The editors of the Washington Post remark on an after action report of sorts on the federal government’s handling of the COVID-19 pandemic:
Looking back at the U.S. response to the pandemic, many setbacks and mistakes are well-known. But a closer examination by a team of seasoned experts has brought to the surface a profoundly unsettling conclusion. The United States, once the paragon of can-do pragmatism, of successful moon shots and biomedical breakthroughs, fell down on the job in confronting the crisis. The pandemic, the experts say, revealed “a collective national incompetence in government.â€
This warning comes through over and over again in “Lessons from the Covid War: An Investigative Report,†a book published Tuesday by a group of 34 specialists led by Philip Zelikow, the executive director of the 9/11 Commission and a history professor at the University of Virginia. Their verdict: “The leaders of the United States could not apply their country’s vast assets effectively enough in practice.â€
concluding:
The United States did some things well, the experts conclude, such as the crash vaccine development and manufacturing effort, Operation Warp Speed, which was a bargain at $30 billion. But “one of the worst consequences†of the bungled response “was that Americans sensed their governance had let them down. It had let them down in performing the most fundamental task governments are expected to perform, to protect them in an emergency.â€
This is a sobering, realistic assessment, one of the most important to come out of the pandemic. The nation should pay heed to it.
There are quite a few assumptions baked into their analysis. In this post I want to consider in particular how we think things should work and how we want them to work.
One way of looking at those is what might be called the “top down” or ‘the buck stops here” approach. In that way of looking at things everything that happens during a president’s term of office is the responsibility of the president. There’s a kernel of truth in that but just a kernel.
For one thing it quickly degenerates into something that might be called the “political” approach. Under that approach everything is blamed on the Republicans/Trump/Democrats/Biden. Here’s an example of that. If you focus on deaths due to COVID-19 (as the editorial does), the fact is that more deaths due to COVID-19 occurred from January 20, 2021 to present than did from December 2019 to January 20, 2021. Do you blame the deaths on Trump or Biden?
Another approach is the technocratic approach, relying on experts. The defect in this approach is that no one is an expert in everything but the temptation to parley your expertise in one field into others in which you have little expertise is irresistible. Under genuine technocracy public health experts would have determined the proper course of action, it would have been managed by those with that expertise, and ensured that it conformed to the law by legal experts. Practically no one wants genuine technocracy. What we have instead is phony technocracy is which, as noted above, people claim expertise in areas in which they have little training, experience, or temperament.
Some would prefer what might be deemed a market-based approach in which the private sector provided solutions largely unfettered. That works for some things but I don’t believe it would in a pandemic. When the poor get sick so do the rich and in a market system willingness to pay which includes ability to pay regulates the system.
My own preference would be for a procedure-based system which I think is more suitable for us fallible mortals. Under such a system legislators, the president, and judges cooperate in establishing procedures for handling contingencies with provisions for the procedures to evolve over time. They would also cooperate in ensuring the procedures are followed.
While I agree with the editors that dealing with the COVID-19 pandemic has not been our finest hour, I’m not sure what approach would be more effective when no one is actually held accountable for anything. I also note that the editors describe losing confidence in the federal government as though it were a bad thing. Is it?
I would also observe that one of the examples of effectiveness they provide, landing on the moon, took place in an America which was very different from the present one in which “the government” consisted almost entirely of white men most of whom had served in the military. I don’t believe we can or should return to that America.
If only the government had followed the law and could blame its lethargic response on following rules!
Operation Warp Speed was the pandemic response’s equivalent to the Apollo missions.
A summary from me would be, the Government response was hampered by the rules but yet was ineffective while breaking all sorts of rules. The supposed experts at the CDC / FDA turned out to not know a lot of their areas of expertise. And our system that was supposed to be superior at course correcting mistakes hasn’t fixed any of the underlying issues.
I mean, has the government done anything to improve its handling of the next (ineveritible) pandemic? I don’t recall any legislation to reform the CDC / FDA, or anything regarding pandemic preparedness.
I think they want the issue to run on.
During the 1st year of COVID various doctors, epidemiologists were questioning, even disputing not only computer model predictions of doom and gloom, but also the duplicity inherent in the data being put out by the CDC. The media, government leaders, and medical establishment, though, rarely even considered whether the dubiousness of other expects merited a closer look at the real impact of COVID. In fact professional dissent over the real magnitude of this virus, as well as alternative early treatment plans, were discredited and then censored. Consequently, the pandemic was governed mainly by the likes of Fauci’s guidance, who took his lead from parroting the CDC’s inaccurate figures.
A post-epidemic analysis, now, is showing that closing the country down, extreme social distancing, and other measures in the government-issued protocols were not effective, doing more damage than good. The same held true for the mandated vaccines forced onto people – that they did not protect people from infection or transmitting it to other people. Some politicians are now attempting to rewrite their participation in virus-derived mandates, saying they never mandated the vaccines because of the harms it created in some people. Trudeau is a fine example of this turnaround, completely forgetting about The Truckers†Saga opposing his mandates.
Unfortunately, despite our rear view mirror look at how we handled vs mishandled COVID, I doubt the government would differ much in dealing with another pandemic. This is especially true given the WHO now attempting to have a global command over all future public health issues for those countries belonging to the WHO.
We had two White House task forces for Covid – one under Trump and one under Biden. Who can name anything specific they did?
The task force concept is a process that has historically worked well as an organizing and management structure for crises. But with Covid, it was half-assed. Most of the politically dicey decisions were pawned off to other agencies, which I suspect was to protect the WH politically. So that’s how you get the CDC assigned the duty of developing NPI policies that must consider tradeoffs and can’t only be based on solely on “the science.” CDC doesn’t have the expertise to do that, yet that is what each administration forced them to do instead of utilizing the task force created for just that purpose.
IMO, the main culprit of the COVID mismanagement is that it became highly politicized, with much of the information being propagated by propaganda rather than the adherence to real, unbiased science. Between using the politics of the moment, directly responsible for creating voting patterns not used before in elections, indulging the CDC and FDA in outlining and revamping protocols conveniently lining up with government’s mandates, the 2 plus years of virus confinement and economical destruction changed lives forever that are now more susceptible to global resets.
The CDC and FDA early on became compromised because much of their budgets were paid for by Pfizer and the pharmaceutical sectors. This became a serious conflict of interest for the FDA, whereby clinical trials were shortened and incomplete, especially in covering safety requirements. Drugs were rapidly approved, under emergency acts, that completely circumvented any financial liability drug companies might have for harmful side effects associated with their product. Less expensive remedies were not only ignored but criminalized if prescribed by doctors for their patients. The compliant Zombi media showed no interest to intercede, even when a large number of noted physicians and scientists cited numerous objections and flaws seen in the development and eventual efficacy of the vaccine. Then there was the inaccuracy of the PCR test, showing numerous false positives – errors upwards over 90%. Even Kary Mullis, the creator of this test, said it was inappropriate to use it as a diagnostic tool. A physician eventually brought into the COVID task force, Scott Atlas, would share the latest data and reports with members in WH meetings, while Fauci and Birx sat on their laurels, downed and resented any new info in favor of following old, unsuccessful guidance.
Basically there were so many wrong turns in handling this virus. Many in the medical community who simply turned a blind eye to voices offering alternative opinions. Others whose motives were swayed by profiteering off the monies offered by pharmaceutical companies.
As Albert Camus was quoted as saying, “The only means to fight the plague is honesty.†This was lost almost immediately in getting a handle on COVID.
Carry on Joe, carry on.
Keep your boots on,
the pooh is getting deeper,
Carry on Joe, carry on.
It ain’t over
til the fat lady sings
Carry on Joe, Carry on!
Most people wont actually read the article but only the usual vague complaints it cites specific problems. Most of the problems occurred early and they stemmed from poor leadership at the top.
“Early on, the government went off the rails.
In February 2020, the focus was on containment, with measures such as the travel ban on China and repatriation of Americans, including those stranded on cruise ships. Emergency mobilization efforts “languished,†the report noted. There was “confusion and friction about who was in charge of what problems.†The government’s “crisis action plan†amounted to little more than jargon. “There was little in it about what people would actually do.â€
On Feb. 24, 2020, President Donald Trump tweeted from India, “The Coronavirus is very much under control in the USA … Stock market starting to look very good to me!†But according to the report, that same day, the White House task force concluded “containment was failing.†It was time to shift to mitigation. The next day, a high-ranking Centers for Disease Control and Prevention official, Nancy Messonnier, announced that community spread in the United States was inevitable. The stock market dived.
“President Trump was furious,†the report recalls. He kept downplaying the danger. “It’s going to disappear,†he said on Feb. 27. “Everything is really under control,†he said Feb. 29.
It was not. The authors of the report show, in detail, how federal crisis management “splintered by the third week of March.†HHS Secretary Alex Azar had placed the assistant secretary for preparedness and response, Robert Kadlec, in charge of the HHS effort — but at the same time, Vice President Mike Pence’s staff kicked him off the White House task force. The head of the Food and Drug Administration was not even on the task force for the first month. The CDC was “fractured into too many missions.†While some officials recognized the urgency of a crash program of testing and masks, “Kadlec had no money, no real emergency fund.â€
“By late April, as a frightened and bewildered country became more and more confused about continuing business and school closures, and after some brow-raising comments at a White House briefing in which he discussed treating the virus with light, heat, or disinfectant, Trump essentially detached himself from his own government,†the report says. “He moved toward questioning and challenging what other government officials were doing.â€
“The administration abdicated its wartime responsibility to lead,†they add. “It left the battlefield, and the war strategy†to the states and localities. By April, the White House chief of staff concluded the task force was “useless and broken.â€
There were many other examples of dysfunction — confusion over face masks, shortages of personal protective equipment, conflict over reopening, mixed messages over boosters.”
We had a department organized to handle a pandemic but it was disbanded and placed into other departments. There was no one really in charge as there was no organization and the POTUS was sending out messages that it was under control and would quickly be gone. As I noted before his choice to lead the CDC, Redfield, had no public health experience but held the office because he opposed abortion.
Along with the chaos at the top there were some errors like telling people they didnt need masks that could have been avoided, if well intended. Its also correct that it took a while to figure out it was aerosol and droplet spread but that was a worldwide mistake. Laying that at the feet of “government” isn’t helpful.
All that said, once we got past the early days the government functioned OK in its roles. The piece does have a weakness in that it doesnt acknowledge that the states were responsible for making and carrying out most of the day to day decisions. The federal govt got the vaccines done but it didnt plan much for delivering and administering the vaccines. State leaders were more responsible for acceptance. At the state and local levels mitigation efforts were enforced or ignored. If people had gotten vaccinated we would have had many fewer people die in the second year fo covid. So we ended up with covid death rates in Arizona, Oklahoma and Mississippi at 2-3 times the rates seen in Maine, Oregon, New Hampshire and Colorado.
Steve
I’m not as convinced as you are, steve, that those differences illustrate the consequences of differences in policies. I suspect that demographic differences have something to do with it as well.
However, I’m more likely to cut state and local officials some slack for their decisions in the first quarter of 2020 than many are. I’m less sympathetic with the policies adopted after that.
WRT schools I predicted what would happen correctly in the first quarter of 2020. My observation was that K-12 schools have multiple constituencies (teachers, students, parents, etc.) and that the interests of teachers as expressed by their unions would prevail.
“Another approach is the technocratic approach, relying on experts. The defect in this approach is that no one is an expert in everything but the temptation to parley your expertise in one field into others in which you have little expertise is irresistible.”
A point I have been making since early days. Policy making for a nation has many facets and requires many inputs. A narrow technocratic approach is bound to fail.
“Under that approach everything is blamed on the Republicans/Trump/Democrats/Biden.”
Heh. See steves comment.
” I also note that the editors describe losing confidence in the federal government as though it were a bad thing. Is it?”
Double heh. See the Comey and current FBI with all the Steele dossier crap, Lois Lerner’s IRS, 51 “intelligence experts” (gag) burying the Hunter laptop story, and which is now unraveling. Biden running down the SPR. “Transitory” inflation. “The border is secure……. ” etc etc etc
“it took a while to figure out it was aerosol and droplet spread but that was a worldwide mistake”
That’s incorrect. Almost every polity in East Asia (Japan, South Korea, Taiwan, China, Hong Kong, Singapore, Vietnam) CDC equivalent agency treated COVID as spread via aerosol from day 1 — hence universal masking and encouraging masks from almost day 1.
A clear shortcoming is test and trace. The East Asian polities were an order of magnitude better at actually doing test and trace.
Never mind simple things like collecting data. Many countries, Eastern and Western did a far better job then the US in this area.
OK, the world except for maybe East Asia. I never read anything from here where they claimed it was aerosol spread even if they acted that way. They have used masks fora long time to prevent disease spread so I think they would do that regardless of droplet vs aerosol belief.
Nationalized health systems are just about always better at collecting info. I dont actually know CDC capabilities in this area but I suspect they would be dependent upon the individual states gathering data.
Steve
“I’m not as convinced as you are, steve, that those differences illustrate the consequences of differences in policies. I suspect that demographic differences have something to do with it as well.”
I have looked for those as have others. Nothing obvious pops out and these are huge differences. I dont believe in magic. However, what I would agree with is that in states where they were lax on mitigation policy the people in those states were also less likely to engage in mitigation efforts regardless of policy. In my area while masks were supposedly still required by the state the stores in some small towns had signs up saying that masks were not allowed and you would be booted from the store if you wore one. So its not just policy but also actual behavior.
“Heh. See steves comment.”
Quoting the cited paper from the commission. Feel free to try to defend Redfield’s appointment.
Steve
Let me dive into my remark a bit more. Arizona has the highest death rate of any state. It’s usually thought of as a Red State. New Mexico is pretty close (fourth highest death rate). It’s usually though of as a Blue State. What do they have in common? They have among the highest percentage Native American population of any states along with Alaska and Oklahoma. Mississippi has the highest percentage black population of any state along with a high COVID-19 death rate.
States with very low death rates include Maine, Washington, Utah, Vermont, and Hawaii. Those states have among the lowest percentages of blacks and Native Americans. Most of those states are Blue States but Utah is a Red State. I don’t think that can be explained solely on the basis of politics.
Update
I suspect that policy may have made the difference between Indiana (3,915 deaths/million) and Illinois (3,304). I would characterize that as a “marginal difference”. Better than nothing but not a lot.
I am not sure what you think the Chinese healthcare system is; but it is far from NHS or even Canadian style provincial managed health care systems.
Lets keep going, FDA approval of at-home tests a year after Asia and EU and a full year into Biden’s Presidentcy. NIH/CDC/FDA style of clinical trials didn’t figure out treatments for COVID like steroids like the British did; or even worse, failed to track the vaccines to figure out they were effective against infection only a couple of months at a time.
My understanding, which of course may be wrong, is that it depends on where you are. In some places there are hospitals that are fully the equals of Western hospitals, possibly adding a dash of traditional Chinese medicine. In rural areas you’re lucky if you can find a traditional Chinese medicine practitioner.
Sure, but then how do you explain the others in the 10 states with worst outcomes? West Virginia has close to no blacks or Native Americans. Tennessee has only a little bit above the national average blacks. Same with Arkansas. Kentucky is below average. You want to compare Illinois with Indiana but if you want to do it by percentage of blacks then why not Kentucky and Tennessee or Arkansas? Maryland has twice the percentage of blacks as Indiana and its death rate was about 33% lower. Finally, DC has a very high percentage of blacks and Puerto Rico a higher than average percent blacks and very low covid deaths.
Since i have friends living in New Mexico I would note that it is akin to Michigan in that it is a barely blue state that has a large population of the radical right, militias and all. So as I noted above it’s not all about policy but also compliance with policy. That leaves Utah which I suspect you know is the anomalous red state where Trump was not super popular (they elected Romney). We recently had a guest speaker from U of Utah. Covid came up as a topic and what he thought was that the population was very compliant with whatever restrictions they imposed, reinforced by the local church leaders. Compliance with vaccinations above average for a red state.
So I think if we are looking for the simplest explanation policy and compliance to policy fits many more states I think. Demographics fits a very few states and the assumptions you used for some states are contradictions in other states.
Steve
I think the death rate was multi-factorial. Policies were factors among many including demographics, preferences, and others.
I doubt any single factor was dispositive.
Yes, high variability, not just in terms quality but how it is organized, how it is paid for.
To the point about data collection; China didn’t have better collection because of a “nationalized health care system”; its because the Chinese Government views it as a core competency and invests a lot into it.
I get the US has cultural issues with data collection by the Government, some of it justified and some of it not, but the pandemic showed the Government is very bad at it, and it needs to be fixed.
When the Republicans have held the House, they have routinely reduced funding for data collection by various agencies for that reason—they don’t trust the federal government. The Census Bureau, for example, no longer produces reports is once did.
” its because the Chinese Government views it as a core competency and invests a lot into it.”
But its not unique to China. AFAICT data collection is a core attribute for nationalized health care systems. We often discover problems with devices and therapies through their efforts.
Steve
I am saying China’s health care system isn’t “nationalized” the way you think. Its a mix of systems.