The only thing keeping this from being a total failure by the federal government was the initial decision to ban travel to parts of China. That bought some time to prepare, which was squandered. Nearly everything that’s happened since, as far as I can tell from public reporting, has been a grievous failure. We’re at the “don’t leave the house if at all possible” stage of managing the crisis because all of the things you’d expect to happen in a situation like this — quick development of diagnostic tests, quick rollout to public labs, quick identification and containment of infected people — hasn’t happened. You want to avoid getting sick now, or avoid killing some elderly person you know by inadvertently transmitting the virus to them? Then isolate yourself from other human beings to the greatest feasible extent. That’s the only advice left. Shelter in place.
We’ve had enough massive policy failures over the past 20 years that I won’t fault anyone for choosing a different disaster as the moment when their faith in government collapsed completely. This is the moment for me because the failure is so basic. This isn’t like invading Iraq and then not having a workable strategy to beat back a determined insurgency. This is like invading Iraq and not having a plan to get munitions to troops in the field.
“We need bullets.”
“We’re working on it. A few more weeks.”
“Jihadis are advancing on our position right now. I can see them with my naked eye.”
“A few more weeks.”
It’s not fundamentally a “Trump problem.” Trump has made it worse, as he tends to do; his complacency about the disease in public comments is encouraging reckless complacency in people who need to prepare. But it’s his experts who’ve failed on the basic nuts-and-bolts mechanics of getting those bullets out when they’re needed. Our position is now overrun. Retreat immediately to bunkers.
The Times has a story today about the Seattle Flu Study, a project designed to research how influenza spreads in the city. When news of coronavirus spreading in China broke in January, doctors in Seattle naturally were curious — and worried — that it had also begun to spread undetected in the U.S. They had a bunch of samples they’d gathered recently for flu testing which could be repurposed for COVID-19 testing. But there was a problem: Red tape. They didn’t have explicit permission from subjects to test for coronavirus (why would anyone object to doctors checking them for a deadly infection without their knowledge?) and the Flu Study’s labs weren’t certified for clinical work. Surely, this is an urgent emergency that requires bending the rules to prevent an epidemic, the doctors said to the feds.
Nope, said the feds. Regulations. The Flu Study doctors waited, and waited, and waited for the CDC to provide its own tests to local labs so that public testing could begin instead. Didn’t happen. So the Study doctors finally ignored the rules and tested their samples anyway, which may be the only reason why we have the limited knowledge we do right now about the extent of the outbreak in Seattle. After they found one teenager in their sample who tested positive for coronavirus, they alerted local authorities and let the feds know that they were going to test the rest of their samples. Result:
The message from the [CDC and FDA] was blunt. “What they said on that phone call very clearly was cease and desist to Helen Chu,” Dr. Lindquist remembered. “Stop testing.”
So this isn’t quite analogous to not supplying bullets to troops in the field. This is more analogous to not supplying bullets, then having the troops stumble upon a cache of bullets themselves — and ordering them not to use those bullets either.
Eventually, hamstrung by their own incompetence in providing their own tests to local labs, the feds backed off on the testing ban. Sort of.
On a phone call the day after the C.D.C. and F.D.A. had told Dr. Chu to stop, officials relented, but only partially, the researchers recalled. They would allow the study’s laboratories to test cases and report the results only in future samples. They would need to use a new consent form that explicitly mentioned that results of the coronavirus tests might be shared with the local health department.
They were not to test the thousands of samples that had already been collected.
The Flu Study’s own ethics review board concluded that it was insane not to try to prevent a major epidemic when the information that might do so was right at their fingertips so they went ahead and tested the samples anyway. And found more positive cases, of course. They’re now working their way through older samples, from February: “The scientists said they believe that they will find evidence that the virus was infecting people even earlier, and that they could have alerted authorities sooner if they had been allowed to test.”
This isn’t the only story today chronicling grievous failure to ensure basic readiness by local health labs:
A looming shortage in lab materials is threatening to delay coronavirus test results and cause officials to undercount the number of Americans with the virus…
CDC Director Robert Redfield told POLITICO on Tuesday that he is not confident that U.S. labs have an adequate stock of the supplies used to extract genetic material from any virus in a patient’s sample — a critical step in coronavirus testing.
“The availability of those reagents is obviously being looked at,” he said, referring to the chemicals used for preparing samples. “I’m confident of the actual test that we have, but as people begin to operationalize the test, they realize there’s other things they need to do the test.”
The reagents have to do with RNA extraction, the very first step in performing a coronavirus test. If you can’t extract the virus’s RNA from a sample, you can’t know what disease the patient has, So, really, the situation we’re in now with testing is like finally sending bullets out to troops in the field — and discovering that they don’t have enough guns.
But it’s worse than that. Remember that the WHO has had a workable coronavirus test developed by researchers in Germany for many weeks, one which the CDC could have shifted to once it ran into problems developing its own. Imagine if a foreign country offered to supply bullets to American troops in the field at a moment when U.S. supply chains had broken down and the Pentagon said, “No thanks. We’ll make our own.”
As I say, there may have been more catastrophic institutional failures since 9/11, the Iraq war and the financial crisis being the most notable examples, but I can’t think of one as basic as this with as many implications. Experts are quibbling with each other now over whether a clear majority of Americans will end up exposed to this disease in the next year or two or “only” 30 percent will. Obviously, the longer it takes to spread, the better the chances are of survival as treatments develop and hospitals get up to speed. There’s a world of difference between 10 million people getting sick over 18 months versus 18 weeks. But the opportunity to snuff the disease out like SARS is long gone.
Read this smart piece at NRO today about the “clash of civilizations” between the U.S. and China that’ll play out on the terrain of coronavirus. No one cares about the geopolitical consequences of this right now; jobs one, two, three, etc, are stopping the disease. But lessons will be learned by people everywhere, including here, about which model of government works more effectively to protect its citizens in the teeth of a dire threat. Is it the totalitarian one that runs concentration camps but can mobilize the manpower needed in a pinch to tamp down a killer pathogen? Or is it the liberal one that can’t figure out how to get “bullets” to medical “troops” as sick people stagger into ERs because of incompetence and red tape? Exit quotation:
In the way they place social stability above everything else, China and Italy are discovering, perhaps to their surprise, a shared cultural substratum. The United States seems to be moving in a different direction. President Trump is taking the enormous gamble of assuming that Americans are different in that they can deal with higher levels of risk. His plan is to manage the outbreak rather than stop it. To be reconciled with society as a field of danger and contradictions and to abandon all plans to improve it might reveal a deeply conservative, even an atavistic, disposition, but perhaps Americans no longer think of society as a home. In that classic American genre, the western, the town does not provide a home for the cowboy — it is not the safe and conveniently anonymous field of experience a European city promises the romantic flaneur — but is rather a hostile place, full of conflict and danger.
For the time being, China seems to be ahead in the geopolitical game.
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