Massive US Government Failure

NPR: Ashish Jha, who runs the Harvard Global Health Institute, says the response to the coronavirus has varied dramatically around the world.

…So how has the United States’ response been?

“Our response is much, much worse than almost any other country that’s been affected,” Jha says.

He uses the words “stunning,” “fiasco” and “mind-blowing” to describe how bad it is.

“And I don’t understand it,” he says incredulously. “I still don’t understand why we don’t have extensive testing. Vietnam! Vietnam has tested more people than America has.” (He’s citing data from earlier this week. The U.S. has since started testing more widely, although exact figures still aren’t available at a national level.)

…Jha believes that the weekslong delay in deploying tests — at a time when numerous other tests were available around the world — has completely hampered the U.S. response to this crisis.

“Without testing, you have no idea how extensive the infection is. You can’t isolate people. You can’t do anything,” he says. “And so then we’re left with a completely different set of choices. We have to shut schools, events and everything down, because that’s the only tool available to us until we get testing back up. It’s been stunning to me how bad the federal response has been.”

I too am stunned .

Comments

People are just now figuring out that a heavily centralized government is bad?

The FDA needs serious reform, sadly I predict things will go the opposite way and we will double down on stupidity, but who knows maybe we will continue to eliminate onerous regulations.

I think for certain things a heavily centralized government is exactly what is needed. Dealing with national, public health emergencies is one of them. If you look at which countries have had successful responses, I think you could characterize them (at least compared to US) as having heavily centralized governments.

Totally agree on the issue with mindless red-tape and regulations, which unfortunately probably comes with the territory to some degree.

What would your lesson be then? To have no CDC or FDA, or to vastly decrease their size? I don't think states could pick up the slack and then adequately coordinate among themselves without a central/federal go-to.

The problem arose two ways. First the FDA made it onerous and complicated to do tests, with the usual blunt instrument enforcement methods. Second the CDC had a single point of failure approach, one test one manufacturer which didn't work.

Both departments consist of a bunch of people. This is the third similar situation that has arisen in this century. Four counting Ebola which is a different beast.

It wasn't a centralization of information gathering and promulgation that was the problem. It was the centralization of control.

By the way, the situation isn't much better in Canada.

It is working as designed.

My theory is that we are in the midst of a changing of the guard with the boomer generation retiring. They are being replaced by the middle level graduates of all the universities. The top level go make some money and wouldn't tolerate the bullshit that characterizes these places. Something like this shows up and it is like the US army going into WW2, where it took a few months for the incapable officer corp to be killed off or demoted due to failure. Except we don't kill bureaucrats, we promote them. Hence every time things like this happen the response gets worse.

"Dealing with national, public health emergencies is one of them. "

The complaint here is that that heavily centralized government failed *in exactly that situation* - but you're saying that we need more of it?

I think very clearly, from the beginning Trump didn't want to find the virus here, so they simply didn't care to test for it. Yes, it's criminal, but that's Trump's MO.

In what way will testing improve things?

People who are tested can be quarantined so that they don’t spread it to others. Instead of going to work, taking the bus, going to church thinking that they just have a little cough and it is no big deal.

in unconstrained environments epidemics last 6-8 weeks where preventative measures like quarantines and shutdowns take place the time line is much longer...anywhere from 4 months to a year....testing at this stage is pointless...world now in madness loop..how when it stops anyone's guess

Could you put periods and/or commas into your text to make it comprehensible? Capital letters help a lot, too, even if one uses periods.

testing isn't pointless at all. AND IT NEVER WAS. We can't stop it, but we can slow it down, lengthen it, allow our healthcare to catch up with health needs. Doing so will save lives.

I think I have gotten into the OODA loop, which is sad, because we are on the same side.

Tyler deleted my comments about how I was praying for the possible victims of the Wuhan virus weeks and weeks ago, and now Alex has deleted my secular comment on the same subject, which was worth reading.

Sad!

Did Trump have anything to do with the availability of tests? As far as I can tell the answer is no?

The CDC blew it. It’s not trumps fault. However, the issue is that the administration as a whole is a cluster fuck. Everything is a cluster fuck... so wild and unwieldy. Shit dropping on Twitter, seemingly out of the blue. Statements are not vetted, scripts are not kept too.

It is like a reality show.

I think once the inside scoop on the tale of the CDC tests is finally told, it will be interesting... but this the MO of this administration. It caught up to them this time and unfortunately, we are all going to pay for it.

"I think very clearly, from the beginning Trump didn't want to find the virus here, so they simply didn't care to test for it. Yes, it's criminal, but that's Trump's MO."

You . . you think Trump told the CDC to screw up the test it developed, and then told the CDC and FDA to enforce their pettifogging regulations to prevent private labs and nonprofits from stepping in to fill the testing gap? Really?? I'm not saying Trump wouldn't have screwed it up if he were involved (particularly given his comments re: the Grand Princess passengers), but I kind of doubt he even knew about the stuff CDC and FDA were doing to bollocks this up. This disaster has the fingerprints of the working level professional civil service all over it -- both incompetence (screwing up the technical details of their test) and the CYA-first attitude (being unwilling to budge on regulations in the face of a looming disaster).

I don't know that there's a structural issue here with the CDC and FDA having too much power. You need that to respond to situations like this. Rather, I think it's a cultural issue with the way the agencies exercise that power. The culture of these organizations needs to be ripped out and remade. After this is over, they can't be allowed to pat themselves on the back and say they did nothing wrong, they are world class, excellent, etc. etc. etc. -- all the trite little lies civil servants tell themselves after a big failure.

+1, this was screwed up before Trump was even paying much attention.

I would doubt called the CDC and told them to screw the pooch royally - but the vast majority of people working for Trump are completely obsequious. Trump REQUIRES it. Im certain there's a lot of blame to go around, and while Trump takes zero responsibility and blames "foreigners/europeans," while the head of the CDC accepts no blame himself, such complete and utter incompetence, absolutely shirking of all responsibilities, and LYING about the facts are Trump's MO.
The buck stops here? When it's an actual buck, Trump'll take it. But when there's an ethic, duty, responsibility, principle? Trump will duck and blame; his administration will duck and blame. Meanwhile people get sick and some die.
This WOULD NOT have been as bad under any other previous Administration.

+1

+1 for Glenn

Because socialism/communism works so well.

Even a socialist like Bernie Sanders would have handled this crisis even better than Trump.

First, Trump's a blowhard but he didn't compel the FDA and CDC to screw up. No president micromanages that much. Or is able to.

Second, socialists are among the worst when it comes to creating, let alone responding to, problems. Literally everyone in a socialist system is a government worker.

But go ahead and score your cheap anti-Trump points.

You are wrong. Trump fired the pandemic response team in 2018 and they were never replaced. He cut funding to the CDC's global epidemic program by 80%.

https://www.snopes.com/fact-check/trump-fire-pandemic-team/

https://www.washingtonpost.com/news/to-your-health/wp/2018/02/01/cdc-to-cut-by-80-percent-efforts-to-prevent-global-disease-outbreak/

"You are wrong" is a lie unfortunately. Read the comment you are saying is "wrong": "Trump's a blowhard but he didn't compel the FDA and CDC to screw up. No president micromanages that much. Or is able to."

BTW the "pandemic response team" was a part of the white house's national security counsel.

The head of the CDC was appointed by Trump. Trump deserves blame here, maybe another impeachment for massive incompetence.

...the CDC and most agencies are run from the career bureaucrats.

Perhaps we need mass layoffs of anyone in the USG for longer than 10 years.

Trump is an idiot but he didn't successfully cut funding to the CDC:

https://apnews.com/d36d6c4de29f4d04beda3db00cb46104

https://www.factcheck.org/2020/03/false-claim-about-cdcs-global-anti-pandemic-work/

Wait? Vietnam is a libertarian paradise with decentralized government?
Because that's the suggestion you are making with that leap of logic.

I'm surprised Sanders is joinin' Trump

I think that the point of the excerpt is that the U.S. government response is bad relative to that of other countries' governments.

I'm not stunned that TC is stunned.

This world-shattering health catastrophe has a way to go to equal the swine flu (H1N1) epidemic that confronted magic worker, Barack Hussein Obama.

Three questions need to be asked whenever liberals come up with such hysterics. What are the facts? Compared to what? How much will it cost?

I'm not stunned that the gravest USA coronavirus disasters are hitting blue states (CA, NY, NJ, OR, WA) with very expensive, huge public health departments/systems.

So, that's Trump's fault.

Bad compared to China's?

Bad compared to Iran's?

Bad compared to Italy's?

Bad compared to Obama's response?

Aside from South Korea and Taiwan, the US has fewer infections and fewer fatalities than the most affected countries.

The point is Orange Man Bad!

I'm so old, I'll likely die from the dreaded Wuhan Death Virus. And, I remember the Swine flu episode, also known as H1N1. The US didn't declare an emergency until 1,000 were dead and 1,000,000 infected. That happened on Obama’s watch and ended with millions of US cases, 265,000 hospitalized, and 12,000 deaths. See Wikipedia.

Was there vitriol hurled at Obama comparable to what we are seeing directed toward Trump?

That's different because shut up.

1) Alex T wrote this one. Not Tyler. Update your priors.

2) How can you suggest we are doing better than S. Korea, China, Italy, Iran? We don't have the testing to support that, which again speaks to the problem

Idk if you're trolling or not, but this is not even Tyler Cowen writing.

Bruh...

The largest cities with the most international travel will be hit first. I'm not sure how you missed that. Few people are flying to China from Kansas.

The problem is Wuhan Coronavirus is contagious for a few days before symptoms are shown.

Based on what I've read about the virus, the Red states will have a much greater mortality rate because there aren't enough hospital beds AND obese and diabetic people die are less able to deal with ti.

Even before COVID-19, blue-state residents could expect to live more than four years longer than their red-state counterparts.

This isn't really a matter of size. It was a matter of incompetence. The bureaucrats at the CDC and FDA were arrogant and incompetent.

"Instead, as The New York Times reports in a terrific new article, officials at the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC) stymied private and academic development of diagnostic tests that might have provided an early warning and a head start on controlling the epidemic that is now spreading across the country."

https://reason.com/2020/03/11/how-government-red-tape-stymied-testing-and-made-the-coronavirus-epidemic-worse/

You probably don’t remember this because Obama was president:

CDC Estimates of 2009 H1N1 Influenza Cases, Hospitalizations and Deaths in the United States
During the pandemic, CDC provided estimates of the numbers of 2009 H1N1 cases, hospitalizations and deaths on seven different occasions. Final estimates were published in 2011. These final estimates were that from April 12, 2009 to April 10, 2010 approximately 60.8 million cases (range: 43.3-89.3 million), 274,304 hospitalizations (195,086-402,719), and 12,469 deaths (8868-18,306) occurred in the United States due to pH1N1. These final estimates are available at: Estimating the burden of 2009 pandemic influenza A (H1N1) in the United States (April 2009-April 2010)External Web Site Icon, Shrestha SS, et al., Clin Infect Dis. 2011 Jan 1;52 Suppl 1:S75-82.

And, you also probably don't remember the market crashed over Obama's handling of it.

1) Obama was a competent president

2) Corona is already much worse

History actually disagrees with you on the first point, the second point is too early to tell.

History actually agrees. Corona already it worse. Trump is so incompetent as to be criminal. Calling it a hoax; saying it's a Democratic aspursion; and now, NOT getting tested himself. You know, crazy is as crazy does, but some people actually listen to and believe the utter tripes that spews from Trump.

No actually, he's right on #1

Per CDC April 15 2009 - First human infection with new influenza A H1N1 virus detected in California.

Per WHO August 11, 2010 - WHO announced the end of 2009 H1N1 influenza pandemic.

S&P 500 - May 1, 2009 - 902.41 August 1, 2010 - 1087.28 up 20.5%

Put a Republican in the White House if you ever think the stock market is too high.

Rather, put democrats in congress. You WILL see a drop.

Put Dems in because your 401K really isn't THE most important thing in this world, and it shouldn't be the most important thing in your life.

@Rich Berger - thanks for the H1N1 numbers, but note the tiny death rates, out of even 43M infected only 12k deaths, that's what, 0.03%? Compare to Covid-19's death rate of 1-3%.

As you are no doubt aware, of the roughly 40 deaths so far, over half are at a nursing home in WA. Fauci has indicated that the mortality rate is around 1%. The numbers are very small, and once the CDC straitjacket on testing kits is eliminated, we will have a better fix on the true parameters.

Hate to break it to you man, but 1>.03 by a lot! Like 33 times as big. There are about 4 hospital beds per 1,000 people in the US. 3 are currently used. If 5% of the population gets it and 20% needs hospitalization as current estimates suggest, that’s 5 people per 1,000 for that last remaining bed. That’s the concern here.

@Ray Berger - reply? Surely, you appreciate the difference?

Mortality rate aside, and eyeballing the math CV has a tremendously higher hospitalization rate.

Still thinks there’s no issue?

Exasperation,

Stunningly stupid comment on your part. Your prerspective, that is of a completely ignorant libertariant perspective, is the precise reason for the utter and complete failure of the Trump adminstration.

Yes. He should have fired the entire CDC and FDA staff the first week of his presidency.

If we give Trump four more years, he will be able to fix everything wrong with America's response to a pandemic.

Coulda Woulda Shoulda. Too late now, Trump is probably out in November because of this. Defeat by a guy with dementia.

Reagan had dementia most of his second term, and people loved that guy.

define "people"

Reagan-lovers: Old, white, stupid. Pick two or three.

Not so sure. Trump's followers are rabid and will follow their leader to the ends of the earth, off a cliff if need be. The country is damned.

I'm not sure if you are being sarcastic, but actually that probably would have been an improvement as far as testing goes, right? Since good tests were widely available and would have been used if not forbidden?

Are we really at the point where not defending a massive government failure resulting in the inability to contain a pandemic is both:

A) libertarian only
B) pro an anti-libertarian President

Come on

It is interesting. If you had access to the raw data you would know that is not me. And having no access you should know that you cannot tell.

Therefore yer nuts?

This is the stupidest fucking comment I have read today

Naturally, batting lead-off on MR!

The free market would have fixed it, am I right?

Actually, yes private companies developed better tests than the Fed/.

That is not what was said, though.

Reading comprehension.

Does anyone know, what percentage of test for coronavirus that give a negative result, should be considered as a waste of the limited amount of test-kits?

I don't think you want to test everyone randomly, because the percentage of infected people is still tiny ( in the population as a whole) and you would be wasting a lot of kits. You probably should test anyone with symptoms, anyone near clusters, anyone in contact to known positives, etc.. Also the turn around to get the result can't be too slow. I think in San Diego at the beginning, it took 3 weeks to get a result back from CDC. There has been a lot of shortage definitely in the US. Even at/near the super infected senior living place in Washington State, testing was limited. Other countries seem to have done much better.

Disagree. South Korea has shown that you can test very broadly (around 1/4 million tests) and get great results. They have had arguably the best outcomes of any country so far with Covid-19.

They were one of the worse hit. Serious question: how do you define good outcomes?

The first cohort affected in South Korea were apparently younger adults.

Equally Wuhan had a lot of festivities and the next region, Hubei, has markedly different economic and social characteristics.

It may be that we'll learn more from cruise ships.

They tested extensively but obviously not randomly. Their population is 51.5 M. Their number of cases is 7869 or 0.015% of the population. If they had tested randomly they would have only discovered 38 cases ! They had a big cluster around that religious sect and tested extensively there and related cases and that's the right strategy test wherever it makes sense .Complete random testing would have wasted 99.85% of the testing effort.

In BC it is 2800/46. Testing consumes massive resources of people as well.

Maybe opposition to big government survives in the US because the US has a particularly incompetent central government.

I first saw that suggested by Meghan McArdle. Looking at the case of the CDC and FDA it's mighty tempting to believe it.

It's extraordinary - you've got that oaf Trump in office and he hasn't remotely been the weak link in the federal government's response.

Yep, the CDC bungled the process from the get go.

Yeah, from late February:

The World Health Organization (WHO) has shipped testing kits to 57 countries. China had five commercial tests on the market 1 month ago and can now do up to 1.6 million tests a week; South Korea has tested 65,000 people so far. The U. S. Centers for Disease Control and Prevention (CDC), in contrast, has done only 459 tests since the epidemic began. The rollout of a CDC-designed test kit to state and local labs has become a fiasco because it contained a faulty reagent. Labs around the country eager to test more suspected cases—and test them faster—have been unable to do so. No commercial or state labs have the approval to use their own tests.

https://www.sciencemag.org/news/2020/02/united-states-badly-bungled-coronavirus-testing-things-may-soon-improve

From https://www.propublica.org/article/cdc-coronavirus-covid-19-test

Alexander Greninger, an assistant professor in laboratory medicine at the University of Washington Medical Center, said after he submitted his COVID-19 test, which copies the CDC protocol, to the FDA, a reviewer asked him to prove that his test would not show a positive result for someone infected with the SARS coronavirus or the MERS coronavirus — an almost ridiculous challenge. The SARS virus, which appeared in November 2002, affected 26 countries, disappeared in mid-2003 and hasn’t been seen since. The MERS coronavirus primarily affects the Middle East, and the only two cases that have been recorded in the U.S., in 2014, were both imported.

There are labs that can create parts of a SARS virus, but the FDA’s recommended supplier of such materials said it would need one to two months to provide a sample, Greninger said. He spent two days on the phone making dozens of calls, scrambling to find a lab that would provide what he needed.

Greninger said the FDA was treating labs as if they were trying to make a commercially distributed product. “I think it makes sense to have this regulation,’’ he said, when “you’re going to sell 100,000 widgets across the U.S. That’s not who we are."
End of quote.

Nobody would pay the slightest bit of attention to these midwits except that they possess a bludgeon that they don't hesitate to use.

Trump appointed the head of the CDC though, and possibly to appeal to the abstinence-only crowd in his evangelical base: https://en.m.wikipedia.org/wiki/Robert_R._Redfield

Are you claiming that the Head of the CDC over rode the scientists and bureaucrats below him and is thus responsible? That seems a stretch.

The head of the CDC is a medical doctor, Scientist, and virologist. He spent a large chunk of his life researching HIV and potential vaccines.

He’s still responsible for much of this fiasco. If he knew and did nothing, it’s bad. If he didn’t know, thats still almost bad.

Well, he must take some responsibility, otherwise he is a ceremonial figurehead , without power or authority.

Reality is the opposite. If he was just there to "take responsibility" without actually "having responsibility" or power, that is exactly what a ceremonial figurehead would be.

No, I'm not saying that the Director of the CDC doesn't bear some responsibility, clearly he does. But it seems as if some people believe that Trump is somehow responsible for over riding the CDC and this fiasco wouldn't have happened otherwise. That seems a stretch to me.

Trump is the boss. He is absolutely responsible. Time for another round of impeachments!

Where exactly is the buck suppose to stop? CDC/FDA is the source of failure, but a competent president who knows how to tell the TRUTH would at the very least have been on top of things and fired the heads of those agencies and found someone who could get the damn job done. That is called leadership. Instead, he sees it as just another MSM conspiracy and all we need is just more spin to keep the market from tanking. It is precisely when a crisis arises that we need people with real character in charge. Now you know why it is foolish to support someone without moral character simply because he passes tax cuts and appoints conservative justices.

Free trade in test kits woulda' done it.

You can't buy what's illegal.

That's why you can't get meth anywhere!

Not at a hospital

He didn’t seemed to be stunned with the stunningly slow response to Swine Flu. Politics ? Nah...couldn’t be.

I would, however, like to thank the good doctor (and, of course, NPR) for trying to tamp down near-hysteria. Well done.

I don't think that's fair. It's possible that behind the scenes the government was swiftly inoculating us against the racism, xenophobia, and unconscionable doubts about globalism that the paper of record cautioned us over the course of more than half dozen pieces were and presumably still are the real menace.

Not only did Vietnam test more, they say they have developed their own test with a 1-hour turnaround time.

Makes me wonder how effective it is. I have no reason to doubt it is, but why the heck wouldn't we just copy it?

Interlectual property rights?

Because Trump is idiot and your leadership is full of morons.

Maybe now is not the time to point fingers while rocking emphatically on your favourite hobby horse. Testing is one of many tools in the epidemiologists toolbox. The symptoms are minor for 99% of those who contract the disease. Self isolate if you have flu-like symptoms. Buy/use a pulse oximeter if your or your loved one's symptoms are severe. Use the phone.

Why is the country that is home to Silicon Valley lamenting the lack of government action? So much can be done with simple web, mobile, and cloud tools. Get on with it.

Silicon Valley grew to prominence in an almost totally unregulated marketplace seeded by some basic government research out of the military. Nothing they do there, nothing at all can translate into the extremely regulated health care sector.

Excellent comment. This blog has been publishing several posts a day of this stuff, over and over again. It's almost like if the government doesn't do it, people don't think it will get done. Your suggestions are excellent.

"The symptoms are minor for 99% of those who contract the disease."

Maybe like 90%?

Government failure or market failure?

Coronaviruses have been known to commercial labs at least as well (and for at least as long) as to CDC or any other federal bureaucracy.

Lab Corp, Quest Diagnostics, et al., or some outfit in their industry could have seized on the news back in January: what prevented the private sector from getting up to speed from, say, mid-January until the end of March? (Were all members of the industry engrossed in impeachment proceedings in those critical weeks?)

Correction: " . . . say, mid-January through the end of February?"

Not a market failure at all. FDA red tape has been holding everybody up. Tons of articles about how manufacturers and labs weren't allowed to make their own kits and administer test.

Studies, investigations, and work within private/commercial laboratories could easily have proceeded, short of product release: surely FDA prohibitions cannot extend to the sector's R&D.

"Studies, investigations, and work within private/commercial laboratories could easily have proceeded" -- How do you know they weren't?

As with so much else, I don't know that commercial labs were not working on developing reliable testing protocols between mid-January and the end of February.

If they were busy working on the challenge from mid-January to the end of February, though, and had reliable protocols ready to submit for FDA approval, I'd have to begin wondering why they were not prepared to ramp up test kit production with some realistic expectation of FDA approval. (Again, my working assumption is that the FDA could NOT prevent internal R&D on a testing protocol--the FDA could only withhold approval for release until the protocol passed regulators' testing. As long as all the "homework" had been completed, the private sector should have been able to ramp up massive production of test kits, if other labs around the world [NOT subject to FDA regulation] had done so.)

I suppose further media accounts on the specifics of FDA regulatory approval and the science concerning the tests themselves will be forthcoming, but I simply cannot lay all credit/blame on the doorsteps of federal regulators when some several somebodies in the private seem not to've been paying any better attention themselves.

How can you say they "seem to've" when you have no clue?

Correction: I wrote "seem not to've".

Some several somebodies in the US private biopharma sector DO seem not to've been paying close attention from mid-January through the end of February: otherwise, Roche (based in Basel, Switzerland) would not be grabbing headlines this morning with a fast coronavirus test that may yet begin to help compensate for the dual failures of US governments' responses (federal, state, local combined) AND the US biopharma sector.

They can certainly stand in the way of deploying any one of the several tests that were already available though.

We've had testing available - the federal government prevented these tests from being used because they weren't certified by the federal government. Only one test was, late, and only one manufacturer of that test was allowed.

ProPublica did dig into the nasty details, and it isn't pretty. It's horrible. https://www.propublica.org/article/cdc-coronavirus-covid-19-test

The FDA and CDC were looking at academic laboratories like they were industry ones and held them to a high standard, as if these were normal times. And then put in several other viruses that threw false positives into the same test all the while not providing control (reference standards) materials so they could validate the test.

A total exercise in frustration. When the FDA issued an EUA (emergency use authorization) in late Feb / early May, about one week later LabCorp and Quest had their own validated LDTs.

One person said on CNBC last week, 'this is a national disgrace', which it is.

"Coronaviruses have been known to commercial labs at least as well"

The CDC and the FDA forbade private testing. Indeed, they reprimanded one lab that went ahead and tested and confirmed a case on their own.

"As the Times reports, the CDC told Chu and her team that they could not test the samples unless their laboratory test was approved by the FDA. The FDA refused to approve Chu's test on the grounds that her lab, ...
A frustrated Chu and her colleagues began testing on February 25 without government approval. They almost immediately detected a coronavirus infection in a local teenager with no recent travel history.
....
Washington state epidemiologist Scott Lindquist recalled, "What they said on that phone call very clearly was cease and desist to Helen Chu. Stop testing." "

https://reason.com/2020/03/11/how-government-red-tape-stymied-testing-and-made-the-coronavirus-epidemic-worse/

Precisely. We have this private health care system which we fiercely defend and claim is the best in the world. And when it fails, we blame government.

This was a government failure, the FDA told other labs to cease and desist on running independent testing.

That is a misrepresentation of what went down

There were multiple failures on multiple levels.

The main one that actually caused the disaster was brought to you by the FDA and CDC.

"That is a misrepresentation of what went down"

That's precisely what is being reported. I put a direct quote from the article above:

""What they said on that phone call very clearly was cease and desist to Helen Chu. Stop testing." ""

Clutch pearls all you want, Al, but it's gonna backfire on you come November.

By then, the Glorified Flu will be long over with minimal harm in the USA, and all anyone will remember is that everyone came together and canceled everything... under the unifying leadership of DJT.

All you'll be able to do is complain how racist it all was. Good luck with that!

Blame the CDC test monopoly....

It's weeks later, and no-one in the CDC's bureaucracy has yet identified anyone responsible for the decisions made, which suggests several people well established within that bureaucracy are responsible. That wouldn't be the situation if someone from outside the bureaucracy, like a Trump appointee, had ordered it, where that information would be blared all over the media 24/7 if it had. This was a huge missed chance by the people who should have known better, but made critical choices that favored their own interests.

They will get promoted. What they really needed was an increased budget and more people working for them. Then they would have made the right decisions.

The head of the CDC IS a Trump appointee.

I think we've seen how little that means. Middle/upper manager types seem to run the show at these places.

...you'd be telling us it means a lot.

Projecting again? I'm just saying we've seen a lot of these issues with the federal agencies lately. There are about 6000 appointees over 2,000,000 federal workers. This is how you get a Lt Col thinking he's in charge of US foreign policy.

A few years ago I watched a debate between Mark Skousen and Jeffrey Tucker about minarchism vs anarchy. Skousen, who was defending a minimal State against Tucker’s position of no State at all, stated that you need government to manage epidemics. Just that, not the usual stuff about police or the military, just to manage epidemics.

Jeffrey was taken off-guard, and did not specifically debated the point that the State is better than the market in case of epidemics, he just said that it would be a lot to accept (all the negativities of the State) just to be defended against an eventual epidemic.

Watching the abismal performance of the U.S. and other countries (I am stupidly quarantined in Modena, Italy, in this moment), I started to worry about the point of Skousen. Yes, China approach was effective, but that can only happen with the Orwellian social control of China.

Here in Italy, for example, they are killing the economy, but they still let people congregate outside to play cards or otherwise kill time. So, they have all the problems of the quarantine with very few of the benefits. It is so bad, that I think personal liberty would have worked better. Each individuals would have decided if what he had to do was worth the risk or not. A young athlete that needs to go see his father dying could have taken the risk, while my 75-years old mother would have avoided to go to the supermarket for a few months and bought grocery on-line. With time, herd immunity would have developed, or maybe summer would have killed the bug.

My take-away is that western government interventions are being actually a negative so far. China’s interventions were not, but paraphrasing what Jeffrey said, even a pandemic is not worth the price to live in a State like China.

Re: " It is so bad, that I think personal liberty would have worked better. Each individuals would have decided if what he had to do was worth the risk or not."

Externalities anyone?

I saw something from Hong Kong where under the lockdown everyone is going to bars and clubs. Nothing else to do.

Almost everyone is going to get this, the only thing that can be done is to slow the new cases so that medical resources aren't overwhelmed. Italy seems to be a situation where a hospital was infected; adequate protocols are readily available to control situations like that. The externalities have already happened.

Then your strategy should be to go out and get sick early before access to the health system gets rationed.

Second, the externality is in the effect of his decision to think only of himself and not those he communicates the disease to.

Third, when resources other than test kits get constrained there will not enough negative pressure, intubation and ICU facilities.

So, go quick, and get sick now. Otherwise you will be on the waiting list for access to the pulmonary ICU.

Finally, this is a diverse country: some parts of it might be hot spots of community spread, and others not. Those that aren't can be better protected by contact tracing so they do not become hot spots.

Don't be stupid. Italy was a government facility failure, akin to Toronto SARS. The only thing that can be done is not make it worse, to slow the thing down as much as possible. It will run it's course by next spring.

There is no way that any rigid attempt to control the population would last that long. It isn't possible. It isn't possible where it is being attempted. At great cost and disruption it is only slowing things a bit quicker than the epidemic would slow down as they usually do.

California and Washington State have banned gatherings greater than 250 people. Travel from badly infected areas is curtailed. Canada hasn't done that yet by the way. Most business are telling people to go home if they have symptoms and some demanding self quarantine if they have travelled to an affected area.

From what I see so far most states, hospitals and jurisdictions are doing a pretty good job in Canada and the US. Remarkably there don't seem to be infected hospitals, just some nursing homes which have a different dynamic. The numbers are increasing but resources seem to be available so far. There are lots of tools yet available; closing schools is a big one. The testing situation has been a serious clusterf**k, but so far I don't think has made much of a difference in the response.

The big challenge is how to deal with the usual March cold/flu season, where the symptoms are identical for most cases. Available resources could be consumed chasing after every sniffle and cough, which would be counterproductive. I don't know the answer to that, other than people self quarantine as much as possible.

Your comments are unbelievable.

Have you done the math on your comment:

"It will run it's course by next spring,"

Are running a high temperature, which might explain the comment.

Are you running a high temperature, which might explain the comment.

My temp is just fine and am enjoying your comment as it is an indicator of misinformation and misunderstanding.

Just for the fun of it, Google the" SIR epidemic model" and enter the parameters for time running to spring of next year, and a reproduction rate of 2.5

What are you talking about? That isn't what the curves look like. There are typically two humps, the first steep and high, the second less steep but longer duration, with a decrease between. We are on the upward swing of the first hump, all that can be done is to slow down the increase to not overwhelm the medical resources. At one point the growth slows down, then the numbers decrease. Likely another upswing in the fall to last the whole of next winter.

The reproduction rate isn't constant. As large numbers in the local population get the disease and get over it, they have immunity, slowing the increase. But the spread dynamics of travel, social connections and the like continue, and when people go to school in the fall the thing takes off again. It is local, still is right now, the numbers are not evenly distributed over the entire continent with large numbers in small concentrated areas, typically tied to a community of some kind.

The US bought roughly 3 weeks according to a link in the last post here by limiting travel from China. Likely in about a month to 6 weeks the first ideas of treatment will start showing up as the experiments going on right now come to fruition, or not. In about a year and a half there will be a vaccine, likely just in time for the thing to disappear.

Right now in BC, there are around 50 cases, most of them from travel, but a growing number of local infections. A couple localized outbreaks; a nursing home, some schools. There are very large numbers of asians travelling back and forth from China, a few from Iran, and there are some infections that are not connected to any known source. But right now outside of a few small circles there aren't any infections. I suspect that is the case all over North America. Hospitals seem to be doing the right thing, we haven't seen a hospital system turning into a disease vector like what happened in Italy.

We are already seeing some places peak and level off, the top of the first hump. It is a factor of time, with some influence from policy and practices. None of this can be represented in an exponential formula.

It is highly contagious, almost everyone will get it, probably 60% of the population. The vast majority will not even know, a good proportion will have flu symptoms, and a sizeable number will be very ill, requiring extraordinary medical intervention to keep them alive. The trick to keeping it from being catastrophic is spreading it out over as long a time as possible.

And hoping it doesn't mutate into something far worse, but typically those strains are limited in reach because they kill their host quickly.

The thing to remember about this mess is the factor of time. Italy hospitals were seeing 200 new people overnight needing intensive care, and are unable to handle the numbers. That 200 over a month or even a couple weeks is bad but manageable, but overnight overwhelms any resources. They are talking about triage where treatment isn't given to people of a certain age.

So everything is about time. All the sports have cancelled their seasons, meaning that 20000 people aren't potentially exposed every game, slowing the spread. At the optimistic .1% that is 2000 people who don't show up a week later needing intensive medical care. They show up in dribbles over the next few months.

Get used to it. There isn't much that can be done to improve the situation, only not doing things that make it worse.

Derek,

Here is a modeling of Seattle done by a firm that advises insurers and health plans.

https://carrothealth.com/carrot-health-insights-predicting-coronavirus-risk/

You are dangerous to your own health and those around you.

Perhaps South Korea will prove to be a happy medium. They seem to be doing a great job of monitoring and control without locking down whole cities or restricting people’s movement.

South Korea was fortunate in having a single infection vector to track.

Meanwhile, Germany is headed for a 70% infection rate, which seems to show that it's a fallacy to think that a country can test its way to containment.

Silly comment. It's not about containment. It's simply about slowing it down enough to flatten the curve. three words to know, Tom: Flatten. The. Curve. If that's too much, then remember Flatten and Curve.

how about more Singapore less China ?

One relative, last night, went to the emergency room. He is a type 1 diabetic, was experiencing a fever, chills, and other flu symptoms They checked for the flu. ER says: you have the symptoms of covid, but since you have no history of contact with anyone who did, we cannot test.

He went home with his wife and is better today.

If anyone wants a test, anyone can have one,

And,

It will all be over by April.

I guess we are the

April Fool.

Thank you so much for posting this. I am type 1 diabetic, and I have been terrified of this. I am happy to learn that your relative is better. That's at least one anecdote in my favor. And I am happy for your relative, as well.

It was terrifying to the wife. He was coughing like crazy, had a fever, shivered....unsteady. To top it off, they live in a senior living complex, but fortunately they do not get out much from their two bedroom apartment. But, even self isolation can't be self isolation because the wife is in the same living space.

ER says: you have the symptoms of covid, but since you have no history of contact with anyone who did, we cannot test.

This is fucking retarded.

However, My co-worker was at the hospital yesterday and got tested just because she entered a hospital.
So it seems the response is inconsistent.

What country are you in? I think you can find the CDC guidelines on who can be tested. I think that the doc followed the CDC guidelines, or if he didn't and failed to test him and complications develop I will know where to find a good lawyer.

Here are the guidelines:"
"Priorities for testing may include:

Hospitalized patients who have signs and symptoms compatible with COVID-19 in order to inform decisions related to infection control.

Other symptomatic individuals such as, older adults (age ≥ 65 years) and individuals with chronic medical conditions and/or an immunocompromised state that may put them at higher risk for poor outcomes (e.g., diabetes, heart disease, receiving immunosuppressive medications, chronic lung disease, chronic kidney disease).

Any persons including healthcare personnel2, who within 14 days of symptom onset had close contact3 with a suspect or laboratory-confirmed4 COVID-19 patient, or who have a history of travel from affected geographic areas5 (see below) within 14 days of their symptom onset." https://emergency.cdc.gov/han/2020/han00429.asp?deliveryName=USCDC_511-DM22106
Note: They asked him if had known contact with a suspect or confirmed person.

I guess this is how you ration testing.

USA. Co-worker is immuno compromised, but she said that they swabbed her just because she was in the hospital and they were swabbing everyone who was in the hospital for any reason. Of course, she has been known to exaggerrate for dramatic effect at times, ....

A lot of this criticism is short sighted. Yes, we decided to create a test ourselves and initially it did not work. Had we chosen to import it and then ran out of it, we would be criticized for "insecure supply lines" (see issue with masks). Not to mention that long term it is indeed safer to have those being produced in house.

Besides that, implying that other places only quarantined places based on tests is incredibly misleading. Everyone started to react based on infections, and testing is useful there but not before infections show up!

Impossible at this point to rank government's responses since different countries are at different points in the cycle.

You can both import and create your own.

No plan B.

We're not seeing a flood of people with severe respiratory symptoms flooding our hospitals. We're not seeing large community spread. Testing more would have yielded more negative tests. The criticism is overblown.

Going forward the MO should be to keep this out of senior communities and schools as they are where death rates and transmission is the highest.

How do you know if you haven't tested?

Is severe respiratory symptoms the cut off for having and being able to communicate the disease? What about moderate respiratory, or other symptoms?

How many days since the first reported case in your area?

Whistling past the graveyard.

Maybe you can get a job in Seattle. Or some NYC suburb. Do you think they are somehow unique?

My son in law is an ER doc. He fully expects to be exposed to it and probably get it. They are this weekend filling his parent's empty house (they are out of town in Arizona) with food supplies so that he can isolate himself from his family if he gets the disease.

Have you figured out how you are going to isolate yourself from your family?

Take a deep breath Bill. Oh sht, bad idea, now you're infected!

If there is a huge swathe of the population that is infected and asymptomatic, then this isn't a big deal. If it were serious and ubiquitous, we'd see serious health repercussions showing up in the hospitals, regardless of whether they've been tested. We have not.

There are already cases in my county, the county to my south and the county to the east of me. Virtually all of the cases are travel related.

Wash your hands, try not to panic, and go buy a stock ETF. You'll thank me in a year.

And, when I said, visit Seattle, I meant you also to read some modeling done by a medical data analytics firm that advises insurance companies and health plans.

Count the number of dead.

https://carrothealth.com/carrot-health-insights-predicting-coronavirus-risk/

No kidding, or license (if you need to) the IP for the foreign test and make that here.

I don't get some of the wailing about test kits.

Yes it would be nice if high-risk locations like hospitals and nursing homes had pallets of these things handy for at-risk staff and residents. But in the general population people are only going to ask for a test if they're already showing symptoms, at which point they've been spreading for days or weeks anyway if it's COVID. Of course people want to know whether they've got COVID or just a regular flu, but is the treatment protocol much different for either at this point?

For example, my school district suddenly closed down today -- until at least Monday -- because one student at one of the four schools has a family member "displaying symptoms." If there were unlimited test kits, would they really test all 1600 asymptomatic kids and staff right now to determine their course of action? No, a lot of this is going to be wait and see, with or without kits.

That point would be good if the test kits and tests were expensive. I can't find price information - it's all "free", but one company is preparing at home test kits and claims it will be able to process a thousand test per day. I infer this is really cheap stuff.

So far I've been hearing you might get charged hundreds or several thousand bucks for a test at a medical facility, I haven't heard about a cheap do-it-yourself model but we can hope. They'd sell out faster than Purel.

In short I'm saying that the testing in some ways seems more like a lagging indicator rather than something that can get out front of the spread. Maybe it's proving more useful in Asia, though.

I believe the point about the lack of testing is less about today as it is about yesterday: Identifying (via testing) known cases when they were small would have better allowed individual isolation and measures to prevent spread. Identifying (via testing) that this approach was failing would have allowed health authorities to close schools and offices earlier, which would have better minimized spread. Instead, without testing early on, the evidence required to take major steps was stymied, creating conditions where we have larger spread and fewer options. Looking at Singapore for example shows what massive, aggressive, early response can do (versus Wuhan).

Spread is not homogeneous; in the US it is likely some places (Seattle, NYC?) are very different than other places... without large scale testing we are forced to assume everywhere is like everywhere else, meaning you look to the worst places and apply the methods appropriate there to everywhere.

Testing is about today too, no just yesterday

And, since there is variation across geographic space, testing in communities where it is not widespread can result in reducing spread through contact tracking.

For over thirty years, the Republicans have campaigned on the premise that government is broken. And they have done their best to make that come true.

When elected, they relentlessly reduce headcount, slash budgets, and hamper the operations of the government. They treat the leadership of agencies as patronage and/or sabotage roles. They purge experienced civil servants and replace them with unqualified partisans, or leave the roles unfilled. They subvert science and bury reports, and muzzle professionals. And they relentlessly attack the legitimacy of the government and the worthiness of the people who work for it.

Then a flood or epidemic comes along...

CDC increased staff about 30% in last 10 years. Their budget exceeds $1 billion. What were they doing? CDC is run by Obama hold over.

CDC is run by Obama hold over.

Lie, Lie, Lie, Lie!

Robert Ray Redfield Jr.[1] (born July 10, 1951) is an American virologist. He is the current Director of the Centers for Disease Control and Prevention, and the current Administrator of the Agency for Toxic Substances and Disease Registry, having served in both positions since March 2018. Before joining CDC, he was a tenured professor of medicine and microbiology at University of Maryland, Baltimore

Who was the president in 2018?

That midwit who demanded that a lab prove their test against SARS samples which could be available in two months obviously needed a bigger budget to not be so stupid.

All the good FDA and CDC bureaucrats are gone and replaced with Trump shills? I’m trying to understand your argument....

It is possible that the CDC and FDA are exempt from the GOP machete and in particular Trump's approach to governance. The strategy is well documented and in general celebrated proudly by chainsaw wielding Republicans. There's no argument about the gutting of the IRS, EPA, climate science, etc. Not to mention state department. The recent BLM putsch is infamous.

But inasmuch as the GOP did not publish inventories of who left, who stayed, and what morale is at the staff level, we must indeed entertain the possibility that the FDA is, um immune to that program.

“Sure, my partisan fever dream may not apply to this actual circumstance that we’re all discussing, in fact it may the exact opposite!

But I’m still right and boo out-group !!”

We’re approaching Dick the Butcher/anonymous levels of partisan stupidity.

How do I switch to team Corona-chan?

just a taste of what you already know is true. and has exploded under trump

https://www.thenation.com/article/archive/gutting-civil-service/

Our government’s response to this virus has been terrible because the government’s attitude was always about using this virus to get the upper-hand in the trade war with China rather than actually solving it. Wilbur Ross came out and said he’d hope the coronavirus would bring jobs back to the US. And Trump initially put Matthew Pottinger, a professional China basher with zero experience relating to infectious disease, in charge of the response, and made it only his part-time job to boot: https://www.latimes.com/world-nation/story/2020-01-30/cdc-coronavirus-preparedness. The government kept accusing the WHO of being in China’s pocket so it decided to make its own tests instead of using the WHO’s which were used by many other countries, again resulting in massive failure and testing delays. Trump also kept tariffs on medical equipment from China in place all the way until last week, which exacerbated shortages here, and led the government to tell everyone that masks are ineffective even though masks seem to be quite effective if everyone wears them in public—but getting that quantity of masks will mean importing from China and we can’t have that now can we?

I might not have stated it so strongly, but you are headed in the right direct. Trump and the GOP have been bashing the federal government, cutting its resources, and rewarding ideology over competence, and it now expects the federal government to be perfect. Ditto for many of the commenters here.

The CDC budget has increased every year.

Its appointee is a career virologist, MD, scientist researcher.

Yeah for the EPA sure, you might have an argument.

But this is just mood affiliation anonymous level bullsht.

I hate to break it to you, but

https://twitter.com/ATabarrok/status/1237208534812635137?s=19

And while we're at it,

https://twitter.com/nprfreshair/status/1238186469690429440?s=19

Fair points Skeptical. You are right -- I got caught up there in mood affiliation, which I do try my best to avoid. I was trying to express my frustrations about how the GOP bashes public servants. And in particular how Trump denigrates them -- in the face of Trump's constant denigration, public servants are going to err on the side of not trying to offend him. I believe this is what happened at the CDC. Recall what happened to Nancy Messonnier.

And thanks for calling me out on it.

This outrage over testing seems overblown. It's only in the last few years that we were able to develop these tests at all. What did people do before that? They had to actually think.

A person goes to the doctor complaining of fever and dry cough -- diagnose them with coronavirus and tell them to quarantine themselves. A test is nice to have, but we can get by without it for a few weeks.

Tests in other countries aren't that accurate anyway. I saw reports that the tests being used in South Korea are 50-60% accurate? If we used that test here, everyone would be complaining that our tests are garbage instead of complaining that we don't have tests at all. Would that be better or worse? It's not obvious to me.

The question, ultimately, is twofold:

1) Is the quantity of people tested a relevant metric of the government's response?

2) To what extent does the United States, a heavily federalized country (still true, by contemporary standards) with a robust culture of privitization (also still true, by contemporary standards) reliant on government response in the first place?

I am not sure that 1) is very relevant. If anyone has been to the doctor for the flu recently, you know that they often won't test to see if you have it, because it doesn't change their recommendation to you: get rest, avoid contact with others, etc. It's not clear how that differs substantially from the bat soup fever. If you waved a magic wand today and had a definitive test on everyone in the country, what changes? You might get some data on specific areas that need quarantine, but it's widespread enough that you're still looking at the same practical measures we have in place. You may find out that a hell of a lot more people have it, but what are you telling them to do then that you aren't now? The vast majority won't need medical attention, if they aren't seeking it now.

That brings us to 2), which is that the problem seems to be getting handled (ham-fistedly, but nonetheless) by the private sector. I would posit that the public's reaction to the same measures would be decidedly different if they came as edicts from the government rather than "voluntary" decisions by private entities. Barring that, the states and theor governors have not been shy about making their own decisions, and they have their finger on the pulse of their state much better than the feds do.

All that said, the response is vastly disproportionate to an outbreak that is not drastically different from a bad flu season. My guess is that by the time summer hits we'll be getting the usual introspective pieces from the media on how they could have handled this crisis better while commenting on how the tanked economy is the fault of you-know-who and not the result of a mass panic they ginned up. Hopefully I'm right, about the ultimate impact of the virus anyway.

1) Is the quantity of people tested a relevant metric of the government's response?

Given that extensive testing seems to have been key to South Korea's successful response to the outbreak. An emphatic YES.

South Korea is different because of *how* they test, not necessarily *that* they test. Their goal is to keep people from running to the hospital and infecting everyone there. It makes for good data but the practical effect is the same: if you have flu-like symptoms, stay home unless you legitimately need medical treatment.

The low death rate is similarly an effect of the testing, not a practical change in their situation. Again, if we could magically test everyone in the US, we'd likely find that a lot more people have COVID-19 who think they have a cold or the flu. It would make the death rate among confirmed cases plummet, but does that actually change the situation? The vast majority of cases resolve themselves without medical attention regardless.

Yes, it does actually change the situation, because the people who have it can self-isolate, and you can inform people who came into contact with them that they too should self-isolate to avoid spreading it.
In China, they didn't just track close contacts, they required all the close contacts to stay home, even if they weren't showing symptoms.

That's what we're doing right now—it's just supply-side. Instead of welding people's doors shut, or enabling the bar-hopping "quarantines" in Hong Kong, we just don't have places to go. Say someone you know gets the Wuhan flu, you don't think you have it, so you'll just head to work... nope, boss said work from home... so you'll catch the game... nope, season's suspended... and so on.

It's possible we could avoid these sorts of ham-fisted closings if there were more tests, but if that's the case, no one has said so. They're "out of an abundance of caution".

Are you dense? If you know you have it, you self-isolate, if you know you don't have it, you don't have to. Knowing whether you have it or not makes a difference! Knowing whether you have it or not lets the epidemiologists trace your contacts and tell people who should be self-isolating.

If you waved a magic wand today and had a definitive test on everyone in the country, what changes?

You know who should be self-quarantining, and whose contacts you need to trace.

I would argue that anyone who is showing flu-like symptoms needs to be self-quaratining whether they have COVID-19 or not. That's good advice regardless, considering we have tens of thousands of deaths from the flu every year.

Aside from that, we would only pick up asymptomatic carriers. That's great, but if that's the goal we would have to be testing everyone on a continuing basis. Is that realistic?

No, you just test people who are showing symptoms and those who are close contacts of people who are confirmed cases.
Which is what South Korea is doing and we are not.

Those tests aren't randomly distributed in the population - but the number of tests performed is a good indication of how much tracking and testing of close contacts is occurring.

CDC and the FDA: Add them to the list of agencies needed to be burnt down and rebuilt.

Why rebuilt?

There's an argument that the CDC should be rebuilt. This coronavirus thing is not the worst possible outbreak.

A competent government would order telecommuting, shut down the schools (thereby risking the realization that we don't really need them), mobilize response teams (by draft if necessary), and close the borders. And then people would cry, so we end up with an inoffensive mishmash of responses.

Yea, free childcare is provided by mothers. They are not needed in the economy.

Yes. I forgot to mention that The Economy would suffer from women taking time off from coding, for example, and people would cry. So best not to do much of anything.

Actually, the point I was making was that people would realise how much schools were needed. I wasn't saying nothing should be done about the coronavirus.

Who hired the head of the FDA and the Head of the CDC? Hint they are both political appointees.

Who slow walked the crisis and refused to issue an emergency declaration that would have allowed the FDA to suspend regulatory requirements? Hint: it’s the same person.

To be honest, doesn't seem to be a lightweight: https://www.cdc.gov/about/leadership/director.htm

The smarter you are the harder it is to convince a guy like Trump. That goes double if you are an establishment pick. Ask Reince Priebus.

...Yes, Trump implemented these regulations that have existed since well before Trump.

Well done, you've proven again, that the issue is not trump, the issue is federal bureaucracy.

This stuff, stymieing of tests and such, makes me more convinced that the wierd virus I got last year was COVID-19, or at maybe a less deadly or less infectious ancestral strain. They didn't run a test, again, because they probably couldn't, because they didn't have permission from the FDA. Clearly, if something is flying under the radar, and no test is approved for it, then it will keep flying under the radar, because nobody's going to bother pushing the test through FDA approval, unless it starts killing mass numbers of people in large clusters. This was last June so weather conditions wouldn't have been right for a severe outbreak. People probably just assumed it was the flu. It could have flown under the radar until winter. The urgent care basically said that there was something viral goind around they didn't know what it was, there was no test, or they couldn't do a test, and no treatment, just gave me a prescription for an inhaler and told me my body had to just get over it. (Lower respiratory tract, bronchitis, fluish symtoms but no head cold).

The first reports of COVID-19 / SARS-CoV-2 are from December 2019

What makes this particular strain so deadly in the aggregate is precisely because it is so much less deadly individually compared to previous SARS/MERS coronavirus outbreaks. We should not be lulled by its mild nature in most people but we should not panic either, especially if you've come in contact with someone with COVID-19 or have similar symptoms yourself. Self-Isolate and self-monitor until a test can be safely taken. An inexpensive pulse oximeter should give you peace of mind if you are struggling to breath (normal SpO2 is above 95% or 92% for those a mile high; SpO2 below 80% is dangerous).

The first "reports". How the heck would Americans know if something new is going around if they can't test for it because the FDA doesn't let them?

The good news is that the CDC has plenty of time and resources for things like comic books that show women being doctors, studies into things like happiness, etc.

The CDC job list should be short and sweet: Preventing germ warefare, preventing pandemics. We don't need them working on coloring books explaining that too much sugar is bad for you.

Like most big agencies, they lose sight of the reason they were created (the hard stuff) and instead focus on the minutia (aka the easy stuff).

Harry Browne laughed.

A fish rots from the head down.

And this is a Federal issue how? TDS is going strong again I see as well as "where is our king when we need him!!!" and it's sad to see all the shills pushing Trump to cross the Rubicon under the guise of "state libertarianism". This isn't a Federal issue, it's barely a state issue. If people want to remain home, they can.

I'm betting this guy is a Democrat.

This is stupid. Trump has spent three and a half years dismantling government, and now it's government's fault that the Trump administration is incompetent?

The federal government has been dismantled?

The FBI
The CIA
The EPA
The IRS
The labor department
The justice department
HUD
The department of education

How many jobs within these bureaucracies have been terminated since Trump and by how much have their budgets been cut. Just trying to understand your argument better...

This is it - argue that government is awful, and so it should get no funding, which then leads to its failure & proves it is awful -- sadly, I think they planned it.

"Trump and the GOP have been bashing the federal government, cutting its resources, and rewarding ideology over competence, and it now expects the federal government to be perfect."

If we could believe in it, ideologically, I think it could be much better.

...This is insanity. The CDC has gained budget almost every single year that Trump is in office. Over the past 10 years, there has also been a 30% increase in staffing.

Stop pushing this insanity.

Well, the delay in testing was due to the FDA rules creating a single legal pathway to create a test and that pathway screwed up.

"Case in point: FDA rules initially prevented state and commercial labs from developing their own coronavirus diagnostic tests, even if they could develop coronavirus PCR primers on their own. So when the only available test suddenly turned out to be bunk, no one could actually say what primer sets worked."

https://www.newmarksdoor.com/mainblog/2020/03/why-the-cdc-botched-its-coronavirus-testing.html

Not sure what’s going on in the east coast but testing kits have become available in most Northern California hospitals. Tents are in fact being pitched in some
ERs for quarantine and to prevent further spread of respiratory illness between patients and visitors. There is an active response; this is a fascinating time for public health as dormant issues emerge at the forefront. The statewide response in California has been impressive, IMHO and the emphasis has been hugely on “better safe than sorry”.

I too think that the lack of testing is appalling. But European response was worse. They allowed tourists from China and elsewhere into the country to attend crowded, highly public events for weeks and weeks before doing anything at all. It's ludicrous to think that the US ban on Chinese flights in late January was not superior to the entire response in Europe. Yes, there are a lot of untested cases, but there is no catastrophic rise in critical pneumonia infections in any major city. NO matter how we failed, it could have been like Italy but it hasn't been.

All I can say is thank God the Democrats got their act together and (it appears) stopped Commie Bernie from winning the nomination. Of course a lot can happen in 8 months, but Trump isn't looking good right now.

Have you seen Biden? Sanders at least won't show up to a press conference sans pants.

People used to joke that Cheney was really running the country during W's terms. Its entirely likely that whoever is Vice-President will determine whether or not Biden has a shot against Trump.

Do you even know what communism is, REALLY? Before you start pontificating about Bernie, check whether you've actually lived in a communist country before you go in with hyperbole and deluding stuff.

If you haven't jumped off of a tall building, you have no idea if it really kills you.

Bernie wants to take America as far as it possibly can go down the road of Communism. Saying he's not a Communist is like saying David Duke is not a Nazi.

I lived and Morris is 146% right.

"It’s been stunning to me how bad the federal response has been.”

Hmm, then maybe we shouldn't set things up so that the Federal government can do things like PREVENT STATES FROM IMPLEMENTING TESTING ON THEIR OWN.

Because they didn't have an FDA approved test - though they had tests. Reliable ones, including ones that were already in use in other countries.

notta good sign
gov. newsome equates managing a viral pandemic
to ordering printer ink?

If true, damning...

Trump Has Sabotaged America’s Coronavirus Response
As it improvises its way through a public health crisis, the United States has never been less prepared for a pandemic.

BY LAURIE GARRETT | JANUARY 31, 2020, 11:07 AM

And yet a few months before that the U.S. got the highest score of any country in the world on pandemic preparedness

Source please, or, if irony, don't quite your day job.

https://www.ghsindex.org/
Click on the US on the map. Score is #1/195 countries.

TMC, There's a problem with your analysis. Although the report says 2019, the data must have been gathered and analyzed prior to that. I couldn't get that information, but it's possible that the data gathered preceded Trump's dismantling of the various programs Garrett mentions, possibly proving Garrett's point. In any case, it was a survey. What we witnessing will tell us how accurate the surveys were,

TMC, I did appreciate your comment.

Thanks. Yes, it was a survey, but i guess it would be hard to truly put numbers on preparedness. As for the article, that's about the removal of the pandemic team from the NSC, which has no expertise in pandemics. We already have two agencies that are tasked with this. The article cites bureaucracy as part of the reason for the Obama's slow response on Ebola, and should have mentioned the slow response to swine flu as well. I'd think removal of a task from an agency that has no expertise in it should reduce bureaucracy and better response time. Seems like it worked.

TDS alert! TDS alert!

Report to isolation immediately!

TDS alert! TDS alert!

Anyone else saddened by the unrelenting partisanship regarding COVID-19? There doesn’t seem to be a story I can find that doesn’t reinforce anyone’s priors, especially if any blame can placed upon a political opponent.

It's a Democratic hoax and it will all be over by this April.

Trump is the President. As the leader, he will be judged for his leadership qualities, and that will effect the party he belongs to. That's fair, as far as I'm concerned. These type of events simply are defining. As for Trump, don't worry, he'll end up saying he did the greatest job humanly possible.

He'll blame someone else.
That's what narcissists do. No kidding. Look it up.

Me: I warned you.

You: But I thought that was partisan!

Global distillation of a huge percentage of this thread:

What the hell does the head of the Harvard Global Health Initiative know!? I am very smart and read a lot of free market blogs so listen to ME on this (not very serious) infectious disease issue.

What about the reports about seed pods in El Mira?
This so-called COVID-19 thing is a distraction from the real threat, seed pods from alien worlds. Your next!

"Massive US Government Failure Under Trump"

Fix that for you.

TDS alert! TDS alert!

Report to isolation immediately!

TDS alert! TDS alert!

Having an entire political party that is actively trying to degrade the performance of government in the service of their ideology has long-term consequences.

Electing a fundamentally innumerate, relentlessly short-term-thinking person President has short-and-medium-term consequences.

Throw in a genuinely high-end disastrous event, and here we are. Perfect storm.

I agree, Obama was a particularly bad president for the Governmnet, we saw all the federal agencies turn into political party weapons.

This was not good.

Trump hasn't been able to truly help with this, so many leftover Obama appointees, really need to eliminate bureaucrats at about 10 yrs.

I should have stockpiled popcorn, because I have run out.

+1, thread winning comment

Confucianism and tough civil service exams ensures government administrators have a fairly high level of minimum competence. In barbarian countries those who can, do, and those who can't go into government to get paid to kowtow to the demands of their capitalist overlords.

Here's Bill Gates in 2015 on virus outbreaks:

https://www.ted.com/talks/bill_gates_the_next_outbreak_we_re_not_ready?language=en

Of all the current events going on in the world, I find this comment thread the most disturbing. It’s clear that I live in a country with complete and total assholes who are willing to die, clutching to their meaningless political priors, so they can FEEL righteous. Pathetic.

Three points, though I know I'm late to the thread:
1. No democracy would be willing to spend what it takes to prevent this kinds of threat - until it happens. We'll go through the same recriminations when a asteroid finally strikes North America - "Why didn't someone do something about it!"
2. If we had prepared, odds are we would have prepared for the wrong threat anyway.
3. Ashish Jha is part of the problem. Instead of telling us "I told you so", he should be focusing on what else we need to do now that this is upon us.

1. Is ridiculous. It’s a rounding error on a budget measured in the trillions.

It’s not done because there’s no incentive for CDC to....you know...actually do their job.

CDC has received $60 billion over the last 5 years. The stockpile of masks in the US is enough for less than 24 hours. The number of stockpiled ventilators is 0. The number of flex excess capacity hospital beds with equipment is 0. The number of excess medics trained to assist ER in an emergency is 0.

Remember less than 10% of the CDC budget is used for pandemic preparation.

The CDC budget is confusing enough that both sides can make wild claims. Each year the original Trump budget calls for large budget cuts for CDC. But the House ends up funding an actual increase. However in the end there is no reporting if Trump did an house sequestering the funds appropriated. Rather than argue over the budget numbers we should look at CDC employment. Since 2016 employment at CDC is down some 591 positions --a 5.4% drop. I would think this is the best number to use rather than funny budget numbers that may, of may not reflect the true case on the ground.

Many agencies have gone to using more contractors, or have outsourced things like IT. Headcount might be up.

CNN reported yesterday in a fact check of Trump that for H1N1 that the first death occurred on 29-Apr-2009. Then they said that 16 days later, 5000 tests had been given nationally.

The first death of COVID was in Seattle on 29-Feb-2020. 14 days later, the Dept of Health in WA state reports they have tested 6500 people.

In other words, there have been more tests in the state of Washington in the first two weeks than there were for H1N1 in the entire country.

It took the CDC 6 months to test 1M people for H1N1. Trump will test that many for COVID in the next 1.5 weeks.

That's what you get when you let small government / low tax / low regulations goons take over.

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