I agree with Joe Biden’s plan for reopening America, published here in the New York Times:
Here’s what our national strategy should look like.
First, we have to get the number of new cases of the disease down significantly. That means social distancing has to continue and the people on the front lines have to get the supplies and equipment they need. President Trump needs to use his full powers under the Defense Production Act to fight the disease with every tool at our disposal. He needs to get the federal response organized and stop making excuses. For more Americans to go back to their jobs, the president needs to do better at his job.
Second, there needs to be widespread, easily available and prompt testing — and a contact tracing strategy that protects privacy. A recent report from Mr. Trump’s Department of Health and Human Services made clear that we are far from achieving this goal.
We should be running multiple times the number of diagnostic tests we’re performing right now. And we should be ready to scale up a second form of testing: rapid serology tests to tell who has already been infected with the coronavirus and has antibodies. This isn’t rocket science; it’s about investment and execution. We are now several months into this crisis, and still this administration has not squarely faced up to the “original sin†in its failed response — the failure to test.
Third, we have to make sure that our hospitals and health care system are ready for flare-ups of the disease that may occur when economic activity expands again. Reopening the right way will still not be completely safe. Public health officials will need to conduct effective disease surveillance. Hospitals need to have the staff and equipment necessary to handle any local outbreaks, and we need an improved federal system to get help to these places as needed.
Make no mistake: An effective plan to beat the virus is the ultimate answer to how we get our economy back on track. So we should stop thinking of the health and economic responses as separate. They are not.
Once we have taken these steps, we can begin to reopen more businesses and put more people back to work.
The devil, of course, will be in the details. I think that testing every American for SARS-CoV-2 not just once but multiple times, something Mr. Biden has also supported, would not produce results relative to its costs.
I think the Trump Administration has been far too slow in taking some of the measures at its disposal to speed this process along.
But treating this as a distinctive failure on Trump’s part is a step too far. It’s a failure of Trump’s but not just a failure of Trump’s. This isn’t a partisan issue. The U. S. failure to take the prospect of a pandemic seriously has taken place over the last four administrations at least. While it’s true that the Trump Administration did not restock the national stockpiles of ventilators, respirators, and so on, neither did the Obama Administration in which Mr. Biden served as vice president. Neither did the Bush Administration or the Clinton Administration.
And the one thing that needs to be acknowledged more than anything else is that a global pandemic has always been a risk of a globalized economy. Now it’s not just a risk but an issue.
It’s reasonable to ask how much time, money, and attention should be devote to low probability high impact events but it’s also reasonable to ask what that we have done instead would you be willing to do without to prepare for those low probability high impact events? You can argue about the advisability of spending money but that time and attention are not infinitely expandable resources is a fact which we need to acknowledge. Should we, for example, not have educated children, built roads, or treated the sick so that we could devote more resources of time and attention to preparing for a pandemic?
One caution on relying on “test and trace†as a main pillar to reopen the economy.
South Korea, Singapore and Japan which were seen as successes doing test and trace had to shutdown — the virus is too contagious with too many asymptomatic carriers. Only Taiwan / Hong Kong has really been able to “test and trace†successfully for 4 months.
Lowering the effective R through other measures such as masks, gloves, humidification, sanitization measures is likely a requirement to successfully doing test and trace.
Then there is the fact that a proper regulatory regime for “trace†does not exist either.
Agree that this problem is not solely due to Trump’s admin. That said, we do need to remember that under Obama we had a very poor, sad economy. It would have been difficult to afford stocking up for a pandemic with such a poor economy. However, the last 3 years under Trump have seen the best economy the US, probably the world, has ever seen. Not stocking up for a pandemic was a matter of choice and not the inability to pay.
But to be honest, I am getting a bit tired of looking back. Looking forward still sucks. I was up at 4 writing to me ICU and OR people explaining to them why we will need to use our existing PPE indefinitely. Whatever is said in the daily briefings, the reality is that the PPE, the tests, etc just aren’t showing up for the most part.* Those 6 weeks we lost to prepare are gone, but now we know what this disease is really like and what happens if we don’t take it seriously, NYC. Why aren’t we more actively doing stuff now? That is what is really killing me. While I worry more about the health care sector and am more aware of the inadequacies of our response, I hope that the planning of reopening the economy is not going as poorly. Last of all I am still waiting for the free market response to provide us all the stuff we need, but it isn’t happening.
* Almost anything that we could do locally we have done. We invented our own UV sterilizer and have modified and are starting a second version tomorrow. Local companies are making surgical masks. We have used our 3D printer and gotten other local companies to use theirs to make face shields.
Steve
You’re cutting them too much slack. It was a choice. There were hundreds, thousands of things they thought were more important and they didn’t feel hamstringed by the bad economy in doing them. They chose to spend money on filling potholes, saving GM, increasing teacher pay, expanding health care insurance coverage, and subsidizing solar companies rather than restocking the national stockpiles. They chose to join the civil war that ousted Moammar Qaddafi rather than restocking the national stockpiles.
The Trump Administration has made choices, too. They chose to cut individual income taxes rather than restocking the national stockpiles. They’ve had bigger priorities, too. Everybody has bigger priorities.
“Everybody has bigger priorities.”
That’s the problem with relying on government. No one should be surprised.
As for Joe – Imagine a perfect sphere, travelling through an ideal gas; ignore friction………
I imagine Joe as being vacuous.
Dave- Actually I was poking fun at Trump supporters. That said, I notice I am getting crickets on why there isn’t a better private sector, free market response. Where is it?
Steve
Private sector is waiting for public sector incentives.
Free Market response, since profiteering is ruled out, there isn’t one. However, should not stop us from spending a few years restocking supplies and many years paying for stock rotation, disbursement, etc. However, the creative class wants money, reparations to be paid, etc.
CuriousOnlooker, states have long traced and treated often for free, folks who have contagious disease (e.g TB, VD, Leprosy, Diphtheria, HIV, etc). Its all a question of having enough shoe leather and willingness to admit the federal role is to shovel baskets of money to state governments.
I haven’t researched it but I can offer some speculations. You may be using the wrong yardstick to measure results. You don’t measure the distance from here to Mars in inches.
The public sector has shut the private sector down. That will impede responses. Incentives, as has been mentioned. Regulations at local, state, and federal levels. Two other factors I would suggest are consolidation and supply chains, both of which will impede a quick response.
If you want an immediate response, the only recourse is the military. Neither the private sector nor the civilian public sector works that way.
I have never heard or read anything offered by a democrat that described Obama’s economy as “poor and sad,†at the same time referring to Trump’s economy as being “the best the world has ever seen.†For years now the economic failures by Obama have been downplayed or waved aside, while animal spirits enthusiasm, low unemployment numbers, stock market gains, small business optimism, return of some manufacturing without a “magic wand,†were met with a “no big deal†reaction.
Now, all of sudden, it benefits Democrat’s narrative to portray all the lapses, in having an instant response to this virus, are due to the current administration being slow and incompetent, in the midst of a “best†economy ever. Forget about the former administration having 8 years vs the current one having 3 years to replenish national stockpiles that were depleted on the previous administration’s watch.. Glide over the obstruction of CDC, FDA entrenched policies, making it difficult to bring private enterprise into the fray at the get go. Let’s not talk about how much mocking was done when borders were closed, or how some of the resistance lied about the administration’s refusal of WHO’s test kits – one of many claims proven to be false. Let’s not go into the mixed signals given by people like Pelosi or Cuomo, who were welcoming people to Chinese New Year events and refused to raise too many concerns about the virus’s virulence until March. Then there was the press who never even dug into virus questions until impeachment proceedings had run their course in February. Now they are ironically questioning and criticizing the WH for not being more on the stick.
There is so much blame that can be equally distributed around, as well as praise for some of the enterprising partnerships that have been quickly formed to address medical shortages and needs, as well as creative ways developed by individuals and hospital services, on the fly, to meet unexpected problems. As for the next hurdle of opening the economy up, without too many pitfalls and setbacks, this will only work out if the R & D part of people’s biases are temporarily put on hold.
Yeah, but if you want PPE now, you need a suitcase full of cash.
It’s out there, it just belongs to someone else. The right amount of Benjamins will change that.
People are partisan, you know. I repeatedly criticized the Obama Administration for taking its eye off the economic ball far too soon, turning its attention to other matters. And I was actually upset by Obama’s economic advisors assertions, as early as 2010, that the economy was “as good as it gets”. However, I don’t think the pre-outbreak economy was the “best ever”. I still don’t think that the cut in the individual income tax rate was prudent and I have been disappointed at the results of the cut in the corporate tax rate. We still needed more domestic business investment in the real economy which I think can only be achieved with much more targeted means.
Steve: Has there been any movement by your organization to get one of those PPE hydrogen peroxide monster cleaners that I mentioned in an earlier thread? Or are they on back-order with you behind much other organizations?
I very much doubt any public sector effort to manufacture tests and needed PPE would go any faster than private efforts. In fact as we have seen with the original COVID tests the CDC’s first batch was a failure which set back testing for weeks. The entrenched bureaucracy in addition to wanting everything run through them seems dead set on patented medicines and vaccines, both of which won’t be available until the horse that left the barn has died and been buried. I sort of agree with Dave that the military might be the better option to get this sort of thing done, but I’m from Missouri on that. It also didn’t help that China knew they were in deep s**t before they let anybody else know and sucked up all the PPE they could worldwide (plus make the majority of the stuff nowadays).
I’m seeing some very nasty articles about the horrific death rates in 24/7 nursing homes, just as you predicted. The fact that these folks were ground zero A+ candidates for lethal outcomes doesn’t help the tragedy. I also saw an article about a Texas physician which so far has kept his patients from taking the last trip so far. The headlines all scream ‘unproven’ ‘dangerous’ and other pejoratives, but considering the alternative, I can’t blame him or wanting him to try. Sorry your HCQ+ hasn’t seem to have worked out well.
Stay healthy, stay safe, and may this be over soon with a few more deaths as possible.
“The public sector has shut the private sector down. ”
Nonsense. If the pillow guy (Trump supporter) said he wants to build a factory that would be cranking out N 95s next month you think that wouldn’t happen? Federal, state and local officials would say no if someone wanted to build ventilators? Not happening. Not even remotely believable.
“I have never heard or read anything offered by a democrat that described Obama’s economy as “poor and sad,†at the same time referring to Trump’s economy as being “the best the world has ever seen.â€
Just paraphrasing Trump. “At the State of the Union Address on Tuesday, Trump said “our economy is the best it has ever been,”
If Obama had the weakest recovery ever and Trump has the best economy ever, Trump clearly had the ability if he chose to do something about it.
“Glide over the obstruction of CDC, FDA entrenched policies”
You know who is in charge of the FDA and CDC right? If you want to be president, lead. China released the genome on January 12. On January 16 Germany had a test. A good leader would have had results or had heads rolling. We just get excuses.
“Let’s not talk about how much mocking was done when borders were closed”
No evidence it helped. Sources of Covid were pretty much China and Europe. Trump’s half ass measure of not letting Chinese come here probably had a small effect. We probably would have gotten a larger effect if we had quarantined Americans coming back from China. That is wha the more successful countries did.
“Cuomo, who were welcoming people to Chinese New Year events and refused to raise too many concerns about the virus’s virulence until March”
Cuomo and DeBlasio made bad decisions for which they should be held accountable. Trump is our national leader and he persisted after they changed. Many states held off locking down until Trump finally recommended it.
“There is so much blame that can be equally distributed around”
No, it really cant. We should hold individuals responsible for their own decisions. However, being POTUS is special position as leader of the country not only in actions but in setting the tone. Trump minimized this well into March. What is even worse is that the effort now is pretty weak. There is little coordinated federal effort to address a lot of the problems and the private sector is not stepping up either.
Tars- We chose the UV route. There are 3 three (maybe more since I last read this) accepted methods to sterilize without too much damage to the mask. They hydrogen peroxide method, letting the masks dry for 5 days or UV. We are debuting our second generation UV device this week. They are looking to patent it.
My preference is that he private sector would actually make stuff. That is what they are good at. The public sector not so much. However, this is one situation where markets fail. They just arent going to do it so we need the public sector to either coerce someone or pay someone.
My gut feeling is that we will find that the HCQ cocktail will have a real, but small effect.
Steve
Steve: Then the UV sterilization route is one that your organization is taking is one that you originated? If so chalk up another proof of American innovative ability when needed. Hopefully you’ll be able to sterilize anything you need in time to prevent having to reuse much if any contaminated stuff.
I was not aware that the H2Ox route was so time-consuming. The articles I read on the subject did not mention that minor detail. Still the beast will be useful in the long run (if not rendered obsolete by your device).
The POTUS executive-ordered the Defense Production Act on 3/11/2020, which seems the route that Dave and you are suggesting we go to ramp up manufacture of needed items. Public authorizing/requiring private industry to produce according to need. Don’t know what else could be done. You know better than I do that manufacturing can’t switch over with a snap of the ringers. It didn’t help that GM didn’t produce per request and 3M found the masks they promised were held up by the Chinese who were snarfing up anything and everything PPE worldwide. You’re closer to the problem than I am so you have a better perspective on the shortfall and its various causes than I do.
India may be a good ‘test’ case of whether or not HCQ and its relative work prophylactically, considering malaria is endemic to the subcontinent and has been in widespread use there for decades. I certainly hope that it is, for their sake.
You are likely already aware of the mini-clot problem with red blood cells in the lungs that some doctors in the NYC area are trying to address on an emergency basis using blood thinners. First reported by the Chinese back in March. Unfortunately the article I read didn’t mention race or genetics, which might be important considering the propensity of the black community (and others with inherited hemoglobin diseases) to suffer from sickle-cell. I am not aware of any Chinese equivalent to sickle cell or thalassamia, however I know southern China suffers from malaria, so the local populace might have evolved their own defense against it, and with the mass movement of peoples since the fall of the Qing dynasty many with those genetics might have ended up in Wuhan.