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Michael Lewis' 'The Premonition' Is a Sweeping Indictment of the CDC (npr.org)
70 points by evanb 6 days ago | hide | past | favorite | 134 comments

About every country in the EU failed in the same way, and we don't have the CDC.

Containing a pandemic is a political matter and there was no winning move.

I compare it to the Year2000 effort : if somebody had taken proper precautionairy measures, we wouldn't have had a pandemic and this somebody would have been roasted over wasting everybody's money and sending the economy in a recession for nothing.

> Containing a pandemic is a political matter and there was no winning move.

How Taiwan’s COVID response became the world’s envy https://fortune.com/2020/10/31/taiwan-best-covid-response/

Culture Shock: Why New Zealand's Response to COVID-19 Worked https://www.medpagetoday.com/blogs/working-stiff/89867

Politics is often a no-win situation, but if we do not do what needs to be done we can't progress.

I was travelling in western and central Europe for a few weeks prior to a bit before the middle of February. Everything was 100% normal. I'm sure there would have been as little appetite for widespread shutdowns in Europe as there would have been in the US.

I'm pretty much as little a fan of Trump and his administration as many people are but the idea that widespread restrictions in mid-February in western democracies was remotely an option on the table is delusional.

Yet we had the early outbreak in Italy. The Netherlands went into lockdown on March 7th IIRC.

Early-ish February is not early March. The event I was at in the first week in March I literally did a flight change to go home rather than attend a next week event. That's a lot different from assuming there would have been a widespread shutdown in Feb.

Looking at Google Trends for n95 is interesting.

In the US the search term 'n95' was gaining interest in the week of January 19, 2020. https://trends.google.com/trends/explore?date=2019-12-01%202...

Worldwide it was January 5th. https://trends.google.com/trends/explore?date=2019-12-01%202...

Oh, I don't disagree. But there was a world of difference in just about 3 weeks.

Personally, I finished preparing and stockpiling around Feb 25th, and I know this of others as well.

Absolutely. I admit I was in the "This seems a bit excessive crowd" when my next small-ish event was canceled in early March. And I vaguely thought of taking advantage of existing reservation to do some skiing and maybe run into some folks informally.

By the time I got home, grocery stores were packed but in pre-shortage times. (Honestly, I'm pretty well-stocked at home even in normal circumstances anyway.)

I already had everything at home from a work perspective as I'm normally remote. But a lot of people I know took months to repatriate their office stuff home.

We (the EU) have of course a CDC: https://www.ecdc.europa.eu/en

...don't have the CDC. The post is highlighting the failures of the US Centers for Disease Control. GP is showing that other countries failed in similar ways, despite not having the same organization.

I am certain the GP comment means "The EU does not have the [politically corrupted] United States CDC."

Which is not the CDC relevant here. (and ECDC is pretty much irrelevant in general, since each country has its own health authorities that matter way more)

The problem with this thesis that the CDC has been "politicized" is that the level of precaution merited in the face of a novel virus is very much a question of policy, not science. All science can do is illuminate certain imperfect information. And as we saw at the beginning of the COVID-19 pandemic, different people interpret those data in very different ways, and with an eye toward different priorities. Always taking the most precautious position in matters of public health is not a scientific position. It's a very expensive policy position that needs to be weighed against other priorities.

Personally, I consider that politicians should be overt about this.

For example "The science is telling us that schools are a principle path of transmission for flu-like diseases, but we want to keep schools open to keep people in work and maintain our economic system". Rather than pretending that it was a big surprise that schools were a principle route of transmission, as one example.

Of course people will vote for politicians who do insane things as long as those politicians don't tell people about it, or manipulate the news cycle to hide their idiocy, so ...

Something to note:

Before the CDC said that kids were a concern about spread earlier this year. The Chicago Mayor (Lightfoot) was trying to force kids back into school again. She tried fighting with the Chicago Teachers Union to do this. (Lied about mitigations in schools, the city doctor "magically announced it's safe in schools", etc)

There was the Chicago Public Schools head literally posting a thing that "a kid in the school said baseball games are much better in person than on the tv" and she used it for justification to support inschool teaching.



This is the elected officials.

The CDC has always been politicized. This was obvious even back in the 80s with the AIDS crisis.

The idea that any powerful government agency can even be non-political is very naive.

> The idea that any powerful government agency can even be non-political is very naive.

The US military appears to be quite non-political actually. And quite well functioning too.

Other then all the issues about integration and equity, and all the pork involved in military procurement.

> The problem with this thesis that the CDC has been "politicized" is that the level of precaution merited in the face of a novel virus is very much a question of policy, not science.

"Obama team left pandemic playbook for Trump administration, officials confirm"

* https://www.pbs.org/newshour/nation/obama-team-left-pandemic...

Here it is:

* https://assets.documentcloud.org/documents/6819268/Pandemic-...

Page 9 explicitly names "Coronaviruses" as a Tier 1 concern.

The transition team had a tabletop wargames / exercises on a pandemic:

* https://www.politico.com/news/2020/03/16/trump-inauguration-...

See also:

> The Trump administration cut staff by more than two-thirds at a key U.S. public health agency operating inside China, as part of a larger rollback of U.S.-funded health and science experts on the ground there leading up to the coronavirus outbreak, Reuters has learned.

> Most of the reductions were made at the Beijing office of the U.S. Centers for Disease Control and Prevention (CDC) and occurred over the past two years, according to public CDC documents viewed by Reuters and interviews with four people familiar with the drawdown.

* https://www.reuters.com/article/us-health-coronavirus-china-...

It should be noted that pandemic preparation was started by Bush43:

* https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1283304/

Obama carried things forward during his eight years.

I'm an epidemiologist, though not an infectious disease (ID) epidemiologist. I'm nowhere near the top of my field, and still fairly young, but I have good credentials and some idea of what I'm talking about (everyone is trained in ID epi in graduate school, regardless of what you go on to specialize in).

I don't have much to contribute here except to say that where I was once very proud of my profession and American public health more generally, the pandemic has left me deeply embarrassed, so much so that I often wish these days I had something else to say when people ask me what I do for a living. The stuff Lewis (who I don't particularly love, by the way) talks about is barely scratching the surface on how bad things are behind the curtain in US public health.

There are huge structural factors that are "not our fault" (e.g. the 70-year project to gut "government" at all levels in this country), but there are others that very much are, from scientific rigor to public communication to what happens when normally pretty powerless people are suddenly given some power, and what they do with it.

HN readers will not like to read this, and I fully expect plenty of downvotes on this burner account, but the fact that a man like Anthony Fauci was (a) chosen to be our Covid guardian angel and intelligent-technocrat foil to Donald Trump at all after his abhorrent behavior during the AIDS crisis in the 80s [1], and (b) allowed to remain in this position throughout the past year, as hundreds and hundreds of thousands of Americans have died of Covid, is ghastly. Even if the deaths are "not his fault" somehow, or that he's been trying his best in a bad system -- I'm sorry, but the buck stops at the top. If you're presiding over a disaster of this scale, you need to be replaced.

That a country like Vietnam - poor and rural - could embarrass the US in handling this is deeply sad.

[1] https://www.huffpost.com/entry/whitewashing-aids-history_b_4...

> e.g. the 70-year project to gut "government" at all levels in this country

And yet the government continues to expand in money, scope, and power at an incredible rate.

When I put government in scare-quotes, I was alluding to - quoting! - what this country's hard-right has always actually meant when they've used the word for said 70 years: they mean services! Human services, social services, the safety net, welfare assistance, and above all any shred of help for the poor, the uneducated, or the disabled.

Every American knows what the word means in the context of the project I'm talking about.

The expansion you're talking about is true, of course. It's just true of, say, the Pentagon, or the "intelligence community", or subsidies to [insert rapacious economic interest groups], or bailing out Wall Street, or the airlines, or the car companies, etc.

Here's what the history looks like over 50 years from 1962 to 2011, so not quite 70 years and a little out of date, but today's numbers would hurt your case even more: https://www.npr.org/sections/money/2012/05/14/152671813/50-y...

In the early 60s military spending was half the federal budget, today it is around 16%.

Social security was 13% of the budget in 1962, today it is 23%. Medicare did't exist in 1962, today it is 17% of the budget. Medicaid didn't exist in 1962, today it is 9% of the budget. Other safety net programs that did not exist in 1962 include CHIP, the ACA, the Earned Income Tax Credit, and the Child Tax Credit.

If there is a 70-year project to gut government it has been a massive failure, government spending has grown at the same rate as the economy. 70 years ago, the majority of the federal budget was military spending. About half the budget today is Social Security, Medicare, and Medicaid, without taking into account the dozens of other social service programs.

> The expansion you're talking about is true, of course. It's just true of, say, ...

It's also true of the welfare state, contrary to what you're dishonestly insinuating.

> any shred of help for the poor, the uneducated, or the disabled

You're dishonestly implying that government programs are the only form of aid, whereas the empirical evidence shows that private charity is much more cost effective.




Just to provide an alternate 100% contradictory source to your claims: https://www.cbpp.org/research/romneys-charge-that-most-feder...

A note that one of the cited papers is from the "The Journal of Libertarian Studies" and the third link is to a blog on the Cato Institute's website.

Can you explain why you think this is a "100% contradictory source to my claims"?

> A note that...

By that logic, I'll note that your link is to the CBPP, a left-wing think tank.

That's false, or at least a major distortion. Social Security is about $1T, Medicare+Medicaid is about $1T, Defense is about $0.7T. (FY 2019).

The money IS going toward health, services, etc. It's just not widely reported that way because talking about the cost of these things is not popular.


I can't upvote this enough. We HAD a plan, both Bush and Obama put together pandemic response plans. We had serious issues in logistics and deployment for sure. We had some screw-ups in early testing for sure. Maybe we should grant some margin for error when there's a lot of uncertainty early on, but after about March or so, the errors are on pure government failure. The CDC isn't solely responsible here, but it has been an embarrassment given the skills it should have had and claimed to have.

Can you be specific to what you are referring to? I’m not sure what’s the point?

“‘Listen, we need to be aggressive early on this,’” Biden announced, according to Brennan.

The next week, Biden made good on his pledge — and set off a deluge of criticism. In an interview on NBC’s “Today,” Biden said he wouldn’t advise his family to fly on planes or ride the subway.

I am specifically saying that the pandemic plan you say was in place prior to Trump would not have been effective with COVID, as evidenced by the statements of those who implemented that plan before.

"It is purely a fortuity that this isn’t one of the great mass casualty events in American history,” Ron Klain, who was Biden’s chief of staff at the time, said of H1N1 in 2019. “It had nothing to do with us doing anything right. It just had to do with luck."

A couple other perhaps more useful quotes from the same article:

“Despite Trump’s assertions, few close observers of Obama’s and Biden’s response to H1N1 consider it a “full scale disaster.” And Biden, despite his early messaging problems, played a role in mobilizing the administration and ensuring enough resources were devoted to defeating the pandemic.”

And just some of the “lessons learned” section:

“ To keep Ebola from spreading further beyond Africa, the administration, which already had dispatched 3,000 troops to West Africa to help contain the spread, had to send public health workers to the affected countries via commercial airlines. This would not be dangerous unless a person was exposed to the blood or other bodily fluids of an Ebola victim. But pilots, passengers, airport workers and others in American cities from which the workers came and went had to be put at ease about the possible spread of the contagion.”

“Fauci was dispatched to cable news shows. Employing another lesson of the H1N1 days, Klain recruited the CDC's Frieden to join him in briefings to add medical credibility to the administration’s assertions.”

2009 may have been luck. They learned things, put together a plan, that plan was trashed by the new administration.

Perhaps not. How many times must someone lie to you before you stop believing them? And worse, shilling for them?

That’s a pretty disingenuous link. The Bush administration did have a plan for Flu and was thinking about the issue. In 2015 (your article recounts stories of H1N1 in 2009) the Obama administration established NSC level officials responsible for pandemic work, Trump disbanded it in 2018. Nobody knows whether those plans would have worked, but A plan is better than NO plan every time. Even so, president “inject detergent”, “liberate America”or whatever, may have screwed it all up. But no, it is not rewriting history to say there were plans that might have helped if implemented. We’ll never know due to institutional failure in part encouraged by the last administration.



> That a country like Vietnam - poor and rural - could embarrass the US

They do have experience.

They do, but they learned from it. What probability would you give to the US learning anything from this crisis? Personally I would say between zero and snowball's chance in hell.

We keep rewriting history when we evaluate the decisions of the previous administration regarding their response. Thankfully there is the internet. I remember a Mayor who told us to go celebrate on the streets mid pandemic and many other health officials who claimed that acknowledging the virus was xenophobic.


And I remember a president who downplayed it and called it a hoax, I remember a governor who encouraged people to go out to eat after we knew better, what's your point? Also, your article does not at all support your claim of "health officials who claimed that acknowledging the virus was xenophobic".

Here is what the article actually said, which, as it turns out, was extremely precedent in light of anti-Asian-American violence that we have seen.

> “While it is understandable for some New Yorkers to be concerned about the novel coronavirus situation, we cannot stand for racist and stigmatizing rhetoric, or for myths and half-truths about the virus. The best precaution you can take is to practice what you would during any flu season: Wash your hands, cover your mouth and nose when you cough or sneeze, and please stay home if you’re feeling unwell. The Health Department is committed to separating the facts from fear, and we encourage all New Yorkers to do the same.”

> Dr. Henry Chen, president of SOMOS, said although risks of infection in New York remains low, he is gravely concerned by the increased xenophobia against the Asian American population, specifically the Chinese community.

>And I remember a president who downplayed it and called it a hoax

Trump called the Democratic criticism of the administration's response to COVID19 a "hoax", not the virus itself. https://www.politifact.com/article/2020/oct/08/ask-politifac...

Yes, on Feb 28…Trump did not realize the true danger of the Coronavirus.


“The basis for the claim is a comment President Donald Trump made at a rally in South Carolina on Feb. 28, when he was complaining about Democrats’ attacks on him and his administration.

Here’s what Trump said:”

"Now the Democrats are politicizing the coronavirus, you know that right? Coronavirus, they’re politicizing it. We did one of the great jobs. You say, ‘How’s President Trump doing?’ They go, ‘Oh, not good, not good.’ They have no clue. They don’t have any clue. They can’t even count their votes in Iowa. They can’t even count. No, they can’t. They can’t count their votes.

> and many other health officials who claimed that acknowledging the virus was xenophobic.

Can you source this? I would be absolutely shocked if any public health officials of note said that even acknowledging the virus was xenophobic.

You mention these memories in the context of having the internet available so we don't forget. And yet you don't provide any links to the source material you post?

To which quote are you referring?

“ When people play off stereotypes, it distracts from the real risks and can lead to misperception and misinformation about the source of the virus. We are grateful to stand with the mayor, city elected officials and community leaders to ensure we eliminate any stigma with the virus, continue public outreach efforts, and educate the public of the real risks,” Chen said.

“While it is understandable for some New Yorkers to be concerned about the novel coronavirus situation, we cannot stand for racist and stigmatizing rhetoric, or for myths and half-truths about the virus. The best precaution you can take is to practice what you would during any flu season: Wash your hands, cover your mouth and nose when you cough or sneeze, and please stay home if you’re feeling unwell. The Health Department is committed to separating the facts from fear, and we encourage all New Yorkers to do the same.”

This basically turned into “it’s just the flu, if you think it is more, you are playing into the racism rhetoric”.

Look, I don’t care which side of the country was right, but ignoring the mistakes we made feels like we are setting ourselves up for falling for the same traps.

We had no government warnings in the middle of February so perhaps the Asian community was feeling attacked? Someone in the government knew the real danger but most were never warned

A month later a Republican Congressman was actively downplaying the advice of the CDC.

March 15

“Representative Devin Nunes, a California Republican, on Sunday encouraged healthy people to dine out at restaurants, contradicting public health advisories that strongly encouraged social distancing and discouraged Americans from attending mass gatherings.“

This article is dated February 14th. The US had only declared an emergency two weeks earlier on January 31st. At the time, there had only been a handful of deaths and passengers had not yet disembarked the Diamond Princess.

It seems you’re similarly rewriting history in describing this event as “mid-pandemic”.

much of what people remember was actually referring to the Muslim ban that happened at the same time.


And you are correct, people from both parties played down the virus well into March. Mardi Gras wasn’t canceled at the end of February.

These people simply didn’t know how dangerous the Coronavirus was.

> These people simply didn’t know how dangerous the Coronavirus was.

I'd be forgiving on that as we've had several pandemic scares before that panned out to nothing in the US.

Many public officials did not know the seriousness of the Coronavirus.

Even Republican officials told Americans to go out and dine.


March 15, 2020

“Representative Devin Nunes, a California Republican, on Sunday encouraged healthy people to dine out at restaurants, contradicting public health advisories that strongly encouraged social distancing and discouraged Americans from attending mass gatherings.“

By March 7-15, cautious companies etc. were widely shutting things down. A month earlier basically nothing was happening anywhere in the West.

What I remember of it was calling it the "china flu" was racist/xenophobic. Now, however, it's fine to call it the Brazilian Strain or the UK Strain or the South African Strain. None of any of this makes logical sense to me, tbh, beyond tribalism.

That link you posted is an example of the rewriting of history, because those policies were "forged under Obama" which the blaming of Trump for them, conveniently neglects to mention. Same for the cages, war mongering, and divisiveness in our society today.


Which health officials claimed acknowledging the virus was xenophobic? And it turns out celebrating in the streets is basically completely safe.

> And it turns out celebrating in the streets is basically completely safe.

You wouldn't know it walking around the well-to-do section of the liberal city I live in.

I live in NYC and the streets and parks have been packed every nice day since last May.

That’s a politician, not a health official.

Read the full article for the quote by Dr. Henry Chen.

He works for a private health care network. He’s not a health official.

True, perhaps it was just that Democrat Mayor who used the word of a doctor to add validity to his assessment and criticize the response of the previous administration.

Ok so to be clear, your best evidence of “many other health officials who claimed that acknowledging the virus was xenophobic” is a mayor citing comments made by a privately employed MD?

I was excited to come across this today on Audible and held off buying it for these same reasons. Several points in that description - politicized for the masses - were right then wrong then right again, and blamed based on voting patterns.

Pandemics are complex, nature does what it wants, and blaming one politician for what everyone else was doing doesn’t help.

Given you are talking about evidence vs memory, you should probably cite... anything you’re claiming here.

I added the link to my comment. Just Google it, there dozens of better sources.

Nobody said acknowledging the virus was xenophobic, the problem was assuming that all east-Asian-looking people might have the virus and therefore you should avoid Chinatown.

Also one of Trump's first acts in office was to institute a pointless Muslim travel ban, so people can be forgiven if they thought this China ban was leveraging a convenient excuse to ban another group of ethnicities he didn't like.

I think the NPR using this headline is actively malicious. It's clickbait because it enrages both the people who believe the CDC hasn't done nearly enough (and Lewis is in that camp), and those that think the CDC has done way too much for a fabricated overly-exaggerated virus.

Those who think the CDC has done way too much because the virus was overly-exaggerated are simply wrong. I have my quibbles with the CDC, especially early reactions and subsequent messaging. I don't think people who say it exaggerated the threat have any evidence in their column. For data, I'd say look around, see India, see 500,000+ dead Americans, and the latter in the context of at least some efforts to contain the virus.

The headline is fine, those who are enraged at the CDC probably should be, it failed us in so many ways, though probably gets a little too much of the blame. Those who are enraged because it did too much? Those people don't deserve consideration at this stage given the fairly obvious science.

Perhaps the CDC did too much that was ineffective or counterproductive and too little that was effective. It's possible for both sides to be right, and not terribly far-fetched, honestly.

In 2020 more US Americans have died of Covid than Malaria globally. It sounds absurd.


Nancy Messonnier put out a warning at the end of February 2020. This must be what Michael Lewis was referring to when he said they denied then said it was too late.

"It's not so much a question of if this will happen anymore but rather more a question of exactly when this will happen and how many people in this country will have severe illness," Dr. Nancy Messonnier, the head of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention, said during a media briefing Tuesday

I'm extremely unsurprised about this. Even with the current administration, they're not doing much to stop the spread. Right now it's all about trying to get people to accept shots (fair.. but you still have other things about the pandemic to account for) If you consider the spread of new variants and where the numbers are: They're not dropping, they're pretty high. (Illinois is still at high 2k-low 3k new cases a day and is staying steady)

They've refused to accept the other nation's work for citizen certified stronger masks. They're still in the "wear a t-shirt" as a mask days. In fact they've tried to enhance that with double masking. (Note: Their statement is that that involves laying a cloth mask over a surgeon mask and that is only how they make that recommendation) The media took that statement and has modified that to double mask always. I've sent the CDC examples of articles where their message has been changed, I've gotten back nothing but form responses about "wear a mask".

Additionally, they've outright ignored findings from other nations about the spread patterns found in restaurants (In Korea it was identified to have traveled 18m in a restaurant), the asymptomatic spread in kids, ignoring long COVID, and spread in long haul flights. Instead they let things run rampant.

Many health organizations even force you to downgrade your mask for their weak surgeon mask to be seen by them.

On masks:

Korea has the KF94

China has the KN95s (however, those certs on those have been faked)

Europe has the FFP2 standard (Germany did the right thing and require it)

For the numbers on effectiveness see Aaron Collin's work: https://www.youtube.com/channel/UC3fF_rzkmZD0ufN685YE7lg

I've read most of Lewis' books. I like his style and he does a pretty good job at explaining the problem. Usually he does it as a hero's journey that makes the story interesting. He also picks a villain. I have not read this book but the CDC seems to be the bad guy here. If not bad, incompetent.

I'm no fan of big governmental agencies but I hate it when so many outstanding members of an organization get painted with a thick brush of incompetents'.

I have no doubt that the agency will go through a period of reform and in a few years it will be billed as the best CDC ever. But at any time bad leadership can taint its abilities.

The failure was really a failure of leadership. Incompetent people were picked to lead the agency. I think we need to keep in mind that leaders matter and we have to make sure that the best ones are selected and not be swayed by politics.

I keep thinking about ways that healthcare professionals and authorities undermined their own credibility from the very beginning

Saying “ah young people are affected” but “young” meaning people in their 50s means that all of society is going to stop listening. The one time that their job was to inform the public but they stuck with industry specific colloquialisms. People wanted to know if it would debilitate “young people” like the 1918 flu.

Just one example of the messaging being wrong and losing crucial support.

here's an interview w/lewis from 60 minutes yesterday (5/2/21): https://www.cbsnews.com/video/michael-lewis-premonition-covi...

In spite of its mistakes, the CDC has still been one of our best sources of guidance throughout the pandemic. Many of our politicians, media personalities, and social media platforms have failed miserably in comparison.

I’m all in favor of constructive criticism that can lead to improvement, but I suspect this book may do more harm than good. Lewis has a history of taking a narrow point of view and inappropriately extrapolating it in a way that evokes strong feelings of misguided righteous indignation. A prime example of this was Flash Boys, which demonized an entire segment of the financial industry that significantly enhances our economy. I still encounter repeated echos of his sensationalized misperceptions coming from intelligent people on HN and elsewhere. I hope we don’t see a repeat with the CDC.

How about Fauci stating in March that masks are not necessary, for what was clearly a respiratory virus...


What about it? Uncertainty around transmission rates/methods, uncertainty around being able to equip medical professionals, and uncertainty that the public would not touch their face/consistently wash hands and mask/wear it effectively are all significant pieces of context for that statement.

But that's not what he said is it? He didn't say, "Masks are important, but right now we need to save them for our frontline workers, so please, stay home, let us get this under control and stock our healthcare system appropriately, and then get your mask. Don't hoard masks like toilet paper. It will harm our society."

No, he said masks aren't helpful. He lied to manipulate people. He caused people to mistrust the system because he isn't trustworthy.

Your first paragraph pseudo-quote is almost precisely what he said: https://www.newsweek.com/fact-check-did-dr-fauci-say-no-mask...

Your second paragraph/claim is completely unfounded. It’s been a year, dude. Get a grip.

I saw and heard him say it, so linking to an article that says he didn't won't work. Saying "Get a grip." is just the kind of condescension that ruins your credibility. You don't have facts to back up your claims, just insults and disrespect.

Dr. Fauci exactly said, “There’s no reason to be walking around with a mask. When you’re in the middle of an outbreak, wearing a mask might make people feel a little bit better and it might even block a droplet, but it’s not providing the perfect protection that people think that it is. And, often, there are unintended consequences — people keep fiddling with the mask and they keep touching their face.”

Should we give your long list of uncertainties to Trump as well? Or only to Fauci? And BTW, he was saying this as Italian hospitals were overwhelmed by a new respiratory virus.

I’ll attribute the uncertainties chalked up to a lack of evidence as stated by a doctor to the doctor, and the uncertainties based on a fragile ego and willful ignorance to the doubly impeached former president.

For now, we’re talking about the former and his advice during the pandemic.

And for some reason people are dead-set on dropping conventional wisdom despite in most countries the experts having disastrously failed.

Play the audio. Michael Lewis is interviewed.

Michael Lewis takes the most obtuse and dry topics and sensationalizes them to be very digestible exciting stories

I cant wait to read this one

But finds/creates Mary Sue heroes in every book and casts everyone that ever gets in her way as a cackling villain or blithering idiot. It’s entertaining but it isn’t how the world actually works.

Yes, he does that and it makes for good stories by following story telling tropes

Definitely not useful for introspection or a dissertation on an industry, but it does provide some insight to learn more about the current state of the world and how it got there on topics that might otherwise be too uninteresting

It just seems like a pretty shitty thing to do when the people you’re caricaturing are real and you’re selling your books as non-fiction.

I see, I never thought too hard about it and wasn’t bothered by it

Its obvious that in his first book - Liars Poker - that its shitty to dunk on everyone in investment banking that doesn’t work in new york city front office. I know people that think that way and I know plenty of people that dont. So from there I can just enjoy the story.

The headline seems at odds with this line from the body of the article: "But by 2020, the Trump administration had disbanded the pandemic response unit and these doctors were forced to go rogue."

I was waiting for past examples of politicization of the CDC, but nothing really concrete was given. I do remember us dealing with a SARS variant during Obama’s admin, and that was seemingly handled scientifically. To hand-wave away the Trump admins effect on several government offices as just “missing the bigger picture” needs some proof, imo.

I'm old enough to remember Trump's COVID response being met with calls of racism and xenophobia.... no thanks on this whitewashing of history.

Oh please. The only thing that you could pretend was "met with calls of racism and xenophobia" was closing the boarder to China, which was done in such an egregiously non-closing way (basically only barring Chinese nationals, while allowing tens of thousands of others to come from China every day) that it may as well not have happened. He then did barely anything else for a month except state that the US had nothing to worry about.

For all the people downvoting you, yes it's a bit obtuse to deny that his opponents (I'm very ambivalent about him, leaning towards distaste) didn't use any and every opportunity to call him a racist/xenophobe/authoritarian/etc.

He was like a drug to both his supporters and detractors.

Was Michael Lewis personally calling Trump's response racist and xenophobic? If not, then what does that have to do with what Michael Lewis has to say now?

I'm sorry, what policy are you talking about, exactly?

I'm having a hard time remembering Trump supporting any Covid restrictions whatsoever. He did not, for example, stop air travel from China or Italy at any point. And he was famously against extending Covid testing.

There's a trick to fixing the CDC. By forcing all their work to move to public git repos, you will dramatically accelerate collaboration, decentralization, and trust; the 3 biggest things the CDC's has failed hard on during the pandemic.


Get ready for five levels of prepush approval signoffs after the first time the media discovers an embarrassing line in some internal document.

Government agencies are structured in a manner which avoids attribution and accountability, the antithesis of revision control. If forced to implement Git, the agency would do so in a manner that would render it useless.

I'm not convinced that perfect transparency is a general fix. People will be more reserved when communications move onto a more transparent medium, and the real decisions will be discussed and made somewhere else.

Classic let's solve the problem by creating a database.

Needs an XKCD link!

Government agencies hate him!

> But according to Lewis and his sources, then-CDC Director Robert Redfield refused to test them, saying it would amount to doing research on imprisoned persons.

NPR doesn't understand informed consent? I'm shocked.

The CDC could have offered testing, and perhaps it did. But forcing people to undergo a medical procedure — yes, a test is a medical procedure, and a particularly invasive one since it involves giving up personal information — to avail themselves of the right to come home is unconscionable.

(ETA, because I thought of a way this could be uncharitably misinterpreted: Enforced quarantine for those who do not test would have been, while heavy-handed at the time, nevertheless morally and ethically acceptable. But I promise you the headline would have been "Xenophobic Trump puts more people in cages!")

There may be some nuance I'm missing, but in fact the US currently has this requirement.

> Effective January 26, the Centers for Disease Control and Prevention (CDC) will require all air passengers two years of age and over entering the United States (including U.S. citizens and Legal Permanent Residents) to present a negative COVID-19 test, taken within three (3) calendar days of departure , or proof of recovery from the virus within the last 90 days.

There are exemptions for emergencies and such, but otherwise it seems entirely possible to require people to get a negative COVID test.


There is a thriving business in counterfeit negative COVID-19 test results. At this point for international travel they're largely just pointless pandemic theater. Just like the useless and inaccurate contact free temperature sensors.

Yeah I don't get this. There have been medical requirements to travel to and from some international destinations for decades. I can understand why you may or may not be in favor of that for Covid - but it is completely within legal (and I'd say ethical) ground to do mandatory test, require vaccinations, require quarantines, etc.

Theres nothing stopping the border from creating this restriction for entry. It's an emergency situation, and there are other medical requirements for entry into the US.

I don't really get your point. To travel to the US now (or at least recently) from various countries you are expected to be tested and quarantine. Sure - we don't imprison you but it is technically required.

What Lewis is describing of the CDC policy is not requiring this.

No, that would not have been the headline, and even if it were, when did a bad headline ever stop Trump from doing something?

One missing question in this is, if the US was so bad, why is the death rate in the US inline with other large countries?

Virtually all the large developed countries are 160/100K deaths/capita +-25%.

Source: https://coronavirus.jhu.edu/data/mortality (make sure to look at the full table, not the small chart on top).

Any analysis of the US response must also look at other countries, and compare.

Yes Canada just surpassed the USA cases per capita (in Alberta). I think personally it is incorrect to attribute case numbers to political leanings or even figureheads. How can we argue that one candidate is more "science" than the other? Where is the experimental control group or null hypothesis? Is it unethical to have a placebo group here? I would argue weakly, yes. But there is actually a group who didn't want to lock down at all! And the opposite group who will refuse to allow them to even be a control group.

When I look at the link you provided, my conclusion is that US among the worst in deaths/capita, and about an order of magnitude above the median...

But to your parent's point, the US outcome was comparable to other countries we'd consider peers, like the UK and France. I feel like this point, that other similar countries did poorly, is sometimes missed when talking about the US response.

The list puts the US at 1.8%. The minimum I’ve found is 0.2%. Most countries seem to hover around 1-2%. There are countries with 9+%. How did you come to your conclusion?

You're looking at the case-fatality ratio, your parent is looking at the deaths per 100k population.

Looking at these two numbers suggests to me that while the US did very well at treating cases, we allowed far too many people to become infected.

I agree with your assessment.

Also Covid mortality scales exponentially with age, and US life expectancy is 5-6 years lower than say Spain or Italy.

They're looking at the deaths per capita, not the case-fatality ratio.

Look at the full table, not the small chart on top.

Australia had about 1/4 of that. Granted it’s an island but I don’t think illegal entry into the United States was a big factor. They locked down the borders and we never did.

FWIW seasonality, geography, and travel patterns seems to have played a large part in how long a country had to decide before enacting measures that would make a difference.

It would seem that any country that was in summer during the spread had the advantage to stomp out virus when the trend was low (and in the case of the islands - shut down all travel).

When large chunks of UK use the London Subway system (or other mass transportation), while the USA is filled with people in personal cars... you have to wonder why you want to compare ourselves to our European allies.

The USA is far more rural and less urban than Europe. We should have had a major advantage in this fight.

Our population concentration is similar. New York by itself host as much people as London while being much smaller.


UK has 66-million people with 128k COVID19 deaths, or 0.2% of its population.

North Dakota has 762k people with 1.5k COVID19 deaths, or 0.2% of its population.

Except... I bet you that North Dakota is far more rural than UK on the average. North Dakota was supposed to have huge COVID19 advantages: its extremely rural. Its got a very car-centered independent culture. For North Dakota to have similar death rates as European centers (or urban US centers, like NYC), is a failure upon North Dakota. It squandered its advantage.

>I bet you that North Dakota is far more rural than UK on the average.

That appears to be pretty true. The UK is roughly as urban as Arizona.

Interestingly Arizona is also 0.2%.

Maybe being rural is not as big an advantage as people assume.

Using vaccine hesitancy and mask wearing behaviors as proxies for how many preventative measures were adopted regionally, it looks to me like being rural is helpful but also higher risk behaviors more likely. IE, being spread out helps, but people who live there don't take as many precautions.

New Mexico (which is Rural but liberal: with extremely high uptakes in COVID19 Vaccine) is also at 0.2% death rate.


Its very possible that the % is set in stone due to human nature.

My mom was VERY lax about COVID19 restrictions until someone close to her died in January 2021 (pretty late into the pandemic).

Once those stories of people "inside your social circle" start dying, then you start realizing its a serious threat.


Rural folk may have advantages, but they won't change their behavior until someone close to them dies (which might be this 0.2% death rate, roughly one-in-500 people). It is said that the typical person's direct social circle (people in your family + you work with + studied with + your church group) extends to ~500 people or so.

Since the "size of people's social circle" is roughly constant no matter where you live (be it in a city or rural area), the 0.2% rate before "average person notices" is constant.

That's 0.2% of all people dying. Sometimes its necessary to emphasize what the "denominator" of this fraction is... this fraction is surprisingly consistent across many areas.

Just looked it up.

16% of UK citizens use mass transit daily or every few days.

> if the US was so bad, why is the death rate in the US inline with other large countries?

Because the US is not uniquely bad. Those other large countries had severe failures.

I think people have higher expectations for the US. I certainly do.

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