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IJPL
18,2 The massive spreads and fatalities
of COVID-19 pandemic in the USA:
symptoms of leadership failure
134 Oluwole Owoye
Social Sciences, School of Arts and Sciences, Western Connecticut State University,
Received 19 August 2021
Revised 12 October 2021
Danbury, Connecticut, USA, and
16 November 2021
Accepted 18 November 2021
Olugbenga A. Onafowora
Economics, Susquehanna University, Selinsgrove, Pennsylvania, USA

Abstract
Purpose – The purpose of this paper is to empirically examine whether the massive spreads and fatalities of
the COVID-19 pandemic in the USA, the country with the most advanced medical technology in the world, are
symptomatic of leadership failure. The authors posit that when political leaders, such as the President of the
USA, in conjunction with a group of state governors and city mayors, employed conspiracy theories and
disinformation to achieve their political goals, they contributed to the massive spreads and fatalities of the
virus, and they also undermined the credibility of the Centers for Disease Control and Prevention (CDC) and the
health-care professionals in providing the pertinent control guidelines and true scientific-based medical
information.
Design/methodology/approach – The authors conducted a review of current studies that address the
handling of global infectious diseases to build a better understanding of the issue of pandemics. They then
employed a theoretical framework to link the massive spreads and fatalities of the COVID-19 pandemic to
political leaders, such as President Trump and the group of obsequious state governors and city mayors, who
propagated conspiracy theories and disinformation through social media platforms to downplay the severity of
the virus. The authors compared the massive spreads and fatalities of the COVID-19 pandemic in the USA
under President Trump to President Obama who handled H1N1, Ebola, Zika and Dengue. More importantly,
the authors compared President Trump’s handling of the COVID-19 pandemic to other political leaders in
advanced countries where there were no concerted efforts to spread conspiracy theories and disinformation
about the health risks of COVID-19 pandemic.
Findings – The authors’ theoretical analysis alluded to the fact that political leaders, such as President Trump,
who are engulfed in self-deceptions, self-projections and self-aggrandizements would engage in self-promotion
and avoid accountability for their missteps in handling global pandemic shocks. In contrast, political leaders in
other advanced countries did not downplay the severity thus their ability to curtail the spreads and fatalities of
the COVID-19 pandemic.
Research limitations/implications – The theoretical viewpoints presented in this paper along with the
derivations of the spreads–fatalities curtailment coefficients and the spread–fatality upsurge coefficients under
Presidents Obama and Trump, respectively, may not be replicable. Given this plausible limitation, future
research may need to provide a deep analysis of the amplifications of conspiracy theories and disinformation
because they are now deeply rooted in the political economy of the USA. Furthermore, since scientists and
medical professionals may not be able to forecast future epidemics or pandemics with pin-point accuracy nor
predict how political leaders would disseminate health risks information associated with different pathogens, it
is imperative that future research addresses the positive or adverse effects of conspiracy theories and
disinformation that are now easily propagated simultaneously through different social media platforms, which
are currently protected under Section 230 of the Communications Decency Act. The multiplier effects of
conspiracy theories and disinformation will continue to amplify the division about the authenticity of COVID-
19 pandemic and the emergence or reemergence of other pathogens in the foreseeable future.
Originality/value – The authors derived the unique spreads-fatalities curtailment coefficients to demonstrate
how President Obama used effective collaboration and coordination at all levels of government in conjunction
with medical experts to curtail the spreads and fatalities associated with H1N1, Ebola, Zika and Dengue. They
International Journal of Public
Leadership
Vol. 18 No. 2, 2022
pp. 134-150 The authors gratefully acknowledge the anonymous reviewers and the editors for their useful comments
© Emerald Publishing Limited and suggestions, which contributed to improving the quality of this paper. The authors are responsible
2056-4929
DOI 10.1108/IJPL-08-2021-0048 for the errors and omissions of this paper.
further derived the spreads-fatalities upsurge coefficients to highlight how President Trump contributed to the The COVID-19
spreads and fatalities of COVID-19 pandemic through his inability to collaborate and coordinate with state
governors, city mayors and different health-care agencies at the national and international levels. pandemic in
Keywords Coronavirus, Leadership, Obama, Trump, Conspiracy theories, Disinformation the USA
Paper type Research paper

Introduction 135
The outbreaks of global infectious diseases, such as the current COVID-19 pandemic, dated
back to the bubonic plague, which originated in China in 1334. The establishment of the
World Health Organization (WHO) on April 7, 1948 shortly after Second World War made
the WHO the world body designed to ensure collaboration and coordination within the
global health-care systems required to provide the necessary bulwark against anticipated
and unanticipated infectious diseases threats. According Bloom and Cadarette (2019),
during the 1948–2000 period, the world experienced prominent outbreaks of epidemics and
pandemics, such as the 1957–1958 Asian flu associated with one to two million deaths; the
1968–1969 Hong Kong flu, which resulted in 500,000 to two million deaths; the human
immunodeficiency virus-acquired immunodeficiency syndrome (HIV-AIDS), which since
1960 has resulted in over 35 million deaths, the ongoing cholera since 1961 continued to
cause between 21,000 and 143,000 deaths annually; the 1974 smallpox, which resulted in
over 26,000 deaths; and the 1994 plague that led to roughly 60 deaths (see Bloom and
Cadarette, 2019, Table 1, p. 3).
Additionally, Bloom and Cadarette (2019) indicated that the 2002–2003 severe acute
respiratory syndrome (SARS) caused 774 deaths, the 2009 influenza (Swine flu or H1N1) led to
284,000 deaths, the 2014–2016 Ebola resulted in 11,325 deaths, the ongoing Zika since 2016
caused unknown fatality, the 2017 dengue resulted in 38,000 deaths and the 2017 plague
caused 209 deaths [1]. According to the Coronavirus Resource Center at John Hopkins
University and Medicine, the current 2020–2021 COVID-19 pandemic has caused over 4.55
million deaths, worldwide, as of October 10, 2021.
Comparing the fatalities of the epidemics and pandemics that occurred in the last half of
the 20th century with those of first two decades of the 21st century, one can argue that the
WHO became more experienced and proficient in using collaboration and coordination with
the global health-care systems to mitigate the outbreaks of both known and unknown
infectious disease threats. For instance, according to the Division of Global Migration and
Quarantine (see CDC, 2019), the public health risks associated with the Madagascar
pneumonic plague of 2017 led the WHO to request for technical assistance from the Centers
for Disease Control and Prevention (CDC) because of its substantial expertise about how
infectious diseases can spread to other countries through travel or tourism. Given that WHO’s
global partnership engagement is rooted in many years of infectious diseases preventions,
border health protection practices and the lessons learned from the coordinated global
responses to the recent outbreaks of Ebola and Zika epidemics, the massive spreads and
fatalities of the COVID-19 since 2020, which presently exceed the fatalities associated with the
1957–1958 Asian flu and the 1968–1969 Hong Kong flu combined, raise pertinent questions
about the roles political leaders at the national and/or international levels play in mitigating
global infectious disease threats.
This paper contributes to the ongoing debates in academic and political circles about
global infectious disease threats by analyzing the roles that political leaders play at the
federal, state and local government levels in the USA in curtailing the spreads and
fatalities of global infectious diseases under the presidential leaderships of Obama
and Trump. Both presidents experienced global pandemic outbreaks during their tenure,
and the data from the CDC Data Tracker show much less fatalities under Obama in
IJPL Leaders and countries Years Pathogen Origin or location MR Cases (rank) Fatalities
18,2
Obama 2009 H1N1 Worldwide 0.02 60,800,000y 12,469
USA 2014–2016 Ebola West Africa 50.0 4 2
2015–present Zika Americas 0.04 2,382 1
2010–2016 Dengue Worldwide 0.33 5,387 18
Total 0.02 60,807,773 12,490
136 Trumpz 2017 Plague Madagascar NA NA
USA
Total COVID-19 2020–2021 COVID-19 China 1.7 24,482,050 (1)* 407,202*

Other countries Years Pathogens MR Cases (rank) Fatalities

Johnsonz 2020–2021 COVID-19 China 2.6 3,395,209 (5) 89,261
The United Kingdom SR 5 1:7 FR 5 1:5
Macronz 2020–2021 COVID-19 China 2.4 2,910,989 (6) 70,283
France SR 5 1:8 FR 5 1:6
Mattarella 2020–2021 COVID-19 China 3.5 2,381,277 (8) 82,177
Italy SR 5 1:10 FR 5 1:5
Merkel 2020–2021 COVID-19 China 2.3 2,050,099 (10) 47,440
Germany SR 5 1:12 FR 5 1:9
Trudeau 2020–2021 COVID-19 China 2.5 708,619 (22) 18,014
Canada SR 5 1:35 FR 5 1:23
Shinzo Abe 2020–2021 COVID-19 China 1.4 322,296 (39) 4,446
Japan SR 5 1:76 FR 5 1:92
Xi Jinping 2020–2021 COVID-19 China 5.2 88,336 (83) 4,635
China SR 5 1:277 FR 5 1:88
Moon Jae-in 2020–2021 COVID-19 China 1.7 72,729 (86) 1,264
South Korea SR 5 1:337 FR 5 1:322
Morrison 2020–2021 COVID-19 China 3.2 28,708 (104) 909
Australia SR 5 1:853 FR 5 1:448
Ardern 2020–2021 COVID-19 China 1.1 2,262 (167) 25
New Zealand SR 5 1:10,823 FR 5 1:16,288
Total COVID-19 2.7 11,960,524 318,454
Note(s): SR and FR are reported for ten other countries in comparison to President Trump as of January 20,
2021. For Presidents Trump and Obama, the SR 5 1:2.5 showed that there were 2.5 times more cases or spreads
under Obama when compared to Trump. In contrast, the FR 5 33:1 showed that there were 33 times more
fatalities under Trump due to COVID-19 pandemic when compared to Obama’s combined experience with
H1N1, Ebola, Zika and Dengue
Table 1. Source(s): World Health Organization (WHO), y obtained from the Centers for Disease Control and
Handling global Prevention’s “CDC Estimates of 2009 H1N1 Influenza Cases, Hospitalizations and Deaths in the United States,
infectious diseases Worldometer’s COVID-19 Data,” MR is the percentage of mortality rates per absolute number of cases
under Obama confirmed, * indicates the data we obtained at 12:01 pm on January 20, 2021 and z indicates political leaders
and Trump who tested positive for COVID-19

comparison to Trump. This observation logically questions whether or not President

Trump’s inability to curtail the spreads and fatalities associated to COVID-19 pandemic
is symptomatic of leadership failure? To understand the basis of President Trump’s
inability to curtail the widespread negative outcomes of the COVID-19 pandemic, it is
important to provide answers to this and other research questions. What strategies did
President Obama use to curtail the spreads and fatalities associated with the H1N1,
Ebola, Zika and Dengue during his presidency? Given that President Trump knew about
the COVID-19 as early as January 2020, the other pertinent research question is as
follows: Why was the USA unable to curtail the massive spreads and fatalities of the
COVID-19 pandemic?
 In answering these research questions, we draw on the theory of leadership espoused by The COVID-19
DuBrin (2013), who provided detailed discussions on the traits, motives and characteristics of pandemic in
leaders, especially the personality traits of effective leaders and leadership motives.
Leadership failure is a reflection of various characteristics of leadership, especially those
the USA
leaders who repetitively engage in self-aggrandizements, self-projections and self-deceptions
[2]. When leaders possess these traits, they tend to focus more on the processes of self-
promotions because they consider themselves to be the most powerful and knowledgeable
about everything around them; and they tend to relegate their responsibilities to their 137
subordinates in order to avoid being held accountable for their missteps. As the 45th
President of the United State (POTUS), Trump displayed self-aggrandizements, self-
projections and self-deceptions thus the inability to listen to the advice given by medical
experts and health-care professionals about how to collaborate and coordinate with
governors and city mayors in all states with respect to the handling of the COVID-19
pandemic. President Trump’s engulfment in self-projections and self-deceptions was
amplified by the utilization of conspiracy theories and disinformation with which he
deceptively projected his leadership failure in curtailing the spreads and fatalities on some
state governors and city mayors, and this culminated in what medical experts considered the
unnecessary politicization of the COVID-19 pandemic. Obviously, President Trump’s failure
to engage in collaboration and coordination with state governors and city mayors led to
medical chaos and confusion regarding the provisions of personal protective equipment
(PPE) for the frontline health- care workers. According Soergel (2020) and Mallinson (2020),
for weeks, states were locked in competitive bidding wars with each other and the federal
government trying to buy PPE, ventilators and other medical supplies, from China and South
Korea, which they needed to fight the pandemic.
The politicization of the COVID-19 pandemic led to the division of Americans into two
groups, basically, along the two party lines: the believers and the nonbelievers in the health
risks associated with the COVID-19 pandemic, and this has seriously undermined the
credibility of the CDC and the entire health-care systems in providing the medical guidelines
and correct scientific-based information necessary to curtail the pandemic. In our comparative
analysis of the outcomes achieved by President Trump in handling of the COVID-19 in the USA
to the outcomes achieved by the leaders in other advanced countries, we observed that these
leaders did not downplay the seriousness and severity of the pandemic right from the onset.
These leaders in other advanced countries did not engage in self-aggrandizements, self-
projections and self-deceptions. Furthermore, they were not engulfed in conspiracy theories and
disinformation that would have undermined the guidelines provided by their medical experts
and health-care professionals. Simply put, the extensive spreads and fatalities of the COVID-19
in the USA were the symptoms and/or results of President Trump’s leadership failure.
The rest of this paper is organized as follows. In the next section, we provide a brief review
of the relevant studies with respect to the global infectious disease threats. We then we use
theoretical analysis to show how the conspiracy theories and disinformation employed by
political leaders in the USA at the federal, state and local government levels hamstrung the
ability to curtail the known and unknown global infectious disease threats or shocks, thus the
significant negative ramifications on all aspects of the economy. Next, we discuss how
President Obama was able to mitigate the spreads and fatalities associated with H1N1, Ebola,
Zika and Dengue and compared his handling of these pathogens to President Trump’s
handling of the COVID-19 pandemic. The paper concludes with political-policy implications.

Background studies
The world has experienced several episodes of global infectious diseases since the deadliest
Spanish flu of 1918. According to Bloom and Cadarette (2019), no other global pandemic has
IJPL approached the magnitude of the Spanish flu of 1918 in terms of fatality over such a short
18,2 period in which there were 500 million recorded cases and fatality ranging between 30 and
100 million deaths. In Bloom and Cadarette’s (2019) viewpoint, “Humanity’s relatively good
fortune with respect to infectious disease can be attributed, in part, to the elaborate global
health system the world has gradually developed as a bulwark against infectious disease
threats, both known and unknown.” In their study, they discussed prominent infectious
disease outbreaks, epidemics and pandemics of the last century. In doing so, they raised
138 several pertinent issues, including the fact that infectious disease threats pose economic and
social risks and that there are a number of complicating and challenging factors when it
comes to managing the risk of infectious diseases.
According to both authors, several ongoing demographic trends point toward an
increased potential for transmission of pathogens. In this regard, Bloom and Cadarette (2019)
identified several factors, such as population growth, especially in developing countries
where there is a rapid growth in urbanization; climate change that could be an important
factor in driving pathogen transmission; human interactions with animal populations, which
can lead to producing pathogen spillovers; civil (political and social) conflicts that can result
in new disease outbreaks or the exacerbation of ongoing outbreaks and globalization, which
enables many diseases with epidemic and pandemic potential to be transmitted domestically
and across countries worldwide.
In addition, Bloom and Cadarette (2019) pointed out some economic and political
challenges that can impede the implementation of measures needed to prepare for and
respond to infectious disease threats. Among some of the political challenges is the lack of a
reliable mechanism for incentivizing international collaboration and coordination in the
development of new biomedical countermeasures wherein manufacturers from high-income
countries could rely on developing countries to provide biological samples needed for
research and development. Towards that end, the authors recommended the formation of a
multi-disciplinary “Global Technical Council on Infectious Disease Threat” to address
emerging global challenges related to infectious diseases and the associated social and
economic risks. This recommendation is premised on the assumption that a newly created
“Global Technical Council on Infectious Disease Threat” would strengthen the global health
systems by improving collaboration and coordination across organizations, such as the
WHO, national CDCs and pharmaceutical manufacturers; fill the knowledge gaps with
respect to infectious disease tracing/surveillance and treatment; provide the needed funding
for research and development, financing models and the social and economic impacts of
potential threats; and make high-level but medical evidence-based recommendations for
managing global risks associated with infectious diseases.
The spreads and fatalities associated with global infectious diseases have also brought
attention to the use of different types of PPE, including the use of face shields, facemasks,
gloves, goggles and glasses, gowns, head covers, respirators and shoe covers. At the forefront
of these PPE is the use of facemasks by the general public to prevent or reduce the
transmissions of respiratory pathogens. In the face of the global COVID-19 pandemic, many
countries mandated the wearing of facemasks in public areas along with social distancing to
prevent further spread and fatality. The ongoing debate is about the efficacy of wearing
facemasks as the preventive measure for the COVID-19 pandemic.
Vainshelboim (2021) documented several experimental studies, which provided the
scientific basis to question the efficacy of using facemasks. Vainshelboim’s (2021) “evolution
of hypothesis” with respect to medical and nonmedical facemasks covered the “breathing
physiology, efficacy of facemasks, physiological and psychological effects of wearing
facemasks, and the long-term health consequences of wearing facemasks.” Vainshelboim
(2021) concluded that wearing facemasks has been demonstrated to have substantial adverse
physiological and psychological effects and that the long-term consequences can cause health
deterioration, the development and progression of chronic diseases and premature death; The COVID-19
therefore, governments, policymakers and health experts or professionals should utilize pandemic in
proper and scientific-based evidence and approach when wearing facemasks is considered
the preventive intervention for public health. Other studies such as Baryck et al. (2020), Konda
the USA
et al. (2020), Salam et al. (2020), Leung et al. (2020), Chu et al. (2020), MacIntyre et al. (2015) and
Fisher et al. (2014) have mixed views regarding the efficacy of wearing facemasks as
prevention for infectious pathogens. Some of these studies do not have sufficient data to
definitively determine whether N95 facemasks are superior to medical masks in protection 139
against transmissible acute respiratory infections.
Other studies such as Parida et al. (2020) acknowledged that the use of different types of
masks based on the risk of exposure should be taken seriously and should therefore be used
judiciously. Furthermore, Parida et al. (2020) pointed out that since this is a novel disease,
everyone should expect the guidelines to change daily and that
one needs to be updated with correct information so that one can protect themselves and their
families from this extreme level of the crisis faced by the world now. The use of facemasks should not
be discouraged as there has been substantial evidence that its use can help reduce the spread of
infection. “Mass masking” along with hand hygiene and social distancing are the only effective
recommended measures to prevent the spread of the disease.
In a study by Chu et al. (2020), they identified 172 observational studies across 16 countries
and six continents, with no randomized controlled trials and 44 relevant comparative studies
in health-care and nonhealth-care settings, and they found out that the transmission of
viruses was lower with physical distancing of one meter or more when compared with a
distance of less than one meter and that protection increased as distance lengthened. They
also concluded that face mask use could result in a large reduction in the risk of infection with
stronger associations with N95 or similar respirators compared to disposable surgical masks
or similar respirators and that eye protection was associated with less infections (see also
Stutt et al., 2020).
In a series of recent studies in International Journal of Public Leadership, Vol. 17, No. 1,
research scholars pointed out that President Trump’s failure to curb COVID-19 pandemic
could be attributed to many factors, such as his display of maladaptive denial and
concomitant power-addiction (Weidner and Nelson (2021)), the defunding of the Office of
Pandemics and Emerging Threats, and the lack of coordination (Schismenos et al. (2021)),
“deathcare leadership in the USA lacks a human-centric approach” (Entress et al. (2021)) and
the crisis in leaderships at many levels of government as manifested by their inability to
collaborate and coordinate to control the cases and fatalities (Sadiq et al., 2021; Glenn
et al., 2021).

Methodology: theoretical analysis of conspiracy theories–disinformation and

COVID-19 pandemic
This section uses theoretical analysis to highlight how some political leaders in the USA
including the 45th POTUS, some state governors and city mayors utilized conspiracy theories
and disinformation, propagated through different social media platforms (Fox News, Twitter,
Facebook, Instagram and One America News) to hamper the collaboration and coordination
necessary in curtailing the massive spreads and fatalities of the COVID-19 virus. Essentially,
the actions of the political leaders at the federal, state and local levels culminated in the
politicization of the COVID-19 pandemic, and it further divided Americans into believers and
nonbelievers in the health risks associated to the COVID-19 pandemic.
We use a quantitatively qualitative approach to highlight how political leaders in the USA
and other advanced countries handled the massive spreads and fatalities due to infectious
IJPL diseases, such as COVID-19 pandemic. This is consilience with the general argument that a
18,2 mathematical model or “a statistical method is fundamentally sound only if it tells you things
you already know” (Ellenburg, 2001). We express what is well known about the spreads and
fatalities in the USA and other countries in composite linear equations as follows:
SFO ¼ – αPLO $CCO – wPLO $CINO – fPLO $CPHRO – βZ O $CCO (1)

140 SFT ¼ σ PLT $CTT þ μPLT $DIST þ ð–λ þ UÞPLT $CPHRT þ δZ T $CCT $DIST (2)

and
SFAC ¼ – ηPLAC $CCAC – ψ PLAC $CINAC –θPLAC $CPHRAC– π Z AC $CCAC (3)
where SFO represents the spreads and fatalities of H1N1, Ebola, Zika and Dengue under
President Obama, while SFT and SFAC capture the spreads and fatalities of the COVID-19
pandemic under President Trump and the leaders in ten other countries, respectively. Also,
PLO, PLF and PLAC stand for the combination of political leaders at the federal, state/regional
and local levels of government in the USA under Obama and Trump and in other countries,
respectively; CCO, CCT and CCAC capture the magnitude of collaboration and coordination
under the leaders as identified earlier; CPHRO, CPHRT and CPHRAC represent citizens’
perceptions or concerns of the health risks from infectious diseases under the leaders as
identified; CINO and CINAC capture correct information about infectious diseases; CTT and
DIST represent the conspiracy theories and disinformation propagated by political leaders
and ZO, ZT and ZAC represent the catch-all term for the WHO, the CDC and other health-care
systems in the USA and other advanced countries.
Equations (1)–(3) serve to provide the theoretical answers to the questions we posed earlier
in this paper. For example, Equations (1) and (2) enable us to compare how President Obama
handled the spreads and fatalities (SFO) in four different episodes of global infectious diseases
with how President Trump handled the spreads and fatalities (SFT) during the COVID-19
pandemic. Next, Equations (2) and (3) allow us to compare how President Trump handled
SFT relative to how other political leaders in advanced countries handled SFAC during the
COVID-19 pandemic.
To provide a clear interpretation of Equation (1), the partial differentiations of SFO with
respect to the explanatory variables on the right-hand-side yield
vSFO vSFO vPLO
¼ $ ¼ –α; (4)
vCCO vPLO vCCO
vSFO vSFO vPLO
¼ $ ¼ –w; (5)
vCINO vPLO vCINO
vSFO vSFO vPLO
¼ $ ¼ – f; (6)
vCPHRO vPLO vCPHRO

and
vSFO vSFO vZ O
¼ $ ¼ –β: (7)
vZ O vZ O vCCO
The negative “spreads-fatalities curtailment coefficients” (–α; –w; –f and –β) depicted by
these equations show how President Obama used effective collaboration and coordination at all
levels of government in conjunction with scientists, medical experts and professionals at the
WHO, the CDC and other health institutions in the USA to mitigate the spreads and fatalities
associated with H1N1, Ebola, Zika and Dengue during his two-term tenure as the 44th POTUS.
 The coefficient (–w) of Equation (5) is particularly important because it shows the degree The COVID-19
to which correct information (see Parida et al., 2020) provided by political leaders can help pandemic in
curtail the spreads and fatalities linked to global infectious diseases. For instance, when
Americans were afraid and distrustful of the resources devoted to curtailing Ebola,
the USA
President Obama came out to allay the fears of the public by delivering a strong statement
in acknowledgment that “People were understandably afraid. And, if we’re honest, some
stoked those fears. But we believed that if we made policy based not on fear, but sound
science and good judgment, America could lead an effective global response while keeping 141
America people safe, and we could turn the tide of the epidemic” (see Condon, 2015). This
was intended not only to reassure the nation of his handling of the Ebola epidemic but also
to build national unity in the fight against Ebola. Furthermore, Equation (6) shows that
when political leaders (especially the POTUS, state governors and city mayors) share the
same perceptions with citizens or show some level of compassion and understanding when
citizens show trepidations about the health risks linked to the spreads and fatalities due to
infectious diseases, the citizens will view the health risks from the same lens and not from
two different lenses.
Similarly, the partial differentiations of SFT in Equation (2) with respect to the explanatory
variables on the right-hand-side yield

vSFT vSFT vPLT

¼ : ¼ σ; (8)
vCTT vPLT vCTT
vSFT vSFT vPLT
¼ : ¼ μ; (9)
vDIST vPLT vDIST
vSFT vSFT vPLT
¼ : ¼ −λ þ U; (10)
vCPHRT vPLT vCPHRT

and
vSFT vSFT vZ T vCCT
¼ $ $ ¼ π: (11)
vZ T vZ T vCCT vDIST

The “spreads-fatalities upsurge coefficients” (σ þ μ – λ þ Ω þ π ) depicted by equations (8)–(11)

show how President Trump contributed to the spreads and fatalities (SFT) of the COVID-19
pandemic through his inability to collaborate and coordinate with the state governors, city
mayors and different health-care agencies at the national and international levels. The
coefficients for the conspiracy theories (σ ) and disinformation (μ) (see Prooijen et al., 2018;
Gagaridis, 2020) are as important as the coefficients of the citizens’ perceptions of the health
risks (–λ þ Ω) linked with the COVID-19 pandemic.
President Obama relied on the advice from medical doctors, nurses and other health-care
professionals to curtail the spreads and fatalities related to Ebola rather than engage in the
politicization and the division of the citizens’ perceptions of the health risks associated with
the disease. In contrast, President Trump managed to politicize the COVID-19 pandemic, and
in the process, this further divided Americans into two groups along party lines. Essentially,
we take –λ as the coefficient that captured the behavior of the risk averse citizens who
believed in the health risks posed by COVID-19 pandemic; and they followed the guidelines
provided by the medical experts in order to curtail the spreads and fatalities. In addition, we
take Ω as the coefficient that captured the behavior of risk-loving nonbelievers or willful
spreaders regarding the health risks associated with COVID-19 pandemic. Unlike President
Obama who relied on science-based medical advice in making good judgment, President
Trump showed contempt for science and medical doctors; therefore, π is the coefficient with
IJPL which we gauge the extent to which President Trump contributed to the spreads and
18,2 fatalities of the COVID-19 through the use of conspiracy theories and disinformation to
undermine the medical guidelines provided by infectious diseases experts at the WHO, the
CDC and all the related health-care institutions in the USA.
Similarly, we take the partial differentiations of SFAC in equation (3) with respect to the
explanatory variables on the right-hand side to highlight how some leaders in advanced
countries handled the spreads and fatalities of the COVID-19 pandemic in their countries.
142 That is
vSFAC vSFAC vPLAC
¼ $ ¼ –η (12)
vCCAC vPLAC vCCAC
vSFAC vSFAC vPLAC
¼ $ ¼ –ψ (13)
vCINAC vPLAC vCINAC
vSFAC vSFAC vPLAC
¼ $ ¼ –θ (14)
vCPHRAC vPLAC vCPHRAC

and
vSFAC vSFAC vZAC
¼ $ ¼ –π : (15)
vZ AC vZ AC vCCAC

The negative “spreads-fatalities curtailment coefficients” (–η; –ψ ; –θ and –π) depicted by

Equations (12)–(15) are in many ways comparable to those indicated by Equations (4)–(7)
because the overarching objective in both cases is to curtail the spreads and fatalities of
known and unknown global infectious disease threats, irrespective of the country of origin.
Even though the actions that President Obama took to curtail the spreads and fatalities
associated with the H1N1, Ebola, Zika and Dengue are different from those taken by the
leaders in other countries to mitigate the current COVID-19 pandemic, but like Obama, they
showed compassion and did not engage in self-aggrandizements, self-projections and self-
deceptions when they addressed their citizens about the deadly coronavirus. Simply put, the
leaders in these advanced countries did not abdicate their responsibilities in handling the
global COVID-19 pandemic and other infectious diseases.
Finally, to comprehend the magnitude of leadership failure as manifested by the massive
spreads and fatalities due to the COVID-19 pandemic under President Trump compared to
the four different episodes of epidemics and pandemics under President Obama, we express
the spreads and fatalities (SO and FO for Obama and ST and FT for Trump) per year in office
(YO 5 8 years for Obama and YT 5 4 years for Trump) as well as the spread ratio (SR) and
fatality ratio (FR) under both leaders as follows:
SO ST
ASO ¼ vs AST ¼ ; (16)
YO YT
FO FT
AFO ¼ vs AFT ¼ ; (17)
YO YT

and
ST FT
SR ¼ vs FR ¼ ; (18)
SO FO
where ASO and AFO, and AST and ASF are the average annual spreads and fatalities under
Obama and Trump, respectively, while SR and FR are the spread and fatality ratios for
comparing Obama to Trump and also for comparing Trump with leaders in other countries The COVID-19
identified in this study. pandemic in
To show the importance of Equations (16)–(18), we utilized the available data provided by
Worldometer, the CDC Data Tracker and the John Hopkins University up to January 20, 2021
the USA
(the last day Trump’s presidency) to provide comparative quantifications of the average
annual spreads and fatalities under both presidents. The computations of AST, AFT, ASO and
AFO showed that the average annual spread (AST ¼ 6,120,512) and fatality (AFT ¼ 101,800)
under President Trump were remarkably much higher than the average annual spread (ASO 143
¼ 35,260) and fatality (AFO ¼ 1,561) under President Obama. The computed spread ratio (SR)
of 1:2.5 showed that Obama had 2.5 times more cases than Trump. In contrast, the fatality
ratio (FR) of 33:1 showed that Trump had 33 times more fatalities due to the COVID-19
pandemic when compared to Obama’s handling of four different epidemics and pandemics in
eight years.

Evidence on handling infectious diseases and general discussion

In this section, we discuss how Presidents Obama and Trump handled the different episodes
of epidemics and pandemics they experienced while in office. Their handling of these
infectious diseases corroborates the theoretical analysis laid out in Equations (1) through (18).
In less than six months after inauguration in 2009, President Obama summoned a meeting of
the President’s Council of Advisors on Science and Technology (PCAST) to find out what the
president must do to prepare for the expected autumn outbreak of swine flu or H1N1.
According to Karlawish (2020), this meeting with scientists and other professionals, in
preparation for H1N1, formed the basis of President Obama’s science-informed
policymaking in handling not only H1N1 but other infectious diseases such as Ebola,
Zika and Dengue that followed thereafter. By listening to the scientists, President Obama
allowed these public health experts to take the lead on messaging. This was aptly captured
in President Obama’s statement, “And I can assure you that we will be vigilant in
monitoring the progress of this flu and I will make every judgment based on the best science
available.” In the process, President Obama facilitated the quick distribution of emergency
equipment from the federal stockpile and got the Congress involved at different times by
requesting for $1.5 bn and $8.0 bn to ensure adequate supply of equipment and vaccines to
handle internal outbreaks (see Kates et al., 2015; Landler, 2016; Moss and Kates, 2019). In
addition, the outbreak of Ebola in 2014 in West Africa, especially in Guinea, Liberia and
Sierra Leone, prompted President Obama to deploy scientists, doctors and over 3,000
military troops to the virus locations as the preemptive measure to prevent the outbreak of
Ebola in the USA (see Cooper et al., 2014). Again, President Obama got the Congress
involved by requesting for $5.4 bn to fund the provision of vaccines and other medical
equipment (Kates et al. (2015). Obviously, President Obama’s experience with H1N1 in 2009
and Ebola in 2014 led to the formation of the Pandemic Response Team under the auspices
of the White House National Security Council (NSC) Directorate for Global Health Security
and Biodefense in 2015 [3].
Furthermore, Karlawish (2020) pointed out that President Trump was anti-science right
from the beginning of his administration, and this was manifested by the takedown of the
PCAST website on January 22, 2017 [also see, Comms, 2020]. The PCAST was originally
established in 1990, by President George H.W. Bush, as an advisory group of scientists and
engineers to augment the science advice received from other White House advisors,
departments and agencies. Rather than following the pandemic response template, which
President Obama put in place in 2015, the Trump administration disbanded the White House
Pandemic Response Team in May 2018 in addition to the elimination of the position of the
CDC epidemiologist stationed in China’s Disease Control Agency after the epidemiologist left
IJPL the post in July 2019. These were strategic policy actions taken by the Trump administration
18,2 to defund science (see Sun, 2018; Karlawish, 2020).
Zamarripa (2020) provided five ways that the Trump’s leadership failures compounded the
coronavirus-induced economic crisis, and these ways included (1) the botched public health
response, (2) the failure to help workers retain their jobs, (3) three years of slashing critical
safety nets during which the CDC cut its epidemic prevention activities, (4) the failure to prevent
layoffs of state and local workers and (5) the failure to help small businesses to remain open.
144 The studies by Karlawish (2020) and Zamarripa (2020) raise some questions. What was the
rationale for eliminating the position of the CDC epidemiologist if being present could have
facilitated international collaboration and coordination with respect to the pandemic from
China? Could the USA have been well informed of the pending COVID-19 outbreak had the
Trump administration not eliminated the position of the epidemiologist in China’s CDC? Could
this have contributed to the fracture in diplomatic relationships with international agencies
such as the WHO and China’s CDC? These are difficult questions to answer. However, while the
historical data provided in Table 1 may not capture everything that contributed to the massive
spreads and fatalities of the COVID-19 pandemic, it provides visual evidence of the cases and
fatalities associated with the H1N1, Ebola, Zika and Dengue under President Obama in
comparison to the massive spreads and fatalities of the COVID-19 pandemic under President
Trump. In addition, it allows us to compare the USA’ experience to ten other countries
(Australia, Canada, China, France, Germany, Italy, Japan, the United Kingdom, New Zealand
and South Korea) that also experienced COVID-19 pandemic in 2020–2021.
We observed that there were more cases (60,807,773) but less fatalities (12,490) associated
with the four different episodes of global infectious diseases under Obama’s two-term
presidency compared to less cases (24,482,050) and by far more fatalities (407,202) associated
with COVID-19 pandemic during President Trump’s one-term tenure. We also observed that
the 24,482,050 recorded cases of the COVID-19 in the USA under President Trump (as of
January 20, 2021) more than doubled the combined 11,960,524 cases with respect to Australia,
Canada, China, France, Germany, Italy, Japan, the United Kingdom, New Zealand and South
Korea. For these ten countries listed in Table 1, based on their ranking with respect to cases/
spreads reported, the 318,454 combined fatalities linked to the COVID-19 were roughly 78.2%
of the 407,202 deaths reported by the USA under President Trump. These comparisons
warrant more explanations as to how and why President Obama was able to curtail
pandemics, yet President Trump failed to curtail the massive spreads and fatalities
associated with the COVID-19 pandemic.
The USA continued to be ranked number one in the world with respect to the spreads and
fatalities associated with the outbreak of the COVID-19 pandemic, even though it is the
country with the most advanced medical experts and medical technology in the world with an
independent legislative body that “plays an important role in determining and shaping the
government’s global health policy and programs.” Moss and Kates (2019) and Kates et al.
(2015) provided detailed discussions on the role that the United States Congress played in
global health efforts during previous episodes of epidemics and pandemics.
Furthermore, Frieden (2021), who was the former Director of the Center for Disease
Control and Prevention from 2009 to 2017, noted that “A successful response to Covid-19
turned out to depend more than a country’s wealth, scientific prowess and history of public
health successes. The US enjoys of all of these advantages but mounted one of the worst
responses to the pandemic: 1 in every 990 [4] Americans has died from Covid-19 since the
pandemic began. Bad politics, quite simply, can Trump good public health.” According to
Frieden (2021), countries or regions that have responded best to COVID-19 included: Taiwan
– best at early action that halted flights from China and implemented widespread testing and
quadrupled the production of face masks within a month; Liberia – best at learning from
recent epidemics such as Ebola in 2014; New Zealand – best at crushing the curve due to
national leadership, especially Prime Minister Jacinda Ardern’s exemplified empathetic and The COVID-19
clear communication to New Zealanders, thus the successful collaboration and coordination; pandemic in
American Samoa – best location or territory in the USA with no reported COVID-19 cases
because their health authorities were already on high alert based on their experience with
the USA
measles outbreak in 2019; South Korea – best at testing with highly effective contact tracing
and quarantine; Hong Kong – best at quarantining despite being one of the highest
population densities in the world; Denmark – best economic protection by providing income
supplements in private companies in order to avoid large-scale layoffs and Finland – best at 145
public communication to dispel rumors and distrust now ravaging the world. According
Frieden (2021), many leaders in these countries showed models of clarity and effective
communications by calling for their citizens to exhibit “patience, discipline and solidarity,”
which can be considered “three essential aspects of an effective pandemic response.”
The USA was not ranked the best in any of these categories with which Frieden (2021)
identified countries or regions that best handled the virus. The ranking as number one with
respect to the spreads and fatalities of COVID-19 is in accordant with, and lends credence to,
our use of SR and FR for the important one-to-one comparison with the ten other countries
identified in Table 1. For both SR and FR, the USA experienced more SR and FR relative to
the ten countries in our sample. For accurate and fair comparison, we computed the SRs and
FRs based on the data collected as of January 20, 2021 under President Trump.
Interpretatively, these computed SRs and FRs (SR 5 1:7 and FR 5 1:5 for the United
Kingdom, SR 5 1:35 and FR 5 1:23 for Canada, SR 5 1:277 and FR 5 1:88 for China and
SR 5 1:10,823 and FR 5 1:16,288 for New Zealand) showed that for each reported spread/case
and fatality, the USA had more spreads and fatalities when compared to the other ten
countries reported in Table 1. If we use the MR, one would instantaneously and erroneously
conclude that only New Zealand (1.1%) and Japan (1.4%) performed better than the USA
(1.7%), who appeared tied with South Korea (1.7%), and that the USA performed better than
these ten countries combined (2.7%).
The historical evidence showed that President Obama managed to curtail the spreads and
fatalities associated with four different episodes of the epidemics and pandemics experienced
while in office. This is indicated by or aligned with the negative “spreads-fatalities
curtailment coefficients” (–α; –w; –f and –β) we derived from equations (7)-(10). In contrast,
President Trump had the knowledge about how severe COVID-19 pandemic would be at the
beginning of 2020, and the failure to control the massive spreads and fatalities in the USA is
depicted by the “spreads-fatalities surge coefficients” (σ þ μ – λ þ Ω þ π ).
President Trump’s failure to curtail the massive spreads and fatalities due to COVID-19
was primarily due to the fact he downplayed the severity of the COVID-19 pandemic from
day one. In several recorded interviews with Bob Woodward in February and March of
2020, President Trump admitted to concealing the true threat of the COVID-19 pandemic.
Essentially, Woodward’s (2020) book provided the details of President Trump’s views
about the COVID-19 pandemic. Rather than share the correct information (CIN), based on
solid scientific evidence, President Trump used every opportunity at his press conferences
to peddle conspiracy theories (CTT) and disinformation (DIST). Through the endless use of
CTT and DIST, President Trump managed to denigrate not only the doctors, health-care
professionals and pharmaceutical industry as profiteers but more importantly, he
succeeded in dividing American citizens into two groups. On the one hand, there are
Americans who are risk-averse believers in the health risks associated with the COVID-19
pandemic, and they adhered to the CDC guidelines. On the other hand, there are Americans
who are risk-loving nonbelievers in the reality of the health risks associated with the
COVID-19 pandemic. Essentially, this later group of Americans did not believe in solid
science-based guideline information from the CDC and the health-care professionals about
the pandemic.
IJPL There is no doubt that the conspiracy theories, disinformation and the division of the
18,2 citizens into believers and nonbelievers influenced the wearing of facemasks, which medical
doctors and health-care professionals recommended as the most effective measure to curtail
the massive spreads and fatalities of the COVID-19 pandemic. This is also manifested in
Americans’ willingness and unwillingness to be vaccinated. The reluctance to vaccination by
the risk-lovingnonbelievers in the severity and reality of the COVID-19 pandemic may
undermine the desire to achieve what medical experts call “herd immunity” necessary for full
146 reopening of the economy.

Conclusions and political-policy implications

The USA is the country that most countries around the world rely upon when it comes to
curtailing the outbreaks of known and unknown global infectious disease threats over the
past three or more decades. However, this reliance has been increasingly questioned by many
European leaders because Trump, the President of the USA, displayed global leadership
failure in many global alliances, including his handling of the COVID-19 pandemic.
Throughout his tenure, President Trump was engulfed in self-aggrandizements, self-
projections and self-deceptions. From this engulfment, President Trump failed to collaborate
and coordinate with state governors and city mayors nationwide; therefore, his inability to
curtail the massive spreads and fatalities of the COVID-19 pandemic can be construed as
symptoms of leadership failure at the national and international levels.
In addition, rather than taking responsibility for the mishandling of the COVID-19
pandemic – glaring symptom of leadership failure – President Trump deflected the blame on
China, the World Health Organization (WHO), the pharmaceutical industry, scientists,
doctors, frontline health-care workers and other medical experts. These were some of the
strategic self-projections and self-deceptions, which President Trump deployed repeatedly to
confuse the public as to who should be blamed for his blatant leadership failure. Similarly,
President Trump’s withdrawal of the USA from the WHO was also a clear signal of global
leadership failure. In other words, President Trump’s withdrawal from WHO was an ill-
advised strategic policy move, which was designed and meant to avoid taking responsibility
for his failure to curtail the raging COVID-19 pandemic while the leaders in other advanced
countries succeeded (see Frieden, 2021). President Trump’s failure to collaborate and
coordinate with other countries and the WHO to curtail the spreads and fatalities due to
COVID-19 pandemic can be construed as the complete abdication of the USA’ global
leadership “role in determining and shaping the government’s global health policy and
programs.” In particular, this action questioned the globally perceived “American greatness
and exceptionalism.”
In terms of policy-political implications in curtailing the spreads and fatalities
associated with the known and unknown global infectious disease threats, this study
shows that the political leaders at all levels of government, especially the 45th POTUS, are
pivotal with respect to how they collaborate and coordinate, share the correct science-
based information with the public and promote national unity based on the provision of
true information. Engaging in conspiracy theories and disinformation will only lead to
partisan division, medical chaos and untold fatalities, and the adverse amplification on
public health will continue to manifest in different ways. For instance, vaccine hesitancy is
more pronounced in the USA when compared to other advanced countries because this is
one of the lingering effects of conspiracy theories and disinformation (see OECD, 2021).
And according to Bor et al. (2021), “In the final year of Donald Trump’s presidency, more
than 450,000 Americans died from COVID-19, and life expectancy fell by 1.13 years, the
biggest decrease since Second World War. Many of the deaths were avoidable; COVID-19
mortality in the US was 40% higher than the average of the other wealthy nations in the
Group of Seven (G7).” In other words, the massive spreads and fatalities of the COVID-19 in The COVID-19
the USA were symptoms of Trump’s leadership failure at both the national and pandemic in
international levels.
The theoretical viewpoints presented in this paper along with the derivations of the
the USA
spread–fatality curtailment coefficients and the spreads–fatalities upsurge coefficients under
Presidents Obama and Trump, respectively, may not be replicable. Given this plausible
limitation, future research may need to provide a deep analysis of the amplifications of
conspiracy theories and disinformation because they are now deeply rooted in the political 147
economy of the USA. Furthermore, since scientists and medical professionals may not be able
to forecast future epidemics or pandemics with pin-point accuracy nor predict how political
leaders would disseminate health risks information associated with different pathogens, it is
imperative that future research address the positive or adverse effects of conspiracy theories
and disinformation that are now easily propagated simultaneously through different social
media platforms, which are currently protected under Section 230 of the Communications
Decency Act. The multiplier effects of conspiracy theories and disinformation will continue to
amplify the division about the authenticity of COVID-19 pandemic and the emergence or
reemergence of other pathogens in the foreseeable future.

Notes
1. Bloom and Cadarette (2019) provided detail explanations regarding the pathogen, geographical
locations, and the cases and mortalities of the prominent outbreaks of epidemics and pandemics
since the Spanish flu of 1918–1920.
2. For more on the theories of self-projections and self-deception, see Gur et al. (1979) and Mele (1998).
3. For more on Obama’s actions, see the “Public Papers of the President of the United States,” AE
2.114.2009/Bk.1.
4. Based on the population data obtained on November 16, 2021 from Worldometer and the data on
fatalities obtained from John Hopkins University, the new calculation showed that 1 in every 425
Americans has died due to COVID-19 pandemic.

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Corresponding author
Oluwole Owoye can be contacted at: [email protected]

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