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.
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
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.
In the US the search term 'n95' was gaining interest in the week of January 19, 2020.
Worldwide it was January 5th.
Personally, I finished preparing and stockpiling around Feb 25th, and I know this of others as well.
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.
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 ...
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 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.
"Obama team left pandemic playbook for Trump administration, officials confirm"
Here it is:
Page 9 explicitly names "Coronaviruses" as a Tier 1 concern.
The transition team had a tabletop wargames / exercises on a pandemic:
> 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.
It should be noted that pandemic preparation was started by Bush43:
Obama carried things forward during his eight years.
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 , 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.
And yet the government continues to expand in money, scope, and power at an incredible rate.
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.
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.
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.
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.
> A note that...
By that logic, I'll note that your link is to the CBPP, a left-wing think tank.
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.
“‘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.
"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."
“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.
They do have experience.
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.
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...
“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.
Can you source this? I would be absolutely shocked if any public health officials of note said that even acknowledging the virus was xenophobic.
“ 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.
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.
A month later a Republican Congressman was actively downplaying the advice of the CDC.
“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.“
It seems you’re similarly rewriting history in describing this event as “mid-pandemic”.
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.
I'd be forgiving on that as we've had several pandemic scares before that panned out to nothing in the US.
Even Republican officials told Americans to go out and dine.
March 15, 2020
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.
You wouldn't know it walking around the well-to-do section of the liberal city I live in.
Pandemics are complex, nature does what it wants, and blaming one politician for what everyone else was doing doesn’t help.
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.
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.
"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
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.
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'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.
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.
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.
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 second paragraph/claim is completely unfounded. It’s been a year, dude. Get a grip.
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.”
For now, we’re talking about the former and his advice during the pandemic.
I cant wait to read this one
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
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.
He was like a drug to both his supporters and detractors.
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.
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!")
> 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.
What Lewis is describing of the CDC policy is not requiring this.
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.
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.
Also Covid mortality scales exponentially with age, and US life expectancy is 5-6 years lower than say Spain or Italy.
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).
The USA is far more rural and less urban than Europe. We should have had a major advantage in this fight.
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.
That appears to be pretty true. The UK is roughly as urban as Arizona.
Maybe being rural is not as big an advantage as people assume.
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.
16% of UK citizens use mass transit daily or every few days.
Because the US is not uniquely bad. Those other large countries had severe failures.