[...] many of them [...] had trained at the Centers for Disease Control and Prevention, in Atlanta, in a program known as the Epidemic Intelligence Service. Alumni of the E.I.S. are considered America’s shock troops in combatting disease outbreaks. The program has more than three thousand graduates, and many now work in state and local governments across the country. “It’s kind of like a secret society, but for saving people,” Riedo told me. “If you have a question, or need to understand the local politics somewhere, or need a hand during an outbreak—if you reach out to the E.I.S. network, they’ll drop everything to help.”
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Whereas the C.D.C. protocol encourages politicians to practice restraint, it invites the lead scientific spokesperson to demonstrate his or her advice ostentatiously, and to be a living example of the importance of, say, wearing a mask or getting a shot. When polio inoculations began, in the nineteen-fifties, many people worried that they were unsafe, so New York City’s commissioner of health—who happened to be married to the E.I.S.’s founder—invited reporters to watch schoolchildren getting injections. She also enlisted Elvis to publicly get his shot.
E.I.S. personnel in the field have carried boxes of masks and gloves to distribute to pilots, flight attendants, journalists, and health workers—supplies that may not be needed by the recipients but emphasize how important universal compliance is. When Besser gave briefings during the H1N1 pandemic, he sometimes started by describing how he had recently soaped up his fingers, or pointedly waited until everyone was away from the microphone before taking the stage. At the time, there was almost no chance that Besser and his colleagues were at immediate risk of contracting H1N1. “To maintain trust, you have to be as honest as possible, and make damn sure that everyone walks the walk,” Besser told me. “If we order people to wear masks, then every C.D.C. official must wear a mask in public. If we order hand washing, then we let the cameras see us washing our hands. We’re trying to do something nearly impossible, which is get people to take an outbreak seriously when, for most Americans, they don’t know anyone who’s sick and, if the plan works, they’ll never meet anyone who’s sick.”
Public-health officials say that American culture poses special challenges. Our freedoms to assemble, to speak our minds, to ignore good advice, and to second-guess authority can facilitate the spread of a virus. “We’re not China—we can’t order people to stay inside,” Besser said. “Democracy is a great thing, but it means, for something like covid-19, we have to persuade people to coöperate if we want to save their lives.”
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Constantine told me, “Jeff recognized what he was asking for was impractical. He said if we advised social distancing right away there would be zero acceptance. And so the question was: What can we say today so that people will be ready to hear what we need to say tomorrow?” In e-mails and phone calls, the men began playing a game: What was the most extreme advice they could give that people wouldn’t scoff at? Considering what would likely be happening four days from then, what would they regret not having said?
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By the time Seattle’s schools were formally closed, on March 11th, students and teachers were already abandoning their classrooms. The messaging had worked: parents were voluntarily keeping their kids home. Cell-phone tracking data showed that, in the preceding week, the number of people going to work had dropped by a quarter. Within days, even before Washington’s governor, Jay Inslee, issued official work-from-home orders, almost half of Seattle’s workers were voluntarily staying away from their offices. When bars and restaurants were officially closed, on March 15th, many of them were already empty. Constantine himself had been working from home for a week. He was giving interviews all day, and always underscored to reporters that he was speaking from his bedroom, and that the noises in the background were coming from his children, who were home from school. After he heard that the county’s basketball courts were still being heavily used, he ordered them closed.
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When the coronavirus pandemic started, E.I.S. alumni began working non-stop, with some setting up cots inside their offices. While the virus remained overseas, the C.D.C. led communications, scrupulously following E.I.S. protocols. But soon after the coronavirus landed on American shores the White House took over. E.I.S. officers were dismayed to see the communication principles that the C.D.C. had honed over the years being disregarded, and sometimes turned on their head. A Coronavirus Task Force, led by Vice-President Mike Pence, was formed, excluding everyone from the C.D.C. except its director, Dr. Robert Redfield. “The C.D.C. was ordered into lockdown,” a former senior official at the agency told me. “They can’t speak to the media. These are people who have trained their entire lives for epidemics—the finest public-health army in history—and they’ve been told to shut up!”
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New York’s mayor, Bill de Blasio, has long had a fraught relationship with the city’s Department of Health and Mental Hygiene, which, though technically under his control, seeks to function independently and avoid political fights. “There’s always a bit of a split between the political appointees, whose jobs are to make a mayor look good, and public-health professionals, who sometimes have to make unpopular recommendations,” a former head of the Department of Health told me. “But, with the de Blasio people, that antagonism is ten times worse. They are so much more impossible to work with than other administrations.”
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