Alex Azar is busy, and 4 other things I learned from watching Trump talk about the coronavirus outbreak

With financial markets in full retreat and coronavirus outbreaks intensifying in countries around the world, President Donald Trump took to the White House briefing room podium Wednesday and sought to soothe a nation’s jangled nerves. Amid defending his administration’s response to the disease, he announced a staff shakeup, trashed a few political opponents, and predicted his re-election this fall. Along the way he gave some insight into his thinking about public health, his cabinet’s workload, and who’s to blame for the stock market’s dive. Here are five key takeaways.

1. You can invest in public health on an as-needed basis.

Earlier in the week, the White House asked for $1.25 billion in new spending to combat the coronavirus outbreak. It was a pretty clear acknowledgement that public health resources as they stand are inadequate. But Trump’s view on cutting the budgets of health programs that might help track and respond to disease outbreaks hasn’t changed. When a reporter asked Trump if the coronavirus outbreak had affected his thinking, the president didn’t hesitate to defend the cuts to agencies like the National Institutes of Health and the Centers for Disease Control and Prevention.

“We can get money, and we can increase staff. We know all the people; we know all the good people… Some of the people we cut they haven’t been used for many, many years, and if we ever need them, we can get them very quickly,” Trump said.

Turning to his private-sector experience as a real estate developer, Trump said, “I’m a business person. I don’t like having thousands of people around if you don’t need them. When we need them, we can get them back very quickly.”

The administration has repeatedly sought to cut public health funds. The Centers for Disease Control and Prevention cut back the number of countries in which it was doing epidemiological work from 49 to 10 in in 2018. White House staff that dealt with epidemic response were let go. Some of the cuts the White House proposed have been stopped by Congress, like the averted cut to 2020 funding for regional Ebola treatment centers.

The administration’s budget request for the 2021 budget cycle, released earlier this month, proposes cutting the US contribution to the World Health Organization in half and slashing funds for Department of Health and Human Services disease surveillance and hospital preparedness programs.

2. Secretary of Health and Human Services Alex Azar shouldn’t be in charge of the coronavirus response; Vice President Mike Pence should, because he was terrific in Indiana (and Azar is busy).

In late January, Azar was put in charge of the administration’s coronavirus task force, the group leading the US government’s response to disease known officially as COVID-19. But Trump said Wednesday that Pence, who as governor of Indiana faced criticism for his handling of an HIV outbreak, would be the face of the coronavirus response going forward.

“I think Secretary Azar is doing a fantastic job, but he also has many other things,” Trump said.  “I mean, we’re working on many, many things together. If you look at his schedule of what he’s doing, including drug prices and—I think it’s perhaps the most complicated job that we have in government. And I want him to be able to focus on that.”

Azar has said he will still lead the task force. It isn’t even the only big role that Azar is supposedly playing in managing the government’s response to disease threats. He’s also at the helm of the National Biodefense Strategy, a 2018 plan that deals with bioterrorism, epidemics, and other biological risks, though that plan has faced a rocky implementation.

3. Fears over coronavirus have hurt financial markets, but the Democrats are doing the real damage.

Even as he called for cooperation, Trump insulted his political counterparts. Senate Minority Leader Chuck Schumer, whom Trump once again referred to as Crying Chuck Schumer, and House Speaker Nancy Pelosi, whom Trump said he beats at “everything,” should focus on the country and work with him to combat the coronavirus. Perhaps it’s not surprising, then, that the president decided that the ongoing stock market swoon isn’t so much due to coronavirus fears as it is to fears that a Democrat could be elected to replace him.

“I think the financial markets are very upset when they look at the Democrat candidates standing on that stage making fools out of themselves,” he said. “And they say if we have to have a president like this? And there’s always a possibility, it’s an election. Who knows what happens? I think we’re going to win. I think we’re going to win by a lot. But when they look at the statements made by the people standing behind those podiums, I think that has a huge effect. Yeah.”

Trump acknowledged at the presser that he thinks the coronavirus is also affecting stocks, but appeared much more interested in contrasting himself with the Democrats.

4. Trump low-balled his initial $2.5-billion request to fund the COVID-19 response.

After facing a backlash from Congress, the president seems to have relented and now says he will accept more money to fight the coronavirus outbreak. The administration’s request this week only asked for $1.25 billion in new funding, the remaining dollars would have been repurposed spending, including more than $500 million that had been set aside to counter Ebola.

“You know, my attitude: If Congress wants to give us the money so easy—it wasn’t very easy for the wall, but we got that one done,” Trump said. “If they want to give us the money, we’ll take the money. We’ll just do a good job with it.”

Azar told Congress Wednesday that the initial request was reasonable. “If it doesn’t fund it enough,” Azar reportedly said, “we’ll come back to you and work with you.” Schumer wants an $8.5 billion package, a level more in line with the funding Congress provided for previous epidemics like avian flu and H1N1.

5. A broader outbreak could happen in the United States, possibly, probably.

The Centers for Disease Control and Prevention reported Wednesday that, for the first time, a patient in the United States who tested positive for the coronavirus infection had not travelled to an affected country or been in contact with someone who was sick, meaning the virus could be starting to spread among the general public. Public health departments across the country should be able to start using new tests for the virus shortly, and experts say testing could become much more widespread.

While Trump didn’t rule out that intrusive steps, including quarantining cities as was done in China, might need to be taken in the United States, he largely downplayed the potential for a broader outbreak.

“I don’t think it’s inevitable,” he said. “It probably will. It possibly will. It could be at a very small level, or it could be at a larger level. Whatever happens, we’re totally prepared. We have the best people in the world. You see that from the study. We have the best prepared people, the best people in the world.”