The full quote suggests this is because he classifies Operation Warp Speed (reactive, targeted) as very different from the Office (wasteful, impossible to predict what you'll need, didn't work last time). I would classify this as a disagreement about means rather than ends.

One last question, Mr. President, because I know that your time is limited, and I appreciate your generosity. We have just reached the four-year anniversary of the COVID pandemic. One of your historic accomplishments was Operation Warp Speed. If we were to have another pandemic, would you take the same actions to manufacture and distribute a vaccine and get it in the arms of Americans as quickly as possible?

Trump: I did a phenomenal job. I appreciate the way you worded that question. So I have a very important Democrat friend, who probably votes for me, but I'm not 100% sure, because he's a serious Democrat, and he asked me about it. He said Operation Warp Speed was one of the greatest achievements in the history of government. What you did was incredible, the speed of it, and the, you know, it was supposed to take anywhere from five to 12 years, the whole thing. Not only that: the ventilators, the therapeutics, Regeneron and other things. I mean Regeneron was incredible. But therapeutics—everything. The overall—Operation Warp Speed, and you never talk about it. Democrats talk about it as if it’s the greatest achievement. So I don’t talk about it. I let others talk about it. 

You know, you have strong opinions both ways on the vaccines. It's interesting. The Democrats love the vaccine. The Democrats. Only reason I don’t take credit for it. The Republicans, in many cases, don’t, although many of them got it, I can tell you. It’s very interesting. Some of the ones who talk the most. I said, “Well, you didn’t have it did you?” Well, actually he did, but you know, et cetera. 

But Democrats think it’s an incredible, incredible achievement, and they wish they could take credit for it, and Republicans don’t. I don't bring it up. All I do is just, I do the right thing. And we've gotten actually a lot of credit for Operation Warp Speed. And the power and the speed was incredible. And don’t forget, when I said, nobody had any idea what this was. You know, we’re two and a half years, almost three years, nobody ever. Everybody thought of a pandemic as an ancient problem. No longer a modern problem, right? You know, you don't think of that? You hear about 1917 in Europe and all. You didn’t think that could happen. You learned if you could. But nobody saw that coming and we took over, and I’m not blaming the past administrations at all, because again, nobody saw it coming. But the cupboards were bare. 

We had no gowns, we had no masks. We had no goggles, we had no medicines. We had no ventilators. We had nothing. The cupboards were totally bare. And I energized the country like nobody’s ever energized our country. A lot of people give us credit for that. Unfortunately, they’re mostly Democrats that give me the credit.

Well, sir, would you do the same thing again to get vaccines in the arms of Americans as quickly as possible, if it happened again in the next four years?

Trump: Well, there are the variations of it. I mean, you know, we also learned when that first came out, nobody had any idea what this was, this was something that nobody heard of. At that time, they didn’t call it Covid. They called it various names. Somehow they settled on Covid. It was the China virus, various other names. 

But when this came along, nobody had any idea. All they knew was dust coming in from China. And there were bad things happening in China around Wuhan. You know, I predicted. I think you'd know this, but I was very strong on saying that this came from Wuhan. And it came from the Wuhan labs. And I said that from day one. Because I saw things that led me to believe that, very strongly led me to believe that. But I was right on that. A lot of people say that now that Trump really did get it right. A lot of people said, “Oh, it came from caves, or it came from other countries.” China was trying to convince people that it came from Italy and France, you know, first Italy, then France. I said, “No, it came from China, and it came from the Wuhan labs.” And that's where it ended up coming from. So you know, and I said that very early. I never said anything else actually. But I've been given a lot of credit for Operation Warp Speed. But most of that credit has come from Democrats. And I think a big portion of Republicans agree with it, too. But a lot of them don't want to say it. They don't want to talk about it.

So last follow-up: The Biden Administration created the Office of Pandemic Preparedness and Response Policy, a permanent office in the executive branch tasked with preparing for epidemics that have not yet emerged. You disbanded a similar office in 2018 that Obama had created. Would you disband Biden's office, too?

Trump: Well, he wants to spend a lot of money on something that you don't know if it's gonna be 100 years or 50 years or 25 years. And it's just a way of giving out pork. And, yeah, I probably would, because I think we've learned a lot and we can mobilize, you know, we can mobilize. A lot of the things that you do and a lot of the equipment that you buy is obsolete when you get hit with something. And as far as medicines, you know, these medicines are very different depending on what strains, depending on what type of flu or virus it may be. You know, things change so much. So, yeah, I think I would. It doesn't mean that we're not watching out for it all the time. But it's very hard to predict what's coming because there are a lot of variations of these pandemics. I mean, the variations are incredible, if you look at it. But we did a great job with the therapeutics. And, again, these therapeutics were specific to this, not for something else. So, no, I think it's just another—I think it sounds good politically, but I think it's a very expensive solution to something that won't work. You have to move quickly when you see it happening.

link

Trump is anti-tackling pandemics except insofar as it implies he did anything wrong

There are many examples of electorates changing their opinions and pretty quickly, so I don’t think polling today is really a very reliable indicator. For example, Republicans and Democrats basically traded places regarding the belief that leaders’ morality is important.

Yeah, I think there’s a big difference between how Republican voters feel about it and how their elites do. Romney is, uhh, not representative of most elite Republicans, so I’d be cautious there

I disagree that there is some clear ontological distinction a priori between "legitimate medical use" and 'abuse'/"stimulants wrecking his brain". I do think different brain types respond to Adderall differently, with some being aggravated (bad fit) and some being calmed down and focused ('real ADHD'), for instance. I am not an ADHD expert. But the idea that a doctor rubber-stamping a prescription is legitimate in kind from self-medication mostly strikes me as an invocation within social reality. Of course it helps to have professional guidance, often tremendously so, but they also screw things up too sometimes, and sometimes en masse e.g. with SSRIs. For someone like SBF, I could totally buy the hypothetical that he really benefitted from it and it also screwed up (or at least worsened pre-existing) decisionmaking processes. This is a contradiction in what sorts of beliefs we are allowed to hold both due to social norms and the structure of language, not a contradiction in the physical world where these drugs can have all sorts of positive and negative effects, where a real need for increased mental functionality could conceivably trade off against a simultaneous increase in the risk of making rash decisions. A genuinely concerned doctor could be on the lookout for that, but then if the user has the means they can just go to another doctor and get the drugs they want. Are people in severe pain addicted to painkillers?

I would only entertain the OP's hypothesis as being the main cause if SBF was taking stimulants since childhood up to college days, with the drugs having had a significant shaping effect on his personality. I think it's an interesting thing to explore further, but hard to disentangle correlation vs causation here. What seems more critical to me is the apparent sociopathic traits, but I am still quite confused about what exactly is going on with his neurodivergence. The Lewis book has been somewhat informative. He clearly does get some amount of addicted to certain types of fast-paced games with lots of uncertainty and evolving rules. I could certainly see stimulants increasing his addictivity and cognitive involvement in these decisionmaking 'games' at the cost of responsibility to factors outside the frame of his focus, but I'm not too sure as I could be typical-minding how dopaminergics influences different neurotypes.