned to another position because he spoke against the advocacy of untested drugs (Shear & Haberman, 2020). This is an example of how Trump’s communications are hav- ing direct adverse effects on the bureaucracy’s ability to respond to the crisis.
In addition, Trump misled the public about how his administration is responding to the crisis. In a press confer- ence in early March, Trump made a list of policy promises, such as providing a website to find testing locations, imple- menting contact tracing, and ensuring widespread testing that would help fight the pandemic, but according to National Public Radio, a month after this press conference, none of the policies have been put in place (Mak et al., 2020). By making unfulfilled promises, Trump is giving the public a false sense of safety during the crisis, and when it is shown that the promises have not been implemented, the bureau- cracy is often blamed, when in fact the failure was with polit- ical leadership from the president.
During Trump’s briefing on April 23, he made the danger- ous, and honestly bizarre, observation that the virus may be treated by injecting disinfectant into individuals, leading to companies such as Lysol putting out public statements on how individuals should not ingest their products (Chiu et al., 2020). President Trump’s comments about disinfectant shows how his attempts to provide medical advice to the public is dangerous and not effective communication during the crisis, and that such statements, as stressed, may cause the president’s supporters to engage in unhealthy behaviors. President Trump’s communications about public health poli- cies along with medical procedures and medications are making it difficult for political elites, health officials, and individuals to respond to the crisis. The communications are leading to untested drugs being promoted, individuals not
618 American Review of Public Administration 50(6-7)
following the advice of medical experts, and political elites not following the guidelines of public health experts.
The Effect of Trump’s Communications on Public Health. My argument in this commentary mirrors an editorial published on April 24, 2020, in the British Medical Journal (Yamey & Gonsalves, 2020). The authors argue that Trump’s denial of the problem and his efforts to shift blame away from him is making his leadership a “political determinant” that is adversely affecting the nation’s response to the crisis. From my review of his communications during the crisis, I cer- tainly agree with this argument. The president’s behavior and communication most likely influence the behavior of citizens regarding how to act during this health crisis. As noted earlier, toward the end of April 2020, Trump encour- aged protestors in Michigan, Minnesota, and Virginia to disregard social distancing and stay-at-home guidelines and many from his government to “liberate” their state gov- ernments. Days after the president tweeted for these gov- ernments to be liberated, Republican governors in Georgia, South Carolina, and Tennessee moved to relax their execu- tive orders regarding the pandemic. The rhetoric of the president and his supporters is most likely affecting the behavior of individuals and causing them to make decisions that adversely affect their health and the health of their communities. The lack of transparency and the failures of political leadership have made it difficult for the bureau- cracy to address the problem. The communication failures of the Trump administration have caused the following main problems that have weakened the public health bureaucracy’s response to the pandemic.
First, the month of February 2020 was a time that action could have been taken to prepare the nation for the coming pandemic, but Trump did not encourage action during this time. In fact, he discouraged action by downplaying the threat. In addition, he did not use this time to prepare the nation and start stockpiling needed supplies.
Second, when action was taken in March 2020 and into April 2020, Trump did not have a standard message that is important in addressing a public health matter. A standard message will encourage needed human behavior to abate the spread of a virus and address public health challenges. This lack of a standard message trickled down through the U.S. political system, leading to some governors and mayors being proactive, whereas others are resistant to action.
Third, the failure of communication to provide nation- wide guidance on addressing the problem caused governors in the Northeast, West, and Midwest to form pacts, in effect sidestepping the federal government, to develop their guid- ance on dealing with the pandemic and reopening their econ- omies. This is causing a reworking of American federalism during this crisis. Perhaps, the most devastating failure of communication is in how the Trump administration talks about the role of the federal government in this crisis and how that communication influences action, such as the
administration’s lack of stockpiling and producing needed equipment for medical practitioners. Some of Trump’s com- munications toward the governors have been the most dan- gerous by failing to provide a nationwide guidance. Trump goes from saying he has “total authority” to open the econ- omy to that decision is completely up to the governors. We need another way forward.
The way forward: Be transparent, follow the experts, and prac- tice compassion. The nation’s response to the crisis high- lights the importance of federalism with states, as mentioned, forming agreements to work together to fight the pandemic, whereas other states have stepped back from action and made moves to open their economies. Whereas President Trump’s communications have harmed the ability of the bureaucracy to address the pandemic, a number of gover- nors have risen to the crisis and led effective responses in their states. These governors have followed key public health principles, including practicing transparency, relying on experts, and showing compassion in their public state- ments. O’Malley et al. (2009) argued how there will often be a disconnect between the rhetoric and action regarding the transparency of political elites during public health cri- ses. To deal with disconnects, the authors call for codifying transparency with model public health policies on sharing information. But these authors most likely did not envision the current situation where a president has so openly misled the public about the pandemic. Going forward, requiring more transparency in decision-making in areas of public health may be a situation at the state and local level in the United States, but not a solution at the nation level, espe- cially with President Trump. However, at least, the Trump Administration and state governors can be transparent in following public health principles that have been advocated for addressing infectious diseases, including HIV, which are routine testing for the disease, monitoring of those suffering from the disease, and providing support to patients (Frieden et al., 2005).
When confronting a public health crisis, Kahn (2020) argues that leaders can follow two models. First, leaders can follow the politician prominence model, what Kahn labels as the Giuliani model after his response to 9/11 as mayor of New York City. In this model, the leader is not only the cen- ter of decision-making but also the media focus during the crisis. Currently, it can be argued that President Trump is fol- lowing this approach. Second, leaders can follow the expert appointee prominence model, where decision-making and media efforts are delegated to the experts. Going forward, given the issues of COVID-19 communication by Trump, the president needs to move away from the politician promi- nence model and toward the expert appointee prominence model to improve the efficacy of the federal government’s response.
To correct the dangerous path that the nation is on, the federal government needs to adopt a more expert-centered
approach to the crisis, and Trump needs to practice more compassion, empathy, and transparency. So far, throughout the crisis, President Trump has not acknowledged the suffer- ing of those afflicted with the disease. He has not thanked the health care workers on the front lines. It is shocking how there is little to no empathy in his communications. This is unlike the rhetoric of any modern president during times of crisis.
Sadly, given the president’s track record, it …
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