As governor of Indiana, an uncontrolled HIV outbreak in Indiana spread for months on Pence’s watch. He currently heads the White House Coronavirus Task Force.

On Wednesday night, Democratic vice-presidential nominee Sen. Kamala Harris opened her debate with Vice President Mike Pence by noting the disastrous consequences of the White House’s failure to control the coronavirus pandemic across the United States.

Harris directly blamed Pence and President Donald Trump for the staggering death toll, infection rates, and economic recession. She also pointed out that Pence, as head of the White House Coronavirus Task Force, has been directly involved in covering up the severity of the disease, despite knowing the toll it could take. 

“They knew what was happening, and they didn’t tell you,” Harris said on the debate stage in Salt Lake City, Utah. “They knew, and they covered it up.” The senator’s comments referred to journalist Bob Woodward’s interviews with President Trump, in which the president admits to downplaying the severity of the virus. 

“I wanted to always play it down,” Trump reportedly told Woodward earlier this year. “I still like playing it down, because I don’t want to create a panic.”

Pence is ostensibly in charge of leading the direction of the nation’s response to the virus. However, The New York Times reports that Pence himself and his staff have allowed politics to overtake the work of the Coronavirus Task Force. In late February, as Trump was admitting the seriousness of the pandemic to Woodward on tape, Pence took control of messaging on COVID-19 from the nation’s leading public health experts. 

That included an op-ed published in the Wall Street Journal in mid-June, in which the vice president denied that a second wave of coronavirus infections would sweep the United States. Pence’s op-ed—penned by his staff, according to The New York Times—notably came as record spikes in coronavirus infections were occurring across the southern and western parts of the country, including Texas, Florida, and Arizona.

As of early October, coronavirus infections are increasing in 39 states, with severe outbreaks in Wisconsin and other parts of the Midwest. The White House itself is an emerging hot spot of infections, with high-ranking Trump administration officials and the president himself becoming infected. More than 210,000 Americans have died of COVID-19, and unemployment numbers continue to remain at record high levels—804,000 new unemployment claims were filed in the past week alone.

At the debate on Wednesday night, Sen. Harris’ criticism of Pence and the Trump administration’s failed response to the coronavirus pandemic put a new spotlight on Pence’s failure to contain an HIV outbreak that rocked Indiana during his time as governor.

In 2015, more than 200 people were infected with HIV in Austin, Indiana—a small city of fewer than 5,000 people.The outbreak was linked to skyrocketing rates of addiction in the state, which were part of a broader epidemic of opioid addiction across the country. Then-Gov. Pence took a hardline stance on practices that public health experts had recommended for helping to control disease outbreaks related to intravenous drug use. That included bans on needle exchanges, which have been shown to prevent the spread of diseases like hepatitis and HIV. 

Calls for needle-exchange programs in Indiana at the time came from all sides, including Pence’s own conseravative allies. According to The Guardian, William Cooke, the only doctor in Austin at the time, brought up needle exchanges to Pence, but the then-governor would not consider the idea. 

According to Cooke, Pence “didn’t really want to talk about a syringe service program, so he moved on from that subject quickly.” The governor proceeded to wait weeks before making a decision on how to address the outbreak. At that point, HIV infections were spreading by the dozen.

The problem wasn’t just limited to 2015. HIV rates among intravenous drug users had been declining across the US before Pence’s tenure as governor of Indiana started in 2013. According to Politico, though, southern Indiana was at that point dealing with a resurgent substance abuse crisis. There were no needle exchanges, due to state law, and Pence’s support of closing Planned Parenthood clinics—the only place for HIV testing at the time in this corner of southern Indiana—spawned a crisis. 

By late 2014, the first case of HIV associated with drug use was identified in Scott County, Indiana, where Austin is located. Two months later, 17 people were infected, according to Politico, but state authorities had not yet notified local officials. It wasn’t until late March 2015 that Pence declared a public health emergency, allowing temporary needle exchanges and providing local HIV testing.

Similarly, the Trump administration had months of warning to prepare for the coronavirus outbreak. 

This spring, ABC News reported that the National Center for Medical Intelligence filed an intelligence brief with the Pentagon and White House in November 2019 on the emergence of a potentially “cataclysmic event” occurring in China. The Pentagon, however, denied the existence of that report. 

Even so, by early January it was clear that the situation in Wuhan, China, had the potential to become a global pandemic. In fact, timelines indicate that the virus had already arrived in the United States by Jan. 20, 2020. The United States declared a public health emergency and created the Coronavirus Task Force shortly thereafter. However, it wasn’t until late March when states started to declare lockdowns on their own. By then, masks, hand sanitizer, and PPE were in short supply across many parts of the country, hospitals and ICUs in some parts of the country were out of room for new patients, and meaningful federal interventions to offset shortages were few and far between. 

These delays in the early months of the coronavirus pandemic on the national level look similar to Pence’s delays in responding to the HIV outbreak in 2015 at the state level. That fact isn’t lost on residents of Austin and Scott County.

“I think he missed telltale signs prior—and then when the problem got big he acted on it,” Austin pastor Jacob Howell told The Guardian. “It’s easier to put a fire out when it’s smoldering. Once it becomes a blaze, it’s harder to control.”