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This article examines the Trump Administration's inability to mount a timely and effective response to the COVID-19 outbreak, despite ample warning. Through an empirical exploration guided by three explanatory perspectives-psychological, bureau-organizational, and agenda-political-developed from the strategic surprise, public administration, and crisis management literature, the authors seek to shed light on the mechanisms that contributed to the underestimation of the coronavirus threat by the Trump Administration and the slow and mismanaged federal response. The analysis highlights the extent to which the factors identified by previous studies of policy surprise and failure in other security domains are relevant for health security. The paper concludes by addressing the crucial role of executive leadership as an underlying factor in all three perspectives and discussing why the US president is ultimately responsible for ensuring a healthy policy process to guard against the pathologies implicated in the federal government's sub-optimal response to the COVID-19 crisis.
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