Trump, Tell Us About Your Flu Shot

It is now likely that more than 56,000 Americans will die of flu this year.

That was the prediction made Friday by the Centers for Disease Control and Prevention. That’s how many died in the 2014-15 flu season, and new infection rates and hospitalization rates — the best predictors of mortality — are now higher than they were at this point that season.

If President Donald Trump can claim credit for the fact that no Americans died in plane crashes in his first year in office, he must also shoulder some blame for this — and the connection to the White House is much easier to draw.

The Trump administration did not choose the leaders of the Federal Aviation Administration or the National Transportation Safety Board who oversaw a decade of declining plane crash deaths, part of a worldwide trend. But Trump’s disastrous choices for public-health leadership did contribute to the deaths that will occur between now and summer.

His first secretary for Health and Human Services, Tom Price, resigned in disgrace in September after it was revealed that he spent $400,000 chartering private jets at taxpayer expense. The president’s choice for CDC director, Dr. Brenda Fitzgerald, resigned in January after reports that she had recently bought stock in a tobacco company. That capped months of recusing herself from various official duties because she owned shares in biotech and health-information companies.

How could that kill Americans? Because public-health leadership matters.

Every American understands why we need a strong Pentagon. Wars must be won, and timidity loses them. The wars the CDC fights against threats like Zika, Ebola, SARS and influenza (bird flu, swine flu and seasonal flu) are the same.

The CDC continues to function, of course, but caretaker directors overseen by a chaotic White House lack the political backing they need to charge up barricades waving a saber. (Most CDC directors do not carry weapons, but those in the Public Health Service, like the current acting director, Anne Schuchat, hold the rank of admiral and wear a naval uniform that comes with a sword.)

Trump admires bold military leadership so much that he surrounds himself with generals who commanded troops in Iraq and Afghanistan, men with nicknames like Mad Dog.

About 4,500 Americans died in Iraq, and about 2,400 in Afghanistan.

American flu deaths are not just far greater. They are also more predictable than ambushes or IEDs. In recent years they have occurred within a regular range, from 12,000 in a mild season to 56,000 in a bad one.

It was screamingly obvious that this season might well be bad. Australia, where the flu peaks in August, just endured a particularly vicious year, and the British papers blared headlines about “Aussie Killer Flu” heading north. Genghis Khan moved with more subtlety.

But the CDC issued no unusual warning and appeared to do less than usual to promote the intervention that matters most: flu shots.

It also missed a public relations opportunity: This is the 100th anniversary of the 1918 Spanish flu, which killed at least 50 million people worldwide, and the 50th anniversary of the 1968 Hong Kong flu, which killed 1 million.

Even though shots are easier to get than ever through pharmacies, schools and workplaces, it is a rare year when 40 percent of Americans have gotten the shots by November.

Worse, those numbers have been slipping. Last November, 2 percent fewer Americans had received flu shots than in November 2016. Coverage among Hispanic adults fell precipitously, by 7.7 percent. The CDC called that “discouraging,” but offered no explanation.

In previous years, the CDC usually held autumn events to encourage flu shots. Led by the director, they could involve detailed discussion of the looming viral threat. Fitzgerald, new to office, did not hold one.

Price’s tenure focused less on public health than on repealing the Affordable Care Act, a mission Trump demanded. “He better get the votes,” Trump told a crowd. “If he doesn’t, I’m going to say, ‘Tom, you’re fired!'”

One day before he actually was fired — or at least forced out — Price spoke at a flu-related event and got his own shot in front of the audience. But by then, he had been under fire for three weeks over his travel, and the room was full of political reporters, who shouted questions as he fled, jacket still in hand.

Flu preparedness never made the front burner — and now flu is here with a vengeance.

Few may remember, but the 2009 swine flu pandemic was one of the first crises of Barack Obama’s presidency. In April, a spike in deaths from a mysterious respiratory illness caused panic in Mexico, closing schools and restaurants. Almost immediately, the same symptoms struck a Queens high school where students had just returned from spring break in Cancun, and the virus was soon ricocheting around New York City.

Two days later, health and Homeland Security officials declared a public health emergency. Three days after that, on his 100th day in office, Obama made a prime-time broadcast from the White House urging Americans to take precautions and asking Congress for $1.5 billion to flight the flu.

By October, a new vaccine was ready in record time, and the president and the first lady got their shots on camera. Ultimately, that flu proved not very lethal, but the country was as ready as it could be.

Trump has an opportunity here. Because he is older than 70 and overweight, he represents the cohort of Americans most in danger right now: the elderly with underlying morbidities.

Has he had the shot? In a 2015 radio interview, he boasted that he had never had one, saying, “I don’t like the idea of injecting bad stuff into your body.” Nonetheless, he appears to have had one this season. He was examined by a White House doctor in January who said his vaccinations, “to include his seasonal influenza, are all up-to-date.” He should now acknowledge getting one and urge all Americans to do so.

Influenza is not the only battleground on which bold public-health leadership could save lives. Smoking killed 480,000 Americans last year. Drug overdoses killed 64,000. Car crashes killed 37,000. Gunshots killed 33,000.

The opportunities for heroism are endless.