Trump himself compared it to the common flu on Twitter, facing the pandemic. In Deborah's view, Trump's administration and himself were unprepared for the pandemic and even shrugged off predictions of possible damage of the pandemic.
Birx describes her first meeting with Trump, on March 2, 2020, when she tried to explain to him that the virus “is not the flu”. Trump listened for a minute, briefly challenged her, then literally changed the channel on one of the TV screens he had simultaneously been watching.
After joining the panel in March 2020, Deborah found that the United States was "dangerously behind the eight ball" on virus data collection.
In 2020, she wrote, data in some states was often being sent by fax and then passed along to the CDC.