“Our regulatory state is failing us”

A number of commentators suggest that the real problem is President Trump, rich people overly concerned with tax cuts, a Republican Party with a deregulatory ideology, and so on.

Instead I have been repeating insistently that “our regulatory state is failing us.”  The FDA and CDC, for instance, have through their regulations made it harder for testing and also widespread mask supply to get off the ground.

I don’t see how you can blame (supposed) deregulatory fervor for the presence of too many regulations, as we have been observing in these instances.

I do think you can blame President Trump, along multiple dimensions, for a poor response to the pandemic, see my grades here.  (If there were a separate risk communication grade, Trump would get an F minus for that.)  Nonetheless a regulatory state cannot be said to work well if it requires such extraordinary attention from a sitting president.

It can be the case that both Trump and the permanent bureaucracy are at fault.  If something takes a long time to get done for reasons relating to preexisting rules, regulations, and laws, usually the current president is not directly at fault for that particular problem.  Was it only Trump’s fault, for instance, that the permits to build a mask factory can take months to acquire?  Or that the HHS did not respond to inquiries about gearing up mask production in Texas?  Or that a law had to be changed to allow industrial companies to sell quality masks to hospitals?  Or that so many a-legal or extra-legal activities (e.g., rich people arranging deliveries by plane, etc.) had to occur to sneak masks into this country?  That the trade barriers on masks persisted for so long? (And yes likely the Trump administration is at fault for de facto toughening restrictions on masks from China.)

It is fine to say “the buck stops here,” and to criticize Trump for not having erected processes to be more aware of these problems and to dissolve them more quickly.  I would agree with some of those criticisms, while noting the Trump administration also has tried to ease many of the regulations hampering adjustment.

This is more something on the horizon, but how do these apples make you feel?  Comforted?  The fault of plutocratic Republicans most of all?

And in both cases, vials and stoppers, a vaccine manufacturer cannot just switch to a slightly different product or another brand. They typically have to run manufacturing changes by FDA first, which could make quick supplier changes to curb shortages a difficult prospect.

The FDA can decide how flexible it will be about this type of change, says Sklamberg. The agency said in a December 2017 draft guidance that companies could note some changes in their annual reports rather than waiting for approval, but it has not finalized the policy.

The ability to switch products could be crucial as the entire world readies for a possible vaccine and vies to secure their supplies.

If you wish, consider a simple question.  When the CDC pooh-poohed masks early on, or botched their testing kit thereby delaying U.S. testing by weeks or maybe months, did the permanent staff of the CDC rise up and rebel and leak howling protests to the media, realizing that thousands of lives were at stake?  That is surely what would happen if say the current FDA announced it was going to approve thalidomide.

Those are still cases of our regulatory state failing us.

Comments

It seems obvious to me that all the problems you've brought up are easily solvable with more regulation (designed by experts of course) and free money.

Slap on another layer of "oversight" and call it a day.

I think you need at least two levels of oversight to function in a proper regulatory manner.

Cut and eliminate taxes and sunset all laws after 5 years so that they must be passed in congress again.

To add to the regulatory state intrigue, the Fed is now buying bond ETFs leveraging the market knowledge of firms like BlackRock to do the picking and choosing of credit assets. As your colleague at Bloomberg Matt Levine writes, it might not be the best use of $750 billion as it will flow to the biggest firms not the ones most in need. With debt yields going to zero and beyond this might be why stocks are headed to infinity and beyond because as they say "There Is No Alternative". Prices everywhere are disconnected from reality.

https://www.bloomberg.com/opinion/articles/2020-05-12/the-fed-will-buy-bond-etfs-now

POSTED ON MAY 12, 2020 BY JOHN HINDERAKER IN MEDIA BIAS
AROUND THE HORN TO THE WHITE HOUSE
My friend Michael Patrick Leahy, a reporter who among other things runs the Tennessee Star, the Minnesota Sun and other online news outlets, emailed me a transcript of his interview of Howie Carr, also a friend, who is the dominant radio news personality in New England and a terrific newspaper columnist:

Leahy: We are joined now on the line by our good friend, Boston talk radio king Howie Carr. Howie, the President of the United States is reading what you Tweet about coronavirus.

Carr: Yes, Michael Patrick Leahy. But he read it in your story that you wrote for Breitbart about the preponderance of deaths being in certain age groups and certain facilities (i.e. nursing homes). I’d like to thank you for getting my Tweets to his attention. (Leahy chuckles) I’m glad somebody picked up on them.

Leahy: Well, it was great work on your end. So what’s interesting is, the Massachusetts Department of Health was putting out all these lengthy, lengthy documents and you found in it a slide that was just stunning. And that was the average age among the 4,000 plus people that have died of COVID-19 in Massachusetts is 82 years old. This was like on page 11 of a 100-page report. You found it. Tell us how you found it first. Then you Tweeted it out and I’ll go from there. How did you find that information?

Carr: Actually I should give credit to John Hinderaker at powerlineblog.com. This is how the modern media works. He’s very interested in this and he’s a lawyer in Minnesota. He actually was just scrolling down through documents and found it and printed it.

And I said holy bleep! Where did this come from? As you said, this is a lengthy document that they post every day. They call it the Coronavirus Dashboard. So I looked at it and I Tweeted it out. I’m based in Boston but I’m in Florida. Then I see a guy from Minnesota post it. You’re in Tennessee and you see it and you put it into Breitbart and then the President of the United States sees it.

Leahy: It’s amazing.

What’s amazing is that most people are unaware of basic facts about the coronavirus because reporters and editors are pursuing a partisan agenda, not trying to disseminate information. So it falls to people like us to pass on basic data to our readers.

One amendment to Howie’s recitation: I wasn’t the one who pored over the Massachusetts Coronavirus Dashboard. Rather, a reader whom I have quoted at length several times read that there was a surge of COVID cases in Massachusetts and, curious, looked up the data. She sent me an email that included a chart from the Massachusetts Health Department which I reproduced here. Howie Carr is a Power Line reader; he saw that post, titled “The Models Were Wrong. Does Anyone Care?” and invited me on his show to talk about it.

Which just reinforces the point. Any concerned, intelligent citizen can run rings around the professional media, not because reporters are dull-witted–although, to be fair, that is a contributing factor–but because modern-day “journalism” is largely about not reporting facts that are deemed inconvenient to the governing class. Such is the sad world in which we live, but fortunately, the news blockade is broken every day.

Exactly what is your point? Even if everything I know about covid-19 comes from CNN, I know that older seniors are especially vulnerable.

>It seems obvious to me that all the problems you've brought up are easily solvable with more regulation (designed by experts of course) and free money.

And that's exactly what Tyler will be voting for in six months!

As always look to the incentives. In a bureaucracy you can only get in trouble for doing something new. Never are you going to be praised.

In a bureaucracy, one is praised for spending one budget year creating a problem, and the next decade expanding the bureaucracy to half-fix the mess.

So, regulators with zero budget failing to issue a contract to produce face masks to a company with mothballed production lines in order to build an empire run by Trump's son in law buying them from rent seekers who are diverting deliveries of imports arranged by hospitals?

How did a regulatory gain by shutting down a program to buy machines the manufacture face Mack's in a crisis when a far bigger supply is needed?

Why did regulators shutdown vaccine development for SARS in 2015 resulting in zero work?

To claim regulators cut spending to build bigger empires is bizarre?

If cutting spending is a regulator gaining more power, the biggest, most powerful regulator is Sen McConnell.

Are any of your claims factual?

Did the regulators face budget cuts or did their budgets stay the same or increase?

Right or wrong, ppl at the medical mfg company I worked for believed that the FDA had a defacto ban on post-it notes. So even if you had a post-it with your kids doctor's phone number on your computer, you were supposed to remove it before FDA visits

The fda regulated international harvester in the 70s? They banned post-it notes.

Maybe people are thinking that there might be regulatory states that are doing well, such that the problem is the "our." If it is "our" that's the problem, then why? Is it a problem of regulation being useless or a problem of the those who think it's useless? From my point of view, regulations are so varied and bureaucracies so different you have to focus on them individually and pragmatically. It's not an ideological question. On the other hand, it is my general bias to have fewer regulations and agencies such that we can actually monitor their behavior in something like real time. I'd like less and better done. If there are screw ups, it's not a good idea to overlook them. So keeping track of failures is prudent policy.

Regulatory agencies have no stake in the economy or the industries that they regulate. The best result would be if they disappeared, then they could move onto other important things like regulating vaping or something.

In Canada during the 90's regulators could justify their existence by doing what was necessary to maintain government revenues, otherwise their budgets disappeared.

The Quebec construction regulators were so perverse and ineffective that they drove over 50% of the construction industry underground, meaning that there were no tax revenues or any health and safety practices. Other government agencies desperate for revenues forced them to rationalize the rules so that companies could actually operate within the law.

Good regulations and regulatory practice are beneficial for an economy, but done poorly simply drives business out of the country. This has been a major failure of economists who were cheerleading globalization without making it very clear, loudly and repeatedly that the regulatory costs were a competitive disadvantage, and the impetus for offshoring.

+1

With regard to government, I have called myself a diminishing returns libertarian. Some government is good. More might not be.

Given the poor performance of the administration and the CDC, I don't think you need the word 'regulatory'.

The CDC is a regulatory agency.

Regulatory state failure is a feature of Republican policy. How else do you convince voters that regulations are bad? Failure has to be ensured by policy.

That is why New York State sent infected people to care homes to spread it to others. Damn Republicans.

Oh because regulatory state efficacy in the Obama, LBJ, Carter, and FDR administrations was so amazing?

When the CDC pooh-poohed masks early on, or botched their testing kit thereby delaying U.S. testing by weeks or maybe months, did the permanent staff of the CDC rise up and rebel and leak howling protests to the media, realizing that thousands of lives were at stake?

Essentially, the federal government said masks worn by laypeople don't work, but masks worn by healthcare professionals do work, and are crucial to protecting them from COVID-19.

The federal government could have offered to pay $3 per mask for up to 500 million washable masks that could be demonstrated to have greater than 90 percent filtration efficiency when properly fitted. Even better would be to publish a design or designs that the federal government would acknowledge would meet the performance requirement.

This ignores all the previous study and publishing done on cloth masks: They don't do anything. "They are better that nothing, but not much" says report after report over the last 20 years.

Why on earth would anyone grounded in science advocate a standard government design for cloth masks when every study says they are worthless?

Nearly every study I've seen on masks has evaluated them exclusively on how well they protect the wearer from airborne germs of varying size. Virtually none of them paid any attention to how well masks prevented the wearer from spreading said germs to others.

It's entirely possible that a cloth mask that does nothing to protect the wearer manages to protect others.

I haven't seen any study with evidence one way or the other.

See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7108646/

They consider both "inflow" (protecting wearer) and "outflow" (protecting others)

Key point: "Pearson χ2 tests comparing the proportion of particles greater than 4.7 μm in diameter and particles less than 4.7 μm in diameter found that the homemade mask did not significantly reduce the number of particles emitted (P = .106). In contrast, the surgical mask did have a significant effect (P < .001)."

and

"An improvised face mask should be viewed as the last possible alternative if a supply of commercial face masks is not available, irrespective of the disease against which it may be required for protection. Improvised homemade face masks may be used to help protect those who could potentially, for example, be at occupational risk from close or frequent contact with symptomatic patients. However, these masks would provide the wearers little protection from microorganisms from others persons who are infected with respiratory diseases. As a result, we would not recommend the use of homemade face masks as a method of reducing transmission of infection from aerosols."

You know those creepy pictures of people wearing googles and giant leather beaks during the plague to ward off infection? Wearing cloth masks is kind of like that.

Aren’t you cherry picking a bit here. Yes. It’s a last resort but better than nothing as the authors say. You forgot this part:

Results from the cough box experiments showed that both the surgical mask and the homemade mask reduced the total number of microorganisms expelled when coughing (P < .001 and P = .004, respectively; see Table 3).

> Results from the cough box experiments showed that both the surgical mask and the homemade mask reduced the total number of microorganisms expelled when coughing

And coughing into your elbow does the exact same thing too. I'd rather if you had a cough you didn't go out at all in this.

Face it: The gov has know forever that in a pandemic only certain masks really help. They also knew a pandemic was coming, roughly every 10 years like clockwork. They didnt' care. The very people in charge of protecting us from all this, huge teams with massive budgets, decided to spend time on coloring books about bullying rather than ensuring we had masks that worked.

I’m m with you on that and also have some skepticism about diy masks and masks encouraging risky behavior, but the risky behavior is less relevant for people who need to work or if we’re supposed to try to get the economy going again.

Impersonal criticism of "the FDA," "the CDC" and "HHS" fails to assign personal responsibility and is the hallmark of a libertarian hot take. If regulations are at fault, who do you think is responsible for reviewing and revising regulations? Who hires and supervising the person who holds this responsibility? And if anyone in the chain of command is negligent, who do you think should hold that person accountable? Are you satisfied with the degree of accountability to date? If not, why not name the people who you think should take action to remedy the situation?

Also, while some regulators and politicians may have failed in the U.S., they failed at a much lower rate in places like Germany and Korea. Why is that? These are not lightly regulated places and, indeed, Germany is a core member of the EU, which is frequently maligned for overbearing regulations.

I’ve said it before and I’ll say it again.

We will never know the names of anyone who made the actual decisions in the CDC and FDA.

Not the insanely poor mask guidance until April (3 months behinds Taiwan), not whoever threatened Helen Chu and thus delayed investigating community spread by weeks, not whoever ran the lab that botched the tests, not whoever made the decision to make the test a single point of failure, not whoever gave guidance to keep air traffic from Europe flowing...

...the list is endless.

If only we had some kind of organization that could ask simple questions - who, what, why, where, when - about those decisions of public interest and publish the results. Perhaps if we had several of them, they could even compete for speed and accuracy.

Helen Chu should ask China.

The problem here is that holding a bureaucrat personally liable for their decisions is a bit like holding a firefighter personally liable for saving (or losing) a life. This isn’t a defence of that concept, but pointing out there’s a systematic problem with this type of governance.

I was there when they built the Obamacare website. What a disaster. Obama was in charge then, and it was his signature legislation. Why do you think a Obama administration would manage this any better then they did their website.

Yes who runs the CDC? I guess we can’t simply look it up or even know who appointed said head of CDC?

Conservatives: the modern know-nothings

I’m not a conservative.

We will need a commission to get to the facts, eventually. If you want to “throw the bastards out” then do it, I don’t think it will change the goings on at the agencies where actual policies are made.

So the director of the CDC has no influence over the CDC?

Do I think the political appointee directors should be held responsible? Sure, throw the bastards out.

Will it change anything?

No. These decisions are not made at that level, and the set of incentives the agencies face will not have changed in the slightest.

In fairness to TC, I don't believe the point he's making is that it's impossible to hold the regulatory state accountable or improve it. His point is that we don't even recognize the need to do so. Anyone that thinks this is Obama or Trump's fault tends to focus their energy there. Ironically, we all clearly understand how to change Presidents.

+1, It's clear that roughly half the population wants to kick out Trump for this and other matters.

But how many people actually want to do a thorough house cleaning of the CDC and the FDA?

I'm curious how much a thorough house-cleaning would help and how much of this is just people responding rationally to incentives (though I guess a house-cleaning would change those incentives).

I'm also curious how what Tyler would suggest to actually reduce the problem. A list of five things Trump could do on his own and five things that would require legislation would be helpful.

But that's hard, though. Easier to throw up a straw man and have everyone take a whack. Come up with real solutions? That won't generate any clicks, sorry.

"I'm curious how much a thorough house-cleaning would help"

First, it would provide negative feedback for obstructive behavior. The FDA/CDC actively squashed independent Covid19 testing. This was an act that was hostile to the American populace. If there is no repercussions to those responsible, then the same behavior will reoccur. Secondly, it would allow new people to rise up who would come to their position knowing their former boss was fired for incompetence. Thirdly, it would allow the American people to see that bureaucrats can be held responsible for their actions.

Enough people need to be very publicly fired for bad judgement and lack of aggressiveness, and other rewarded for taking correct aggressive action, that it makes a significant impression on the culture to influence behavior next time.

The military tries to do this, albeit with mixed success in peacetime, so that when it falls in the pot, people at least know they are supposed to respond. Historically, it takes the military a year or so and a lot of casualties to weed out the bureaucrats.

This is my criticism of journalists. I've read numerous times reports of CDC/FDA failures, but none apparently thought it interesting enough to ask the agency why the offending regulation was in place?
My theory is that Congress gives agencies many, too-narrow mandates without specifying how much economic cost is acceptable in fulfilling the mandate. This means that regulations do not have to pass cost-benefit analysis.

The answer is that America is third world nation with third world institutions. Not surprising that public intellectuals would gin up a third world solution as well. American institutions failed because American governance failed. Abetting it is America's failed intellectual class.

Test and trace needs buy in. Good luck telling someone who just had an exposure to quarantine for 14 days.

The lefts inability to understand what these United States of America actually IS and not what they hope for it to be, cripples their ability to reason.

Let’s go back to the facts.

USA-3rd most populous country in the world.
It’s also one of the freest countries in the world, not just in the Western European way.
It’s also the most ethnically, religiously, politically, and racially diverse nation in the history of human civilization.
On top of that, states wield enormous power.

Trying to overlay gigantic federal structures on the fly and make them work isn’t just something that gets accomplished with words.

Enormous chunks of the populace are openly hostile to government and not just because of right wing propaganda.

You have hard core Trumpers, apolitical African Americans living in slums, illegal immigrants, the mentally ill, and the permanent rural and urban underclass of drug addicts and dealers who want NOTHING to do with the state.

Some of the motivation for those attitudes are because or racism, trying to avoid the law, ideology, or just plain survival.

Those people will not under any circumstance participate in any test and trace system. That group represents a huge chunk of the country.

Then from there you have other groups like
1. Better quality republicans who May grudgingly participate
2. The giant apolitical mass of America that can barely be bothered to pay attention to anything serious for longer than 60 seconds. Again you may get a grudging by in.
3. Blue state America-strong buy in-Will represent the bull work of any successful test and trace program.

It’s just not enough buy in to make it all work all over the country. The blue states have enormously homogenous populations politically speaking. Try test and trace there and prove it’s efficacy.

But rounding up Americans and threatening fines or jail time to arguably 150 million plus Americans won’t work.....

Dabbling with home made drugs during these tough times I see.

While it is ultimately the case that, unfortunately, the permanent civil service can only be held to account through elected representatives (removing reps from office if they fail to remove useless civil servants), there is...

...something inconsistent in bellyaching for years about Trump's loud proclamations that he'll de-empower the permanent civil service - "These are the best people. How dare he criticise or threaten to remove them?!", was oft the claim - and now raging at him for not having already removed them when they have prove and demonstrated their incompetence.

It's one thing for people who wanted Trump to drain the swamp to be angry he hasn't done so, another for those who insisted all along that no such clearing of house was ever necessary.

(This is a lot like the inconsistency that we see in who hates the term "MAGA" because the US was already great, but have now abandoned the idea that the US is still great, argue for national renewal, but still hate the term!).

I find this comment to be dishonest. The criticism I recall is that Trump would staff up civil service with cronies and loyalist hacks, which apparently he has. So really the inconsistencies are from the drain the swamp folks.

Here is an article from 2018 claiming that Trump's pick for CDC Chief is a disaster:
https://amp.cnn.com/cnn/2018/05/13/opinions/trumps-terrible-choice-for-cdc-redfield-garrett/index.html

Drain the swamp, fill the swamp, what's the difference?

A CNN article criticizing Trump isn't a particularly credible source. CNN has experienced significant to extreme difficulty in accurate portrayal of facts surrounding Trump.

So you think the CDC has done a bang up job handling Covid?

Of course not, but to claim that Trump is the root cause of an agency with decades of failure...

The permanent Civil Service tends to be the issue when you see bad regulation. People stay for decades and the culture never changes. Outside of a few specialized job categories, we should likely have a maximum service time of 7 years.

Or perhaps implement rotation, every 3 years you shuffle people around offices. Spend 3 years at the DC HQ? Awesome, welcome to Nebraska or Georgia, or Alaska (or insert state here).

Job rotation uncovers a significant amount of wrongdoing and is a basic security tenet.

Evidence? I mean where are these past pandemics that crippled America? Seems like Ebola and Sars were handled much better than the current mess. Oh right you are a conservatard so nothing to see here move along ignore South Korea and all the other countries with a superior response. It isn't the fault of the people at the top calling the shots must be the fault of the drones. That's the ticket.

I suspect your recall of 2016 is itself dishonest (since you are a lunatic and serial fabulist).

An example - https://thehill.com/blogs/pundits-blog/the-administration/326756-drain-the-swamp-americas-dedicated-workforce-is-not-a -

Lots of defensiveness towards the fine civil bureaucracy. The objection wasn't just that Trump would appoint cronies, it was that there was nothing fundamentally wrong with the bureaucracy and agencies as they were.

What retarded nonsense is this? The CDC isn’t doing a good job so the problem must not be with the people put in charge of running it? Thinking drain the swamp is a bunch of hokum is what you think hypocrisy means? You conservatives never cease to amazes with your retardation.

Ok, but using this reasoning shouldn't Germany's regulatory state be looking to Belarus and Poland to learn.

That is to say, if this is how you feel then you shouldn't want a Merkel you should want an Orban.

After all, when the president suggested on live TV during a White House coronavirus task force briefing suggested injecting disinfectant, our regulatory state seems to be have been quite competent at preventing anyone from following such a lethal suggestion from someone who notes "I'm not a doctor. But I'm, like, a person that has a good you-know-what."

Your partisanship is showing, it takes only a modicum of intelligence to understand context.

Yeah,
That Fauci,
He is just one of those
Who are leading the
Regulatory state.

He never gave Chlorox
The chance it deserved.

I am prepared to give
Donald
Emergency and Compassionate Use
Exemption for him to use Chlorox
On himself.

Not sure if Haiku Bill is connected to dotard lawyer Bill, but clearly Trump was discussing methods of cleaning particles of coronavirus off of surfaces, like hard plastic, or metal, where it might survive long enough to infect someone. But if you wish to score cheap points by taking words out of context, go ahead. Do you think your potshot has added to the conversation? Are you 16 years old, “OMG Trump!”?

Sorry, Immature Namecaller,

We all saw the press conference.
People can't be memory washed that easily.

Here is the part of the Press conference for those who have not seen it: https://www.youtube.com/watch?v=33QdTOyXz3w

Everybody should review the tape again.

Two points. These regulatory agencies write their own regulations. They decide how to enforce them. The process, culture and decades of practice are to say no, oppose changes and expand their influence. It is working as designed. The regulations are challenged then decided by a second unaccountable party, the judiciary. The costs of the massive amount of regulation is the reason that so much economic activity has moved offshore; it is far easier to get access to the market with things made somewhere else than to manufacture it here.

Two states that I'm aware of by order of the people responsible sent people who were infected and hospitalized back to their care homes to spread the infection New York State and Pennsylvania. The Pennsylvania situation is even more perverse, it seems the person responsible for that decision removed their mother from a care home before ordering the infected people back.

There are ways to regulate to reach the desired goals without imposing ridiculous costs, but why would you want to do that when there are no consequences for incompetence?

2. The agencies who failed will get massive budget increases in the next year. Failure is always rewarded. The companies who got tests and masks to market quickly will be punished.

"The costs of the massive amount of regulation is the reason that so much economic activity has moved offshore; "

No, not true for medical. China's rep for poor quality means no one wants to buy supplies or equipment that say "made in China". Parts like screws and labels and casings, ok. Whole pieces of equipment or important supplies? No. Even during the pandemic counties have rejected shipments from China because the quality is poor

Most of this stuff, including medications are manufactured in China. During the pandemic it becomes a gong show because the demand outstrips supply, and there aren't options of a bunch of manufacturers all over the place spinning up production because it all comes from the same place.

But almost all the consumables in this industry are made outside of the US.

Within China there are is a wide variety of quality. Most of our suppliers have firms in China who have figured out how to meet quality guidelines and have long term incentives not to muck around with quality.

However, there are also in China a bunch of suppliers whose quality is exceedingly low and may be actively detrimental. They have been sending stuff out and they have had such bad lots that the products have been refused/returned.

In better run countries you would have some mechanism for holding these sorts of fraudulent producers to legal liability. In China, they typically either walk (if the CCP is not directly bothered) or go to jail/get executed (if they make the CCP look bad). Having a basic tort system response seems to be beyond the ability of the Chinese manufacturing sector.

Close to the entirety of PPE supply (including masks, respirators, gloves) and API for drugs comes from China with some coming from India

Re: our regulatory state - It’s going to disappear. One day, it’s like a miracle, it will disappear.

If by disappear you mean "collapse under its own weight" then I have to agree.

Re: collapse under its own weight - If it does come back, it’s not going to come back, and I’ve spoken to 10 different people, it’s not going to be like it was.

It seems they’re not really failing us in normal times, but they certainly are in extraordinary times like a pandemic.
They need to have 2 speeds. Normal speed and emergency speed and decide ahead of time what can/should be accelerated/chucked in an emergency.
And It looks like these glass vials ought to be recycled. They’re just too valuable.

No. All this has done is expose the perversity. Companies can spin up manufacturing and bring to market products far faster offshore than work through the interminable regulatory requirements and costs of doing it onshore. Those delays cost money all the time. We are seeing what doesn't get done because of them.

We're talking about the FDA here. Most of the drugs we use are already manufactured offshore.
What exactly is the problem withe FDA in normal times ? too onerous regulations of the food supply , of biopharmaceutical products? of medical devices ?
Can you give some examples ?

How many regulatory agencies does a pharmaceutical manufacturer have to deal with to manufacture in the US? The FDA is one.

I don't manufacture. I have about a dozen regulatory bodies that regulate what I do, from the municipalities to the provincial and federal agencies who regulate my industry. If I could do it offshore, I can't by the way, I would shed about 2/3 of them.

There have been around 100 "national drug shortages" a year, every year, for over a decade.

Of these it is estimated that 3% are due to natural disasters. The bulk appear to be due to an inability to manufacture cheaply in the US and the difficulty of maintaining quality overseas. For years, we dealt with these while the FDA took its sweet time inspecting new manufacturing facilities (either here or overseas) and only recently did they begin having "expedited" inspections for critical needs drugs that are on national shortage. Worse, some of these shortages end up being to mundane things like wording in the National Drug Code which in turn limits our flexibility to prescribe the same medication in different packaging and still get reimbursed by Medicare and insurers who follow CMS rules.

And it should be noted this morass of red tape does not just lead to drug shortages. Martin Shrekli, for instance, was one of the many who took advantage of the glacially slow FDA process for certifying new generic drug lines. His basic play was finding a single producer generic drug, jack the price up 20-fold, and then make bank for the year or two it would take anyone else to get a competitor generic to market. Which, after spending millions, might be useless as Shrekli could just drop the price and they would be out the fees for the FDA validation process. Nor was he alone in this. There was an entire cottage industry running arbitrage around the expense and delays of FDA validation right up until Mr. Shrekli provoked public ire to the point that it became congressional issue.

And then, of course, there is just the glacially slow pace for novel drugs. Beyond all the required clinical trials we have literally months of dead time while the FDA reviews things and requires quite specific presentations of data. Bureaucrats have sent back printed materials for being in the wrong font, and after a thousand such cuts approval gets delayed a few months and my patients die waiting.

The FDA is terrified of approving something that is dangerous. They move heaven and earth to avoid that error. They are remarkedly insensitive to the pitfalls of moving too slowly even when that is statistically far more likely to kill patients. They are sufficiently bad at this side of risk that amoral venture capitalists arbitraged it for millions (if not billions) in profits.

So yeah, all of that was without a major epidemic going on and all of that was increasing patients' risk of death by a percent or two all the time.

This is a good comment. Thank you for this.

Trump is nutty on his own, the regulatory state fails all on its own.
We have to figure out the proper medicine.

> When the CDC pooh-poohed masks early on, or botched their testing kit thereby delaying U.S. testing by weeks or maybe months, did the permanent staff of the CDC rise up and rebel and leak howling protests to the media, realizing that thousands of lives were at stake? <

The CDC was the sole provider of tests for H1N1, and it took them 125 days from first death to hit 1M tests. They toot that horn all over the place on their website. They are SOOOO proud of that.

It took the CDC 16 days to hit 5000 tests for H1N1.

In the first 14 days, WA state alone administered 6500 tests for covid. Today, we're at 9.2M tests. Just 73 days after the first death.

Trump's admin has shipped nearly 10X more tests in half the time that Obama's admin did for H1N1. And that's 100% because early on Trump pulled in the private sector. And that was done AGAINST the wishes of the CDC and FDA you can bet.

I can promise you this: If Obama were in office, the media would be celebrating the covid testing figure as the greatest accomplishment one might imagine.

10X more in half the time. In what universe is this a failure? We might not like the reality of the scale required. But that decision was made a long time ago when we decided to send manufacturing for most everything overseas.

Trump communication sucks. But nobody ran out of beds. Nobody ran out of ICUs. Nobody ran out of ventilators. Not a single democrat would have closed things faster than Trump.

Our failings are due 90% to the states' inability to manage senior care facilities. In every state, 50-70% of deaths came from the facilities. All of which are heavily regulated by the states.

How is that Trump's fault?

What would a dem president done WITH CERTAINTY that Trump failed to do that would have resulted in a dramatically different outcome in deaths?

Lol conservatards! The non-existent H1N1 outbreak in America proves Trump's spectacular handling of Covid 19. The poor guy it's not his fault it's all the mean people that hurt his fee-fees on the TV.

I initially thought you were responding in these threads in good faith. Now I've noted you are merely trolling.

Benny did respond appropriately. It's just that you disagree with him.

Note: You did not respond to his H1N1 example because you couldn't but instead called him a name.

Who has the good faith?

> The non-existent H1N1 outbreak in America proves Trump's spectacular handling of Covid 19

But if the handling of H1N1 was so much worse in terms of time required to hit key milestones (eg time to 1M tests) what makes you think those in charge of H1N1 would have gone faster?

In other words, all the kings horses and men took a long time to get to 1M tests for H1N1. Are you saying they were sandbagging in spite of people dying? And if only they had the change to try their hand at coronavirus they'd have done better?

Not a chance in hell. It's not in Obama (or Bernie, or Hillary, or Biden's DNA) to rely on the private sector. Just look how much was wasted on the healthcare website, using the same gov boobs managing and the same gov boob contractors coding.

Great post. Neatly sums up my own opinions on the subject, so I might be biased.

For the masses: I am checking neither of the boxes for notifications because I don't trust the trolls, nor do I want their input.

Is it so ludicrous to believe that a normally paralytic bureaucracy (no arguments here!) is further paralyzed by being at the mercy of an executive (unitary or otherwise fragmented) that has consistently proven itself to be mercurial, political, and unshackled from reality, norms, or decency as this one has?

Is it so easy to forget that the people who are making decisions here are PEOPLE, who have seen time and time again the firing, conspiracy targeting, and scapegoating of those that make decisions based on pragmatism, ethics, and a desire for the common good, in the face of outright incompetence and/or corruption (depending on your explanation du jour) by those in the highest (necessarily political) positions of power?

Does one have no regard for the fundamental sense of vulnerability that is the human condition? Or has one never experienced that and taken it to heart?

In these times when the stories (and personal realities) of unexpected fragility, loss, and uncertainty have reverberated across every dimension of the social fabric, is it right to blame the nature of "the bureaucracy" as opposed to the nature of individuals faced with both systemic and personal insecurity choosing inertia over action?

Is this a real demonstration of public choice theory? In which case, incentives are actually exogenous to the bureaucracy itself and to understand the currently observed phenomenon as a pathology of regulation is to miss the actual and active creation of perverse incentives on the part of the executive.

I have generally found your blog to be more illuminating than not Tyler, but your harping on this issue of "bureaucratic failure" is extremely short-sighted, curve-fitting in an illusory sense, and hubristic, and I am saying that with truly felt, deep sympathies to your point in a general sense to this idea in normal times.

But these are not normal times, even independent of the issues of the current pandemic.

The "Trump administration also has tried to ease many of the regulations hampering adjustment"? Directives to ease regulations are only as effective as the clarity of signal that those who choose to ease will not be punished for taking risks. I would bet you that Trump's treatment of Kemp has more than actively worked against whatever ham-fisted and/or ambiguous "directives" may have been given to the career staffers in the executive branch (unitary or not?).

I believe this is an example of the aftermath of the American version of the Hundred Flowers campaign. I trust you appreciate the analogy.

That will surely be one of the dumber comments of the day.

Fraudulent misreading of events. The FDA actively interposed itself in the development of testing and screwed it up. They didn't do that because they were risk-averse and afraid of being fired by Trump.

That's an interesting point about the belief that Trump would not support people following his directives. But, on the other hand consider the situation with HQC. Most of the world is or was using it with out much controversy. Does it work? Maybe, maybe not. It is relatively low risk and there is evidence it can be helpful. So here is an instance when Trump makes a push for the relaxation of regulation, in a case that seems pretty obvious. But this push has generated an untold number of leaks, insider concerns, whistleblower complaints, and the prospect of congressional investigations etc.

So it is probably fair to say political dysfunction is making the regulatory failure worse, and of course ultimately the political system generates the regulatory system, but saying Trump is the sole or primary source of that political dysfunction seems wrong.

And what is even weirder is how as soon as Trump mentions HQC, then you immediately have a group of people that INSIST it must fail. As if Trump dreamed it up himself. I'm sure in a meeting someone said "Sir, the French a few other countries are seeing some very promising results from HQC" and then Trump, being the optimist he is, mentions that at a press meeting, and suddenly the battle lines are drawn: HQC must fail.

Who are the inept ones in all this? Who is acting child like in this?

Anyone doubt that if the current pandemic in the United States was the result of a deliberate bioweapon attack by the rogue nation of Austria (Note to US weapon targeters: Not Australia!) the US would not have the problems it is having now with containing the virus? If you think the US response would be massive and effective in the face of a deliberate attack, then the current US problem is one of "moral" not capability.

No need for a counter-factual. Over here, any suggestion even that the virus might have been *accidentally* released from the Wuhan lab, and that we should join Australia in calling for an investigation, is met with charges of racism. In the event there was a deliberate attack, the same people would presumably campaign to deny that fact for as long as possible.

No, Australia is calling for an investigation into China in support of Trump. I'd like to think that our PM has put rational thought into this and decided Trump is a greater danger to Australia and that Xi, being more rational, can be placated after the danger Trump represents to trade and security recedes, but occasionally I have particles of doubt over the rationality of our leadership.

There's redundancy built in to the system. Any attack on Austria automatically initiates an attack on Australia and vice versa.

Ask yourself how the masses would be responding if a major US pharma or GMO manufacturer had accidentally released this. There would be dead CEOs, dragged out of their homes by the masses and fueled by the media. Instead, the media parent companies want to sell movies to China, and thus it's a bunch of "oh well, bad luck happens. Besides, we don't even know this is China's fault"

This really is quite remarkable to see.

A view from the UK.

There seems to be plenty similar examples here, eg general medical council not fast tracking approval of some experienced immigrant and refugee doctors.

If the government tell the regulatory bodies that they can put their rules aside for now, they will do it. They need to do this clearly and *take on the risk* of being blamed if things then go wrong. They are not willing to do that.

This government do not want stories of how immigrants and refugees who were not allowed to work under their previous rules are now saving British lives. This might sound far fetched but they depend on anti-immigrant sentiment to win elections.

Well this pandemic has seen government responses across the world of dubious legality that have been accepted. I am not so sure it is that easy for political leaders to tell regulators to put things aside, especially if the regulators dont agree. It also probably doesn't help if the regulators don't like the political leadership.

The FDA has approved thalidomide. It's a treatment for myeloma.

De-regulation implies removing, but have many deregulation plans reduced the size of the laws in an area? It should be branded as re-regulation in most cases, e.g. a rearranging of the deck chairs on the Titanic, not installing more life boats.

Almost always a change in regulation results in legal action. The country, including the anonymous regulatory agencies, is basically in bondage to the legal profession at every level and, in fact, the most important figures in those agencies are members of the legal community. They are the priests of the secular religion "democracy". Making the payments on their BMWs, European vacations, and children's Ivy League tuition is more important than some 80 year-old surviving another year at Nap Time Acres.

First, kill all the lawyers. Evergreen.

Tyler Cowen: "Nonetheless a regulatory state cannot be said to work well if it requires such extraordinary attention from a sitting president."

I thoroughly disagree. What we want MOST of the time is a slow bureaucracy with lots of oversight to catch mistakes. But that means that the head of the executive branch must have, already in place, various task forces dedicated to emerg

...emergencies with both monitoring capabilities and lines of communication already open to the proper agencies, which can present the President with ready plans on Day One. By contrast, Trump believes that government can be run like a business and so has a management style that wishes to order results from his executive surroundings as if it were a marketplace with everything availlable just-in-time. Or put his son-in-law in charge. (He is also enormously short-sighted, which can get you pretty far in the market culture.) You economists appear to think in the same way, and thus you misunderstand the nature of government as much as you overplay the virtues of the market.

Regulatory fail is today's welfare queen. As Rene Girard understood, humans need a scapegoat.

+1 Will the proposed CDC recommendations ever make it out of the White House?

Actually, I thought the prior posts were
Setting it up to be the
Space Aliens
Who were going to be
Responsible.

Tyler, if you're going to criticize the government, please understand how the government works.

To me, it's odd that you separate Trump from the performance of the bureaucracy. As president, he selects some 4,000 appointees to run the federal agencies and departments. These appointees and the president himself have the capacity, through executive directives and other means, to shape, reshape, or short-circuit many regulations. Not all, of course. Some regulatory change requires legislative change. But the president and his team have considerable influence over the content and compliance of regulations. Especially under emergency conditions, presidents have enormous powers to circumvent regular legal and regulatory obstacles and to push for dramatic government action. The problem with the Trump administration is that it's headed by people who have a contempt for and a stunning ignorance of the federal bureaucracy they lead.

Federal employees are guaranteed a salary and there is authority for the theory guaranteed employment. Hiring is limited by civil service rules as is termination, salary, conditions of employment. If you'd like to research terminations over any period of time, please report your results. You will have more success with access to public info on the number of lawsuits brought by federal employess against agencies like the CDC. Hundreds of discrimination lawsuits.

Name any large employer other that government which prohibits managers from hiring based on qualifications, restricts hiring by closed lists (or, exceptionally, by requests from connected elected officials), prohibits termination, offers the highest salary and benefit package in the country.

Hiring and firing of civil servants is unrelated to the point I'm making.

Please explain how anyone exercises control over any organization absent ability to hire, fire, set working terms, salary. and all disputes are settled by an employee friendly body or in the courts under discrimination law standards.

Do the Trump critics who say, "Trump should have overruled his experts," think that the rest of us perceive them as sincere? Newsflash: we don't.

This isn't about overruling experts. It's about stocking the federal agencies with competent leaders. HHS and the CDC are in near-chaos right now, not because of regulations, not because Trump listened to experts, but because Trump and his team don't know what they are doing.

To step away from this case and to examine another: Why did FEMA fail so spectacularly in its response to Hurricane Katrina. It wasn't that regulations or the experts were the problem; it was that President Bush had foolishly reorganized the agency to handle primarily terrorist attacks, not natural disasters, and then selected an expert in Arabian horses to lead the agency. So it had the wrong mandate, the wrong procedures, and the wrong leadership, and when a big natural disaster hit, things went south.

That is largely what's happened here. Presidents should be understood as being, above all, bureaucratic mangers. They are in charge of the executive branch, i.e., the federal bureaucracy. If they are incompetent managers, then they will produce major policy failures. A focus on federal regulations or experts is largely misdirected here.

> This isn't about overruling experts. It's about stocking the federal agencies with competent leaders.

But CDC and FDA experts had to to be overruled to bring in the private sector fon testing. For H1N1, the CDC made the first million tests in just over 4 months from the first death, because they wanted to be sure they could control the quality. And they are very proud of their test rollout speed on H1N1. Very, very proud.

When the CDC botched the tests for covid, it was Trump that said "No more time for amateur hour. We're bringing in the private sector." The CDC and FDA did not want this.

But we're going to hit 10M tests in the next few days. That is 10X more tests in half the time of the CDC rollout for H1N1. Pretty spectacular.

Where is the failure?

Trump selected the heads of HHS and the CDC. Those heads, including Alex Azar and Robert Redfield, set up a Covid-19 task force in January that did not consider the need for testing or stockpiling medical supplies. That was a huge leadership failure, not a bureaucratic or regulatory one.

Then, in early February, Stephen Hahn, the FDA commissioner, wanted to have private companies develop and produce Covid-19 tests. But the heads of HHS--in other words, Trump's appointees--blocked Hahn from doing so and opted to use the CDC instead. The choice to use the CDC, not the private sector, had nothing to do with regulations. It had to do with incompetent leadership.

For a full rundown of the disaster, see: https://www.washingtonpost.com/national-security/2020/04/04/coronavirus-government-dysfunction/

The article doesn't quite play this out as you claim. Hanh was a Trump appointee. It was the rank and file that told Hanh (paraphrasing) "You ought not bring in the private sector. It will look bad if you are calling them because your job is to oversee them."

Ditto with CDC rank and file. Azar didnt' decide in a vacuum that CDC would be at the center of this. Every single person in the CDC was telling Azar "we rocked this for H1N1, we'll rock this for covid"

The article clearly states the CDC plan for covid was identical to the H1N1 plan (no private companies for 6 months).

Hahn, Trump's appointee, was obviously was right in the end. And the FDA/CDC rank and file was wrong. To argue that the FDA and CDC rank and file were demanding the private sector be brought as the WaPo claims is nuts.

So Azar and Redfield were the employees who made it illegal for every PCR test lab in the country to diagnose based on in house tests?

They were the ones threatening everyone, raising IRB threats in Seattle, demanding that anyone using a non CDC test could be sued and lose their medical license or hospital certification ?

I’ll buy incompetence from the admin, sure. But that’s not where all of the other major failures lie. These were permanent government employees making these decisions.

> did not consider the need for testing or stockpiling medical supplies.

There are 5M doctors and nurses in the US. If any day 2M are on duty and they are each using 20 sets of PPE per day, that's 40M sets per day. I'm sorry, but if you are just deciding in January to stock up on PPE, while China is going through their own outbreak, you don't stand a chance.

Everyone knew a pandemic would require 2-3B sets of PPE. Everyone in charge decided to roll the dice. And that was happening long before Trump took office. Blame the medical profession for this. It's not Trump's job to ensure the federal government has stockpiled enough copper wire to replace our electrical grid in the event of a massive solar flare. It's just not.

Anyone in gov that opted for spending money on "green" over PPE screwed up. Badly. And it highlights how inept gov is at every level.

Thalidomide is approved to treat myeloma.

For those who prefer an academic point of view for America's failed state, here is the link to Francis Fukuyama's excellent essay in 2016: https://www.prospectmagazine.co.uk/magazine/america-the-failed-state-donald-trump

Agreed, it was a failed state right before Trump took office (did you check the date of the article?). Or maybe just highly corrupt. FOIA is shining a light on that now.

Actually, that is not what Rayward said, but what you say, as to the poor state before Trump..

Why didn't the CDC workers rise up and risked their jobs for us?!?..... Asks the tenured professor.

+1 Ask a fired and former Inspector General

Gerald Walpin? Yes. We are now just acknowledging how corrupt the last administration was.

No, not the 78 year old one Obama dismissed when the board claimed he was delusional at a meeting, and was behaving erratically, and who later acknowledged it must have been a sickness, and not the one who interfered with a federal investigation and was told not to make public information until the investigation was complete, and not the one who lost his court case seeking reinstatement. You should read Media Matters discussion of how Fox News misreported this. Even Senators who initially supported him backed away after getting more information. Here is a Media Matters summary: https://www.mediamatters.org/fox-friends/fox-friends-give-walpin-pass-allegations-hindering-us-attorneys-investigation

No, I was talking about the Intelligence Community Inspector General (who Trump appointed) who turned over the complaint by an NSC staffer that led to Trump's impeachment.

And, no, I am also not talking about the DOD IG who was transferred so Trump could get a different IG to oversee other matters.

So Obama gets rid of one for reporting corruption is equal to Trump removing one for not doing his job?

At least you remain consistent, Bill.

That is not at all true if you read the materials. The 78 year old guy was having mental problems as reported by a board composed of Republicans and Democrats, and interfered with a US Attorney investigation after being told not to. Furthermore, the Administration provided an explanation, whereas Trump never did for the Intelligence OIG. If you only listen to Fox, you only get part of the story. Deliberately.

TMC,

Post below the reason the Intelligence Agency OIG was dismissed and the reason for doing so.

While there have certainly been failures, I think TC's academic background is showing here. Outside academia, leadership really does set the tone and priorities, and Trump was pretty consistent ("I'm a genius. I'm right. You can't do anything without me."). When a leader like that tells the public a virus is no big deal and is going to zero, what do you do? I'm sure there's a little schadenfreude going on here as well. Isn't watching Trump try to grapple with this just a little funny?

And yet here you are trying to convince is that you genuinely think that Trump should have overruled his scientific experts in order to make the development of testing run better. Even seeing aside the strawman about Trump's reaction, the chance that you genuinely believe that and would have supported his doing so at the time is, I think, zero.

Whatever one thinks of Trump, why should anyone trust the critics who are making it up as they go along and retroactively conforming their past beliefs to suit their current positions? Put another way, why should we trust the policy judgment of the critics to be any more consistent or effective than Trump when the only animating principle is "reacting to Trump"?

Fauci testified yesterday that the Trump administration hit the "accelerator in every respect" in responding to the virus.

Don't confuse Trump's public position (optimism) with his behind the scenes dealing (pulling out all the stops). There's not a dem that would have responded more aggressively than Trump.

As I've posted above, we've shipped 10X more tests in half the time of the H1N1 rollout. We're about to his 10M tests. Do you think Pelosi would have relied more on the private sector than Trump? Not a chance.

Our test rollout is a triumph. Yes, it's far short of what was needed. But it moved 20X faster than H1N1, which is staggering. And it's 100% because the CDC was told to sit down and shut up while the private sectors did their thing.

I'm just pointing out that Trump routinely takes credit for things he has nothing to do with, so I see no reason not to completely throw him under the bus for his COVID response being less than ideal. I can't imagine what the media would be doing to Hillary if she'd said those things and we were where we are today.

The liberal media gets pretty bad, but its got nothing on this Trump spin machine. Over 100,000 Americans are going to die. Countries like Japan, Germany, South Korea, and Taiwan that had far more exposure to the initial outbreak have so far managed to contain it. Were their experts saying something different than the WHO on Jan 31st?

At best we are going to come out of this on par with Italy and Spain? Now Trump wants to push an America first vaccine even though China already has a head start on drug trials? Trump has truly made America great again, American exceptionalism is alive, defeat is victory, our response is double plus good!

We’re between Sweden and Ireland. Not Italy and Spain. Anyways, I find it amusing that people think the President is the operative difference here.

If it makes you feel better, vote him out!

It won’t change the incentives at the FDA nor the CDC, and you’ll never get the opportunity to know what actually happened nor who made the decisions.

The public choice facts on the ground are not going away.

I can't imagine what the media would be doing to Hillary if she'd said those things and we were where we are today.

The media would be cheerleading how well Clinton ran this... Let's not pretend that the Media would ever criticize a democrat....

Besides, you might want to let facts get in the way of your misery, the US is doing pretty well especially when compared to the EU and EU countries.

Great post, Tyler, very balanced.

I do think, though, that Trump is more at fault than your post indicates. Every organization, particularly during a crisis, needs clear and consistent guidelines from the top down. What are the guidelines of this President? Can anybody summarize them in a few sentences? Blaming China, quarreling with reporters, tweeting in response to evening news etc. are not guidelines.

> Blaming China, quarreling with reporters, tweeting in response to evening news etc. are not guidelines

Just curious, but what % of the blame do you feel China holds for the world's predicament we're in?

And if a reporter is not acting in good faith, they deserve to be quarreled with. Trump won because the people saw what reporters did to Bush over, say, Katrina (or Iraq, or pick your cause). Bush aimed to stay above the fray, but the reporters with an agenda destroyed him unfairly. They were not operating in good faith.

Trump is the only way to fight a media with an agenda. If they treated Trump as they treated Obama, you'd see a totally different Trump.

Yesterday we saw Brian Stelter wondering aloud on TV "Why is Trump so obsessed with the Russia investigation?"

Yes, the network that covered it wall to wall for 3.5 years, with nary a shred of evidence all in an effort to destroy Trump...Good god.

Since you asked.
A high percentage of the blame falls on China. But even if you pick 100%, it contributes nothing to addressing the crisis in the US.
If a soccer team is down 0:1 because the referee awarded a ridiculous penalty to the other side, what prep talk should the coach give at halftime? Go on about how the ref sucks and how unfair the world is? No, you talk about how you are going to win the game. You inspire your team and tell each player exactly what they are supposed to do. You can then criticize the ref or anything else after the game is over.
Mr. President, please act like a good coach.

The efficacy of the other side is 100% dependent on Trump acting as a good coach. Bush did nothing to defend himself against Katrina attacks and was destroyed because of it.

The media knows this is destroying their credibility. Every poll out there shows horrid and still declining numbers for the media. They do not care. Their goal is to put their guy in office. Full stop.

That's not substantive criticism, though. And the reality is that Trump can't communicate with the pubic without fighting with China and the media, because they're striving to control the news as much as he is, with no evidence of greater accuracy or good faith. You're essentially asking that Trump retire from public discourse and let his adversaries define this crisis, which just sounds like anti-Trump wishful thinking.

Lots and lots of mood affiliation on this topic from all sides. I think it's important to ground first in the question of whether the US response has actually been unusually poor, before trying to explain it.

In general, the US seems to be within the range for large, open Western economies with high levels of global interconnectedness - a bit better than the UK and Italy, a bit worse than France. Germany is the outlier...

Lots of people think Trump is "to blame" because of his buffoonish public behavior, but Canada, with more or less diametrically opposed leadership style, has more or less similar deaths per capita (certainly within the margin of measurement error).

Lots of people blaming excessive regulation. But I wouldn't call the US over-regulated compared to China, Norway, Austria, or Singapore, all of which did clearly better.

Perhaps is the sclerotic bureaucracy - what Tyler calls "state capacity". Yet I don't think of Germany as particularly famed for its nimble bureaucrats....

It will be a long time before we can come up with a clear understanding of who did this right, and why (or even whether it's all just luck). Beware mood affiliation as you go.

I agree with your assessment overall. A quibble: We (US 252 deaths/mil) did better than the UK (482) and Italy (511), and France(414).
It'll be a while, as you say, before we have any idea why any of these countries did as bad, or as well as they did. When we do learn, we (the world) will over-apply the lessons, which will likely no longer apply to the next situation, and react poorly to that as well.

The US is two contiguous stories you can draw on a map. One includes Maryland and everything north and east, along with states north of the Ohio and east of the Mississippi but stopping at the Illinois-Wisconsin border.

105 million people, 63K deaths, 602 deaths per million (higher than Spain and Italy).

The other is everybody else:

227 million people, 19K deaths, 84 deaths per million (lower than Germany and Denmark, they'll almost surely pass these countries, but pretty good company.)

Apparently, the CDC and the FDC have done a great job in the latter group and a terrible job in the former. Perhaps different regulations were in place. Ditto for Trump. His skill has been very unequally distributed.

+1, excellent comment

The key feature missing here is the attitude of Trump. Has the US response been worse than in Europe? Generally no. Worse than Germany, better than Italy (so far and with advanced notice). But only one of these countries is run by a self promoting blowhard tweeting 24/7 about how brilliant he is and how amazing he's made America.

I choose to take Trump at his word. Anything less than going to zero like a miracle by Easter is unacceptable...

Great comment +1 internets to you Sir!

All the people who are claiming that over regulation or under regulation is the problem have failed to understand. Bureaucracy is capable of failing in both directions and does. Examples:

The NRC is such an aggressively hostile bunch that they not only killed the industry they're responsible for they also managed to kill the unrelated rare earth mining industry at the same time.

NASA is a failure in the other direction. They are so thoroughly captured by the large aerospace firms (ULA, Boeing and Lockeed) that every year they pored half their budget into a rocket that is a decade and a half over schedule and has a per lb cost to LEO that is twice that of an already flying commercial rocket.

Every happy family is the same, all unhappy ones are unique.

What is really quite interesting
Is that the persons who assert the existence of
A failed regulatory state
Are those who oppose
Congressional oversight.

ARe

It’s so interesting that it doesn’t happen to be true.

Ignore those Congressional subpoenas and request for Administration witnesses.

Willful blindness.

Tyler opposes Congressional subpoenas? I don’t recall that.

I certainly don’t oppose them.

Outgroup homogeneity fallacy is tough eh?

Skeptical,

Please post below evidence that Trump has assisted Congressional oversight, has reasonably responded to requests, and has not unreasonably resisted Congressional oversight.

Is that the persons who assert the existence of
A failed regulatory state
Are those who oppose
Congressional oversight.

Tyler asserts a failing regulatory state. I assert one as well. I don’t oppose subpoenas, I seriously doubt Tyler opposes subpoenas either.

If you want to restate your claim from “persons who assert regulatory state failure” to “the POTUS”, go for it.

But as it stands it’s clearly false.

Am still waiting for the evidence. You are not the judge of whether something is false. The reader does. Perhaps you think too highly of yourself and do not have to offer evidence to support your positions.

Woooosh. Here’s your claim:

Is that the persons who assert the existence of
A failed regulatory state
Are those who oppose
Congressional oversight.

I assert the existence of a failing regulatory state. I exist. I don’t oppose subpoenas. Thus your claim is false.

Obviously.

Whether you specifically oppose subpoena is irrelevant to the question or to the observation that Trump has resisted subpoena, denied persons from testifying before Congress.

As for the Republican congressional members who have failed their duty to support or conduct oversight, it is because they are afraid of Trump.

The failed state is Trump and the Republican party members, except Romney, who have been cowered in performing their oversight responsibilities.

We rely on checks and balances. We rely on Congressional oversight. We rely on Executive department compliance. Our founders put this system in place to prevent a failed state.

Is that the persons who assert the existence of
A failed regulatory state
Are those who oppose
Congressional oversight.

If I assert regulatory failure and yet I support Congressional oversight then your claim is false. You've now completely changed your claim to:

Trump has resisted subpoena, denied persons from testifying before Congress.

Which is true, but you've taken the scope from "people who assert the existence of a failed regulatory state" to "Trump". Which is why I said:

"If you want to restate your claim from “persons who assert regulatory state failure” to “the POTUS”, go for it.

But as it stands it’s clearly false."

Well, I am glad that you support Congressional oversight, and I'm glad that you agree that Trump has failed to comply with oversight.

I knew you would come around.

You can't argue failed state and deny oversight remedies.

He certainly has failed to comply, and hopefully this week the Supreme Court puts an end to it.

I knew you would come around.

Actually, I've never argued otherwise. My stance hasn't changed in the slightest.

You can't argue failed state and deny oversight remedies.

You certainly shouldn't, it would be illogical.

I think the problem is compounded by the fact that ambiguity is difficult to deal with and a novel virus is the epitome of an ambiguous event. Further, there is a conflict between rules that a regulatory state makes and flexibility. The reason for rules are to eliminate ambiguity and flexibility! Thus a regulatory state needs to know when to go outside of its usual remit.

This is mostly a failure of leadership. As others have noted most of those regulations are designed for safety, not speed. So, for example, you get the results of drug study and then you give the scientific community 2 months to read and respond. In a crisis you eliminate or shorten that step to a week. That is what leadership needs to do.

The CDC failure to quickly produce a test is a near perfect example of the failure to quickly have a test. When we didnt have a viable test in a couple of weeks like many other first world countries we needed a leader to step in and fire people. Make a deal to use the test developed by someone else. Also, need I comment upon the irony of the pro-business, anti-regulation leaders of the present executive branch not allowing academic centers and private testing companies the leeway to develop their own tests (which they clearly had the expertise to do)? Nope, this was largely a leadership issue.

Steve

To be clear, saying that trump had to do everything himself to overcome relations is a straw man. He is responsible for the leaders he chose. So in the case of the CDC he chose someone with no prior public health training or experience. Some of his other choices for leadership seemed suspect also, but the performance of the CDC during this crisis has been especially poor. The other area where Trump has been a failure, and this is surprising with his background in private commerce, is in not setting timelines and demanding performance. He didnt have to personally set aside the regulations, but he needed to set expectations and authorize the people he appointed the authority to meet his timeline.

Steve

The Director of the CDC is anything but inexperienced -https://en.wikipedia.org/wiki/Robert_R._Redfield

And per your previous comment, quoting Phinton above, "Trump's admin has shipped nearly 10X more tests in half the time that Obama's admin did for H1N1." Precisely because in got the private sector involved early.

Redfield is good virologist by all accounts. However, and yes I read that, he has no training in public health or experience. Running a large medical group is not the same a shaving experience in public health which is a separate expertise.

As to testing, we didnt have them when we needed them. If trying to find some meaningless statistic to compare with what was done another time go ahead. But with his pandemic many other first world countries managed to develop and use tests much earlier than we did and not so coincidentally many of those had better outcomes. We have the resources, we just didnt have the leadership.

Steve

"As to testing, we didn't have them when we needed them."
Never notice that we call COVID a novel virus? There were no tests, anywhere, at the beginning. They had to be developed. Trump's reaction to the CDC's failure was quick. Remember, they were reporting that they had a test and were shipping it. When it failed, he let the private sector loose. Tests give great info, but they are after the fact. My guess is that they will come out to be much less of a factor when we analyze our response.

Your only goal here is to defend Trump, but in case I am wrong let me tell you why those numbers are meaningless. At our hospitals we prepared for H1N1 but it never really became a big thing. We were grateful that we didnt see the admissions and deaths we feared. So, we never ran out of tests. I didnt have to tell my staff we couldn't test them because we didnt have enough tests. Maybe this was different at your hospital, but that is what we saw and also held true with the hospital systems with which I keep close contact.

With Covid we have had test shortages all along. Even now clinical decisions we make are influenced by the availability of testing. In economic terms I think you would say we have a supply and demand mismatch. We didnt have that with H1N1, at least at the places I know. Maybe your hospitals were different.

Steve

I agree, given the slow response to it, we were lucky H1N1 was comparatively mild. That's why you did not run out of tests. 60 million people got it, but very few deaths. The test for H1N1 did take longer to develop as well, so good thing you didn't need it. We waited until 1000 people we dead to declare an emergency back then. I'm just pointing out the double standard in what a good response is. Not sure how you find comparing situation A to situation B is meaningless. Pretty much how all evaluations go. And yes, the CDC is effed up on the test. Better controls should have been in place so contamination did not happen. Worse ones happened during Ebola, we actually imported the virus and didn't contain it. Maybe CDC gets back to disease control is the answer.

> In economic terms I think you would say we have a supply and demand mismatch.

And so why is this Trump's fault? The fact is that the US runs 3-4M PCR tests a year--HIV testing is biggest driver of demand. Not a single doctor anywhere said "You know, if we every do have a real pandemic we're going to need to ramp up our PCR testing capability by almost 1000X. What would it take to run a billion tests a year?"

You seriously think that is Trump's job? Our medical system failed at every turn. Hospitals were having to send out to labs that were far away because they didnt' have any or enough machines to run the tests.

Think about it: Everyone in the medical industry knew this was coming. But you didn't even have plans to get enough PPE and you didn't have the installed PCR test infrastructure.

That's not Trump's fault. That's the medical industry's fault.

When wondering if an organization is doing well, you benchmark against the previous crises. In Trump's case, ICU beds, ventilators, testing...every direction was very positive: Far more provided than last time and in shorter times.

It's not Trump's fault that your hospital didn't buy 5 PCR machines 5 years ago. That's your fault. Your prioritized amenities over basics.

"And so why is this Trump's fault? "

We did elect him president right? If he wants to lead he needs to lead. As I said it is not his job to cut through individual regulations or determine how many tests we need, it is his job to put the right people into place to make stuff happen, to set goals and monitor to make sure people produce.

It was not just testing machines, it was also reagents, swabs and other stuff. Every other first world country recognizes that it is not rpctical for every hospital to maintain supplies for a pandemic. So the federal govt maintains stockpiles or helps everywhere else. Our problem is that we delayed to the point that we didnt have them when we needed them. The agency most capable of developing the test, the CDC is bing lead by someone with no public health experience, and maybe that is not the only reason, but for some reason the CDC absolutely failed to develop at test on time. On top of that the federal government, and again since you see to keep forgetting, which is lead by Trump, also forbade private companies and academia from developing tests. This is bad leadership multiplied.

" Far more provided than last time and in shorter times."

When is this mythical last time you keep mentioning? Our last real pandemic where we could have used more ventilators, etc was in 1918. You want to make this some competition. I am pointing out that in the past we had adequate supplies to meet our needs. This time we didnt. This time we also had a bit of warning, but we wasted it. Plus, we still dont have adequate amounts of PPE being made. Every purchase is a struggle. Where are supposed to buy? China?

" Not a single doctor anywhere said "You know, if we every do have a real pandemic we're going to need to ramp up our PCR testing capability by almost 1000X. What would it take to run a billion tests a year?""

No, actually a lot of people have asked that. No individual hospital would do that unless all of the others also did it. The hospitals maintaining enough PPE would lose money compared to the ones who didnt while waiting for the every 50-100 years pandemic. So it wasn't going to happen unless mandated by government or the government itself maintained the supplies. I am guessing that you are a small govt type so lets guess where that foes? (Da*n fascist big govt making us pay fo stuff we never use is my guess.)

Steve

> We did elect him president right? If he wants to lead he needs to lead.

He did lead: We didn't run out of of beds or ventilators. We got tests 20X faster than H1N1. He closed borders far sooner than Obama, Hillary, Joe would have.

He demolished every metric set during the H1N1 handling.

> It was not just testing machines, it was also reagents, swabs and other stuff.

Yes, all stuff we've decided we don't want to make in this country. EXCEPT TRUMP. Trump campaigned on bring manufacturing back. You think it was HIM that was advocating we dump all this overseas?

> Our problem is that we delayed to the point that we didnt have them when we needed them.

There is no amount of stockpile that would have solved this. We'd have needed 3B sets stockpiled. And for something that expires every 3 years and normally needs 100M sets a year, this isn't practical. The only practical solution is to make and have factories set up but mothballed to handle peaks.

> which is lead by Trump, also forbade private companies and academia from developing tests.

Yes, but this has been their rule for 20 years. Once an emergency is declared, the rules change. You keep wanting to assign Trump blame for things that have been rules forever. That guy HATES regulation. You LOVE regulation. But you are blaming HIM for excessive regulation? You sound like a nut.

> When is this mythical last time you keep mentioning?

For better or worse, H1N1 was our last taste of a pandemic. It was a level 1. This is a level 3 or level 4. H1N1 was a wakeup call to our hospitals to prepare: Buy a crapload of PCR machines. But they didn't.

> This time we also had a bit of warning, but we wasted it.

First warning this was serious was Jan 23 when China shut borders. Days earlier, China had been encouraging folks in Wuhan to meet for potluck. One week after Wuhan closed, Trump closed the border. And people like YOU (and Pelosi, and Biden, and Hillary, and Cuomo) criticized him for that.

The people that wasted that lead were the govs that shoudl have closed in February. Trump can't close states. He can only close borders. And he did. But he should have done more and could have if people like you wouldnt' ahve called him racsist.

> No individual hospital would do that unless all of the others also did it. The hospitals maintaining enough PPE would lose money compared to the ones who didnt while waiting for the every 50-100 years pandemic.

Yes, so again, how is that Trump's fault? Sounds like you admit doctors, hospitals and their state regulators all knew a problem and decided to roll the dice. How is that Trump's problem? Is Trump responsible for makign sure we have enough nails after a hurricane? For enough cranes after an earthquake? For enoguh copper wire after an solar flare?

Admit it: If Obama was president through this you'd be raving about his handling.

I'm glad that Tyler acknowledged that these failings might at least be related to who's at the top. One thing that still bothers me is the implication that because our state might be failing that the regulatory state *in general* is failing. That would be like saying that because my local restaurant failed that capitalism is failing. That might well be true, but I don't see a guy like Tyler drawing that conclusion. It might make more sense to look at all regulatory states and see which ones are doing well and which ones aren't.

So are you now willing to acknowledge his main point that the regulatory failings are separate from who's at the top?

You say the monolithic impersonal agencies are a ‘regulatory state’, independent of the Executive function, and your evidence for this is: they still have lots of rules.

You seem to claim that the President has little control over these agencies - despite his appointing their entire executive suite and allocating their budget and controlling their priorities and communications.

You seem to claim that the GOP’s centerpiece campaign of destroying the regulatory state has been largely ineffective, despite holding federal power, and having control of the narrative for most of the last four decades. (And even though federal government employment has declined sharply and steadily for that entire period).

Again, you define the evidence of GOP’s failure to reign in the agencies as: there’s still a lot of rules.

You claim these agencies are impervious to pressure from the President, who is only putatively in control of them. Presumably, we all know this because Trump was impotently begging his agencies to reform for months in the early stages of the impending crisis, begging them to be more responsive, insisting they loosen their rules to prioritize rapid development of responses, and yet they refused the appeals of even the President and continued about defiantly with their arrogant pointless self-aggrandizing rules. The nameless, faceless bureaucrats refused to follow the President’s efforts to rally the nation and retool a robust federal response, and they faced him down and won. If only they had followed the President’s calls to action, we probably would have more masks and a vaccine by now. But no, they obstinately got in the way of action on their own initiative.

PS. The reason that state and local direct purchases had to go underground, was to hide the transactions from being seized by another federal bureaucracy (which according to your logic was acting entirely on its own, certainly not on orders issued by the President).

This is what mood affiliation looks like

this is what a troll looks like

A wall of fact free text attacking your tribal outgroup.....

Yeah

George, do you have ANY shred of credible proof for federal seizures?

Usually we see an anonymous source, followed by the agencies themselves stating the article and allegation was false.

Numerous articles gave named sources that they had to hide from the feds. They cited indcidents where the feds showed up and seized the goods. They named the agency, named the location, and named the date.

Why else did the buyers need to go underground (as cited by Tyler himself) except to hide from seizure?

George,

Take it for what is worth. Troll Catcher is telling you he has no knowledge or information about this subject. I believe him.

The way you handle a person who calls himself Troll Catcher is to post the evidence for your assertion and challenge him. It shows everyone who he is, and it also enlightens the reader. Troll Catcher is performing a service because he is causing you to provide more information, like this below:

"Whenever you start to think that the federal government under Donald Trump has hit a moral bottom, it finds a new way to shock and horrify.

Over the last few weeks, it has started to appear as though, in addition to abandoning the states to their own devices in a time of national emergency, the federal government has effectively erected a blockade — like that which the Union used to choke off the supply chains of the Confederacy during the Civil War — to prevent delivery of critical medical equipment to states desperately in need. At the very least, federal authorities have made governors and hospital executives all around the country operate in fear that shipments of necessary supplies will be seized along the way. In a time of pandemic, having evacuated federal responsibility, the White House is functionally waging a war against state leadership and the initiative of local hospitals to secure what they need to provide sufficient treatment.

Yesterday, a letter published by the New England Journal of Medicine highlighted the extraordinary measures that had to be taken to secure the delivery into Massachusetts of equipment that had been bought and paid for. The NEJM, which featured the letter in its COVID-19 Notes series, is far from a platform of partisan alarm or hysteria — it is among the most sober and high-minded professional journals in the country. It’s worth reading the correspondence, written by an executive running a small health system, at some length:"...full article follows. Here is the link: https://nymag.com/intelligencer/2020/04/hospitals-face-a-white-house-blockade-for-coronavirus-ppe.html

Many regulations make sense or are lightly cumbersome under normal circumstances. They come with a cost, but are part of "business as usual." Some have become deadly obstacles under radically altered circumstances.

But, it is the Trump administration's job is to choose enforcement priorities and give shape to the federal response. Would Tyler be talking nearly as much about regulatory failure in an Obama, Warren, or Romney administration? I don't think so.

Trump has done quite well.

But by all means, when the majority of deaths from a flu are confined to three US states, definitely keep clamoring that All of This is An Epic National Failure.

It is frankly hilarious! And we do need good comedy.

I find it hard to say these failures are somehow unique to the US or US agencies. After all I hear similar stories from my European colleagues and the idiocy spans all manner of regulatory bodies.

Even within the US, well, the FDA may have silly rules on vials. But the ACGME is literally shorting us over a thousand docs by not increasing residency slots to fight a national epidemic. The Joint Commission has been exceedingly slow to free up resources from silly mandates. And then we have all the boondoggles with payment for telemedicine.

Frankly I suspect that we are hitting much larger trends here. We have become risk intolerant. We have become much more driven by optics and what will go viral. We have eliminated most stable professions outside of the regulatory state. We have used the courts to enforce our wills on others whenever possible.

Is it then that shocking that worldwide we have largely found a bunch of regulators, on the job for life with civil service protections, who are terrified of making errors that would result in them getting tarred with bad judgment. We have regulatory agencies that rule with an eye towards the inevitable lawsuits.

You can tell me this is about an administration. But it has been going on for decades. You can tell me this about the Deep State. But it happens with private regulators from the insurance companies.

Frankly I suspect this is something deeper going back to the lose of respect from the clerics and the growth of the state as the sole arbiter of all disputations in life. We no longer trust people to have personal codes of conduct sufficient to stop them from abusing the system. So we introduce regulators who can only restrain things by every more minute actions and as noted above their incentives are skewed. I do not see a way back to a light regulatory state where you could trust people with power to act as though they were constrained by a higher power or civic ethics absent some major cultural changes.

I think one commonality between bad response countries is that their regulatory agencies are old, like half a century old. whereas I think countries that were more responsive have much younger organizations.

I think younger organizations are more interested in getting things done and less concerned about turf battles.

"I do not see a way back to a light regulatory state where you could trust people with power to act as though they were constrained by a higher power or civic ethics absent some major cultural changes."

How about if we got a conservative party which valued ethics?

You have to admit it would be a most excellent reinvention.

I’ve said it before, I’ll say it again.

The US is a low trust society. Low trust societies have high transaction costs. Litigation is common. Regulatory and non regulatory agencies are sclerotic and care little for their actual stated purposes, but instead exist for the benefit of those who profit by their largess and authority.

High trust societies: South Korea, Japan, Taiwan, Australia, New Zealand, Canada, the Nordics, Germany

We’ve been a low trust society for decades now. There’s no going back

Interesting point of view. I'd like to see that idea filled out to some degree. In particular what are the signs/indicators of a low trust society versus a high trust society.

A great indicator is the murder solve rate.
US: 62%
Taiwan: ~99%

Another great indicator is liability costs as % of GDP
US: 1.7% of GDP
Japan: 0.3% of GDP

I think the first is really an edge case. But the second could well be a metric. Though we would need to see if it holds up across a sample of different countries.

In Finland it was 98% from 2009 to 2014 and 95% in Switzerland over the same time period.

As Ray would say, control-f this page, search for "Lewis" as in Michael, as in The Fifth Risk.

It is possible that the status quo prior was not perfect, but clearly responsibility in the executive branch was ripped apart, like kids' packages on Christmas morning.

And I think it's a pretty weak argument that packages should be so well made that they function after the kids rip them up.

So I'm not sure this is such a good take. Because it is purely a counterfactual. Implicitly you ask if we had had a good executive branch could they have stayed on top of things?

We will never know.

It's remarkable to go back and listen to Lewis's 2018 interview with NPR about his book. The point about federal government as managing a portfolio of low-probability high-magnitude risks and the admin being managed in a way that seems actively hostile to that function strikes home in the current moment. Plus his response to "give us one outlandish prediction" [Trump may seek to selectively default on the national debt] is looking prescient today.

There is definitely something worth considering here. Trump has had 3 years running all these agencies, so he deserves a substantial portion of the blame for their poor performance. However, agency culture and priorities have been in place for a long time and even though Trump has made pretty much everything substantially worse with the non-stop punishment of truth-tellers and rewarding of toadies, an entry level presidential performance probably would have still resulted in relatively poor agency performance against an international baseline.

But then we just have to back up and look at the political situation in the United States. We have one party interested in governance and the other party trying to strangle it in the bathtub. There was a time where you could say the Republican party was more interested in quality governance than the Democratic party. That time is long past. I can't remember the last Republican party policy proposal to actually improve agency performance. Their only moves are 'burn it down' or 'make it more friendly for big-moneyed interests'. Sometimes 'burn it down' is the right move, but a high quality state requires a non-negligible set of high quality agencies. If one party is only willing to play hostage with the public interest to advance a narrow set of policy priorities, the result, which we have today, is utterly predictable.

You have to be an elite level smooth operator like Tyler Cowen to be able to look at this situation, describe it's salient features, but somehow fail to acknowledge the fundamental factor here. The Republican party has become a death cult and has brought this country to its knees. Until it is burned to the ground the United States government will continue to massively under perform.

As someone who has called for good governance from the conservative party in these pages for years, I agree.

It has been a very lonely position.

Mood affiliation.

What would be examples of promoting good governance, and strangling it?

If you think your daily energies are best spent attacking solutions, and best spent defending failures, you are definitely part of the problem.

That can be as simple as constantly saying "we are a low trust society," and in so doing, help to create a low trust, do nothing, society.

So you have no examples and this is all mood affiliation. Thanks for making that clear.

We are a low trust society and that's true regardless of how that particular fact makes you feel. Facts over feelz.

The US transitioned to a low trust society 4-5 decades ago, before I was even born. This in effect is your generation's gift to the United States: a low trust society and all that it entails:

Excess litigation, high transaction costs in everything, dysfunctional politics, and rent seeking. This ain't on us, we weren't even alive when you chose this future.

It was only supposed to be low trust when it was "Don't trust anyone over (their age)" you see. They didn't actually want it to be the case when they were in charge.

> Trump has had 3 years running all these agencies

If Trump made changes that resulted in the problems, then sure. But if an agency is running on autopilot and and getting more money shoveled their direction every year then I'd disagree. Kids in cages happened on Obama's watch, nobody cared. Gitmo happened on Obama's watch. Nobody cared.

Fault the person that pushed for the decisions that precipitated the failure. That means if the previous administration did something that make us weaker (loosened lending requirements) and something bad happens, it's not the fault of the guy in office at that time. It's the fault of the person that did the thing that caused the crises.

For example: in the last 10 years, the US gov has probably spent $100B on "green". Anyone that advocated for spending on money on green BEFORE we were set for a pandemic screwed us. And screwed us badly. Obama squirted money from a firehose to green projects without doing anything to prepare our agencies for a pandemic. And now you are saying all that gets erased and the guy holding the bag when the music stopped is at fault?

If Trump slashed EPA budgets by 90% in 2017 and shoveled that money to CDC virus preparation, would you have agreed with the move at the time?

If you remove New York, New Jersey, Connecticut, and Massachusetts from the numbers, you are left with a nation of 293 million citizens with a lower death rate, more slowly rising deaths, and more slowly rising cases than Canada.

Is Canada considered to have botched their response horribly?

US exceptionalism here is due almost entirely to New York.

Actually, when you take out NYC, the data shows there is an increase.

According to the Associated Press.

"Deaths in Iowa surged to a new daily high of 19 on Tuesday, and 730 workers at a single Tyson Foods pork plant tested positive. On Monday, Shawnee County, home to Topeka, Kansas, reported a doubling of cases from last week on the same day that business restrictions began to ease.,,,Gallup, New Mexico, is under a strict lockdown until Thursday because of an outbreak, with guarded roadblocks to prevent travel in and out and a ban on more than two people in a vehicle. Authorities have deployed water tankers, hospital space is running short, and a high school gym is now a recuperation center with 60 oxygen-supplied beds.

On Monday, a model from the University of Washington nearly doubled its projection of COVID-19 deaths in the U.S. to around 134,000 through early August, with a range of 95,000 to nearly 243,000.

Dr. Christopher Murray, director of the institute that created the projections, said the increase is largely because most states are expected to ease restrictions by next week....He said he is particularly concerned about Florida and Texas, where cases have been rising steadily and the potential for explosions seems high.

While death rates in some places have been trending down, that could change and hospitals could become overwhelmed, he said." https://apnews.com/4450a59eb5276bc5cecc61613e797018

Happy Talk never Ends.

Nothing you said gainsays anything I said.

Your comment indicates a poor grasp of the matter.

His reading comprehension is extraordinarily poor

Maybe you should read the material that I post below that report the new hotspots.

When you disagree with facts you turn on with perjoratives the person who presents them because you have no facts to offer.

Like I said, poor reading comprehension, and a large dose of innumeracy. He made a claim:

If you remove New York, New Jersey, Connecticut, and Massachusetts from the numbers, you are left with a nation of 293 million citizens with a lower death rate, more slowly rising deaths, and more slowly rising cases than Canada.

You haven’t provided any evidence to the contrary.

Is it true? I don’t know. But if you have the data then show that he’s wrong

Yes I have presented evidence to the contrary below,
But apparently you do not read them.
Look at the next response below which was posted before your comment.

Apparently you just go from item to item in the same thread without reading items below.

As you would say,
Sigh.

I responded below. No data you’ve provided invalidates his claim.

You think you are the judge, but you are not.
The reader is.

Read the claims restated as inequalities below.

It’s obvious you haven’t offered any evidence to the contrary

What do you mean: Brian and you have not offered any evidence for his initial claim. Provide support for Brian's claim below:

Why would I offer evidence for a claim I'm entirely agnostic on?

In every comment I've said I don't know whether it's true. My point was that you've offered nothing to demonstrate it's untrue.

OK, Skeptical,
I'll admit it:
I've played a little game with you.

It's a math problem. If one part of the country starts off with a high base of infection, and it grows exponentially, or even linearly, it will most likely always be ahead of every other part of the country that started later, even IF, that other part grows exponentially.

Think of it this way: Part of the house starts during, emits sparks, and another more distant part starts burning. The percentage of the house that is burnt completely will always be the part that starts first. But, that doesn't mean the other half of the house will eventually burn down.

Or, think of a spreading forest fire that emits sparks and starts a fire across a canyon. At a certain time, one fire is bigger than another, but that doesn't mean you don't try to put out both fires, or ignore the one that just got started. It will burn.

So, in otherwords, Brian's statement was one of sophistry that he probably learned from Fox News which picked it up from Kelley Anne Conway who focus grouped it earlier in the week.

You didn't play a game with anyone, you just have poor reading comprehension and math skills. You're in your 60s.

That's enough time to have learned how to say "I was wrong," I'll post a more substantive reply below

Yeah, ignore the AP materials, it doesn't fit the story.

Hope this is not near you and that this does not disrupt

"New coronavirus hotspots are emerging in Republican heartland communities across multiple states, contradicting Donald Trump’s claims that infection rates are declining across the nation.

Fauci says US reopening could trigger outbreak 'you might not be able to control'
Read more
At a fraught press briefing on Monday, the president declared: “All throughout the country, the numbers are coming down rapidly.”

Yet county-specific figures show a surge in infection rates in towns and rural communities in red states such as Texas, Tennessee, Alabama, Kentucky and North and South Dakota, according to data tracking by the New York Times.

Trump’s claim is also contradicted by data used by the White House’s own pandemic taskforce to track new and emerging hotspots.

In a 7 May report, obtained by NBC News, the list of top 10 surge areas included Nashville, Tennessee; Des Moines, Iowa; Amarillo, Texas; Racine, Wisconsin; Garden City, Kansas, and Central City, Kentucky – a predominantly white town of 6,000 people which saw a 650% week-on-week increase. Muhlenberg county, where Central City is located, has voted Republican in every presidential election since 2004, with Trump winning 72% of votes in 2016 – the biggest ever victory for the party.

The geographical spread of new hotspots suggest that the virus is advancing quickly outside major coastal towns and cities such as New York, Newark and Seattle where infection rates are now plateauing or dipping."

From the Guardian: https://www.theguardian.com/world/2020/may/13/new-us-coronavirus-hotspots-republican-heartland-areas

If you remove New York, New Jersey, Connecticut, and Massachusetts from the numbers, you are left with a nation of 293 million citizens with a lower death rate, more slowly rising deaths, and more slowly rising cases than Canada.

Nothing you’ve provided proves or disproves his claim.

Is it true? Shrug. Provide the data. You need state level and Canada.

Skeptical,

You have the report above. You post your evidence to the contrary.

Post below. Identify regions and cities mentioned above where you have contrary evidence.

I challenge you to dispute all of the claims in the report above.

Ball is in your court.

If you remove New York, New Jersey, Connecticut, and Massachusetts from the numbers, you are left with a nation of 293 million citizens with a lower death rate, more slowly rising deaths, and more slowly rising cases than Canada.

Nothing you’ve provided addresses his claim. At all.

Take the state data, aggregate it, remove the states he listed and compare it to Canada.

Is it true? I don’t know. But nothing you provided invalidates his claim whatsoever.

The innumeracy....

Skeptical, You did not provide evidence contradicting the article's claim that county specific surges were occurring and chose to ignore that part. I don't see any state specific data in your reply either so I don't see support for Brian's claim or yours. I do read both the AP and Guardian articles which you have not refuted.

You don't read very carefully Bill. Here's me:

Is it true? I don’t know. But nothing you provided invalidates his claim whatsoever.

Is he right? I don't know. Pull the data and call him on it if he's wrong.

Is it true? Shrug. Provide the data. You need state level and Canada.

Here's Brian's claim in inequality form:

Let US- = [US - (NY, NJ, CT, MA)]

US- death rate < Canada death rate
US- death 1st derivative < Canada death 1st derivative
US- case 1st derivative < Canada case 1st derivative

The AP and Guardian articles neither validate nor invalidate his claim whatsoever. To validate or invalidate you need:

US aggregate data with those 4 states removed
Canada aggregate data

Hotspot county data is entirely worthless. Note that even if you had US aggregate data, without the OTHER SIDE of the inequality you also have no idea whether his claim is correct.

Math is fun

Skeptical,

See my reply above this where I explained the math and how it was a trick for those who do not understand starting base and exponents.

If one part of the country starts earlier, then has a high base and continues to grow exponentially and another part starts later from a small base and also grows expontially, one will be ahead of the other for a time, until the other overtakes later. Read the comment above. We put out forest fires when one sparks over a canyon and starts another fire which ravages later. Or, a house has a fire in the kitchen, sends sparks on the roof to another part of the house, and the house burns on that side until the house collapses. It's network math stuff which you can play with on software if you are interested. That's why Brians comment was disengenuous. There is T, and then there is T(30), Try Gephi.

This is an exceedingly poor attempt a walk back. Thanks for the network metaphor, but a large part of my job is to create sophisticated modeling for clients. I'm well versed in network theory.

Your claim was that he was wrong, not that his claim was misleading or irrelevant. Pretending it was a trick is pretty absurd.

D-

If you had an understanding of the math you would have spotted the misleading character of Brian's and Trump's talking points.

If you are a modeler, and employed to do so, you spend an awful lot of time on this site and not working.

I am glad you understand my comment on network math.

To explain why your links don't add anything to the conversation, let's rephrase this in logic terms.

Here's his claim: Let US- = [US - (NY, NJ, CT, MA)]

US- death rate < Canada death rate
US- death 1st derivative < Canada death 1st derivative
US- case 1st derivative < Canada case 1st derivative

You've replied with links showing county level hotspots across multiple states. Which is great, but it doesn't answer the question at all.

Is he right? I don't know. Pull the data and call him on it if he's wrong.

Canada (140 deaths per million and growing) doesn't seem to be doing great with this fwiw.

Well, if you're going to consider the US-NE, then you really need to consider Canada-Quebec. 56 deaths/million.

Most Canadians would consider Quebec to have botched their response...

+1

This is a real response

Here's a group of 15 states plus Guam and Puerto Rico that have fewer per capita deaths than Canada - Quebec as of yesterday. Kudos to Maine I reckon.

State Deaths / MM
Nebraska 55
North Dakota 52
Maine 49
South Dakota 44
Texas 42
Tennessee 40
Idaho 39
Puerto Rico 36
West Virginia 33
Arkansas 32
Oregon 32
Guam 30
Utah 23
Montana 15
Alaska 14
Wyoming 12
Hawaii 12

By the way, at this moment Trump is letting "masks are for pussies" take root in American folk-conservative culture.

It is not just "bad communication skills" to let that happen, it is an evil calculus that this brings political advantage.

He said that?

Anytime you hear something controversial that Trump "said" or "did" you always need to double check the facts.

You'll find most of the time the claims significantly differ from reality.

Re: Masks are for pussies

Hey, if you had a pussy,
And were next to Trump
Wouldn't you want some protection.

Actually, it's not about pussies, it's about manhood:

"Sources close to the White House have leaked that the president believes that wearing a protective cloth covering is “a sign of weakness.” This is no surprise, given that Trump loves to publicly humiliate other men for falling short of society’s expectations of masculinity. Whether it was mocking Sen. Chuck Schumer, D-N.Y., for crying, former Vice President Joe Biden for being “physically weak,” Sen Marco Rubio, R-Fla., for being “little” or claiming former Energy Secretary and onetime presidential rival Rick Perry didn’t have the “toughness” to debate him, Trump’s sense of self-worth has always depended in tearing down men around him." https://www.nbcnews.com/think/opinion/trump-s-coronavirus-mask-standoff-reveals-dangerous-ripples-fragile-masculinity-ncna1205441

Despite the leaks from his own staff, I think it is just he does not want to convey a sense that there is a health risk from interaction, even though a good number of his staff are home under quarantine.

So far the only place I’ve heard it is anonymous and Bill

I am not saying the President said pussy, in this context. So you are again misrepresenting, which is par for your course.

I did attach an article which says, and your are not disputing or offering contrary support, that the President has said to others that a cloth covering is a "sign of weakness". You also cannot deny how he has used physical features of his opponents in the way described in the article.

Again, Skeptical, thank you for letting me respond to someone so I can provide the reader with more information.

If I misrepresented you, apologies that was not the intent.

If you actually click through the link provided on "sign of weakness" in your article, it goes to the source article here, where we find that quote was actually made up:

https://www.nbcnews.com/politics/donald-trump/trump-tells-allies-his-wearing-mask-would-send-wrong-message-n1202001

It turns out he did not say "sign of weakness" at all. The quote is actually "send the wrong message."

Trump has told advisers that he believes wearing one would “send the wrong message,” according to one administration and two campaign officials not authorized to publicly discuss private conversations.

The president said doing so would make it seem like he is preoccupied with health instead of focused on reopening the nation’s economy — which his aides believe is the key to his reelection chances in November.

Equally stupid, but not the same thing. The word weakness does not even appear in article

Perhaps its worse if he is saying that a mask would send the wrong message if the CDC is urging masks. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html

Sure, maybe it is worse. He should certainly be wearing one and encouraging others to do the same. Massive fail to not encourage others to mask up.

My only contention was that the original claim was wrong.

So the FDA just approved an at home test, but in order to get it you must meet the CDC guidelines. They just can't help themselves.

Amazing that Douglas Adams addressed this so well in H2G2.

Cowen's friend Megan McArdle has the habit of honesty when she isn't trying. McArdle: "I am a libertarian, and libertarians expect large government efforts to fail. I have written previously about the peculiar inability of American governmental institutions to do things that seem to work abroad. Obviously, it’s possible for a government to keep covid-19 at bay, if not entirely under control. But I allowed my hope to overwhelm my natural skepticism." https://www.washingtonpost.com/opinions/the-triumph-of-experience-over-hope/2020/05/12/abca343c-947f-11ea-91d7-cf4423d47683_story.html If one expects to fail, one is likely to fail. Alas, that is the governing philosophy of our libertarian friends. Reading McArdle's essay this morning reminded me of the Fukuyama essay that I linked in an earlier comment. Here's the link again: https://www.prospectmagazine.co.uk/magazine/america-the-failed-state-donald-trump America's regulatory state fails because it's designed to fail. Trump's failures are different only in degree: he has no interest in the hard work of solving difficult problems; he is only interested in self-promotion and settling grudges. So here we are, in a crisis not of Trump's making, but saddled with Trump, who is incapable of either crafting a plan or carrying out a plan crafted by others to get us through the crisis. https://www.vox.com/2020/5/13/21255221/trump-coronavirus-plan-covidreopening-lockdown-liberate It's a nightmare scenario, but an opportunity for our libertarian friends to tell us "I told you so". Me, I'd prefer something useful from our libertarian friends.

"If one expects to fail, one is likely to fail."

If one expects to fail, will one ever support, or promote, someone who expects to win?

Happily for you then we don’t run the CDC, the FDA, the NIH, and currently hold zero seats in Congress.

Since we don’t run or staff these agencies, nor are we more than a handful of the employees therein, your entire point must be

Mood affiliation

The regulatory state is way stronger than Trump. Look what happened when Trump crossed the regulatory state in connection with the Russia hoax and Ukraine hoax -- conversations were leaked and low level bureaucrats were given a podium in Congress to vent their grievances.

there were leaks in Washington?!

[clutches pearls and faints]

More like conversations were invented.

"I don’t see how you can blame (supposed) deregulatory fervor for the presence of too many regulations"

It's quite easy, if you phrase the questions correctly. If you start by phrasing it as "too many regulations", rather than "inappropriate regulations", you can start to see that deregulatory fervor can cause you to be stuck in the wrong conversation.

If the conversation switches to "less vs. more" rather than engaging with the details, then you never get a chance to address the details, which is what is really important. Instead you go round and round, never making effective decisions.

Idealogical fervor, obstructs progress on any effort to get the right regulations. I put the blame mostly on the right. Yes, the left has ideology as well, and often forgets the details in the process of supporting idealogical causes, like ending racism and discrimination, gender equality, etc. The difference is that their ideological concerns are at least correct, whereas idealogical concern with gun ownership, freedom to discriminate, not paying taxes, and "deregulation" are mostly fictions that serve little purpose other than to prevent having an honest dialog about the concerns of the left or the details that should be non-partisan.

It might seem odd that so many fictions exist on one side. But I don't consider it an accident. Powerful interest have collected those fictions as best they could into a group that can be counted on to obsure any progress on issues that threaten them. Fossil fuel interests are one significant example of those interests. That one is abundantly clear in the linkage. There are others stronger or weaker.. tobacco, weapons manufacturers as examples.

Excellent point! What do we tell all of the poor black people and immigrants that come to this country??

Oh I’m sorry, because of the regulation mad NIMBY Republicans you can’t live in San Francisco or NYC. I mean you can live there, but you have to dedicate four to five hours a day to commuting to those towns just so you can work.

Also do you really need to be a kleptocratic Republican Country Club oligarch to argue against price controls, growing unionization, land use regulation, nationalization of industry etc?

Your argument is that none of those right wing causes has any socially optimal outcomes associated with it? It’s all just Koch brothers propaganda?

If only the US was more like France and Germany.

The only reason that Sweden, the US, UK, and France went belly up along with every single left wing government in the history of Latin America is because rich people have a better propaganda machine to support free markets??

A simple question
What’s more dangerous to bank systems, something rated AAA turning out risky, or something rated below BB- being confirmed as very risky?
Basel Committee’s risk weights:
AAA rated 20%, below BB- rated 150%
Are not regulators failing us?
http://subprimeregulations.blogspot.com/2019/03/my-letter-to-financial-stability-board.html

But it's important to note that Trump and his team appointed the leadership of the CDC and HHS/FDA. Azar and Redfield were either not qualified or simply not up to the job. Moreover, the staffing problem across most senior levels in these agencies has been enormous--empty positions, nepotism, cronyism. That's on the Trump administration.

Yes, but: the CDC under the Obama Administration and its prior leadership acquired the dismissive appellation "Centers for Dissemination of Coronaviruses" almost a decade ago with the institutional blunders and failed protocols being made then amidst Ebola, avian flu, and other coronaviruses.

Any problems lingering in Trump's CDC surely have an institutional history.

Ebola and avian flu aren't coronaviruses. SARS (an actual coronavirus) predated the Obama administration. The CDC response to MERS (another actual coronavirus) was considered exemplary, and the US was prepared when the first cases arrived in the US.

Perhaps you can share with us some links to people using the term "Centers for Dissemination of Coronaviruses" almost a decade ago.

Given that our beloved internet is today full of SARS-CoV-2 items, you'd have to perform some intensive research with the right search terms on the CDC's failures during the Tom Frieden era, but this might be one place to start:

https://www.usatoday.com/story/news/2016/06/02/newly-disclosed-cdc-lab-incidents-fuel-concerns-safety-transparency/84978860/

I myself coined the appellation "Centers for Dissemination of Coronaviruses" strictly in satiric jest back in the day in various internet chatrooms (possibly even here at MR): sorry, I don't save links to my posts.

So your statement "the CDC under the Obama Administration and its prior leadership acquired the dismissive appellation "Centers for Dissemination of Coronaviruses" was made up in some long forgotten chat room. By you. And you use your own made up and utterly illogical term to imply an institutional history of failure. Cool.

Get a grip and/or a working sense of humor: I owned up to my satiric usage (I am a practicing science satirist) AND I supplied a link documenting (if not validating) my satiric usage.

The CDC continues to be another sprawling (and partly dysfunctional) bureaucracy within our Failing Regulatory State, just as the USA Today piece from June 2016 suggested.

In which Jerry Taylor goes full failed state:

https://twitter.com/jerry_jtaylor/status/1260548826491953152?s=19

By the way, as I attempt to assess my mood this morning, I think I am pretty "failed state."

And not very tolerant of libertarians who think "I told you" so is a constructive argument.

If you saw this coming nimrods, you should have done something about it. It was especially nonsensical to see it coming and hasten it all the same.

We had that wonderful moment in history, when Theil thought it was good time to go all in for Trump 2020.

1) We did tell you

2) the president doesn’t matter much, if at all. If voting him out makes you feel better, go nuts. It won’t affect the real outcomes. Only hardcore partisans suffering from mood affiliation would care one way or the other

3) public choice, public choice, public choice

4) look to the incentives at the agencies that actually create policy

5) look at their history of success or failure

Isn't it amazing. This guy talks now and then about the strength of Bayesian logic. He had the "prior" that who is president didn't matter that much.

And as of this date he has still not seen any reason to update that prior.

I think broken in the head is the only answer.

So, do CEO’s matter or not? Does control of budgets matter? Is three years a long time to be in power or not?

Does your reply depend on who is in power?

"The FDA and CDC, for instance, have through their regulations made it harder for testing and also widespread mask supply to get off the ground."

Consider a simple question: What countries, in which there was NOT already a culture of wearing masks in public, have succeeded in generating a mass supply of masks and also convinced the general public to wear them? Bonus - assuming you can name multiple examples, please rank those countries on the spectrum of 'regulatory state'.

Consider another simple question: What countries have managed true widespread testing from early in the pandemic? Bonus - rank those countries on the spectrum of 'regulatory state'.

There is no answer to the first question. Every country outside of Asia, where there was already an entrenched culture of mask wearing, has failed at this, and are continuing to fail. On the second question, there are at best a very few countries that have done a good job on widespread testing. As far as I can tell, these are all states with very well developed regulatory systems, and my sense is that most of these places look at the US as being far less regulated.

Here's a quote from one of Tyler's links yesterday, about the difficulty of testing in the US compared to other countries: "In countries with successful testing programs, deference to government authority is higher than in the U.S. Information on where people live and work is often less closely guarded. And acceptance that the state has a monopoly on force is virtually uncontested."

There are examples in the US of people being killed for demanding the wearing a mask, and cases where health officials recommending masks have been overruled and muzzled by government officials. We've had government officials, including most obviously Trump, saying that we have have plenty of testing and that the problem was solved weeks ago.

If your hobby horse is excess regulations, there will always be plenty of examples of regulatory excess. Is there plenty of egg on the faces of the CDC and the FDA and the WHO? Yeah, you betcha. But are they, and their excess regulations, the main culprits on the situation the US is in currently? I think Tyler's post today is a straw man argument to scapegoat the regulators.

Let's consider a different example than thalidomide to example these cretins at the FDA and CDC - early on, there was irrational exuberance about hydroxychloroquine and azithromycin for COVID-19. What could it hurt, right? It's cheap, it's available, some people said it worked, doesn't seem too toxic. Let people make their own choices, right? At this point, it appears that it's not only useless, but in some cases toxic. Do we give the regulatory state some credit for sanctioning incredibly rapid RCTs to determine the safety and (lack of) efficacy of this treatment? Do we give them credit for keeping thousands more patients from getting bogus and toxic treatment?

Let's consider a different example than thalidomide to example these cretins at the FDA and CDC - early on, there was irrational exuberance about hydroxychloroquine and azithromycin for COVID-19. What could it hurt, right? It's cheap, it's available, some people said it worked, doesn't seem too toxic. Let people make their own choices, right? At this point, it appears that it's not only useless, but in some cases toxic. Do we give the regulatory state some credit for sanctioning incredibly rapid RCTs to determine the safety and (lack of) efficacy of this treatment? Do we give them credit for keeping thousands more patients from getting bogus and toxic treatment?

Is that paragraph accurate? I have NOT seen anything stating the AZ+HcQ is toxic, nor a conclusion that it is bogus.

Derek Lowe did a good summary article a week ago: https://blogs.sciencemag.org/pipeline/archives/2020/05/04/hydroxychloroquine-update-may-4

And here is a rather brutal takedown of the key scientific proponent of HcQ, Didier Raoult, and his research and methods: https://forbetterscience.com/2020/03/26/chloroquine-genius-didier-raoult-to-save-the-world-from-covid-19/

There are definately side effects, but we've known that for 60 years. Studies I seen is that there is no effect for patients in serious shape, but some others saying some good effect for thos in less serious shape. Published just today:https://www.ny1.com/nyc/all-boroughs/news/2020/05/12/nyu-study-looks-at-hydroxychloroquine-zinc-azithromycin-combo-on-decreasing-covid-19-deaths

"Researchers at NYU's Grossman School of Medicine found patients given the antimalarial drug hydroxychloroquine along with zinc sulphate and the antibiotic azithromycin were 44 percent less likely to die from the coronavirus."

Not to mention that after first loosening the regulations on Covid tests, the FDA had to tighten it back up, because hospitals and officials were relying on the ineffective and outright phony tests that flooded the unregulated market.

Some Libertarian dingbat the other day claimed that this was the hospital's fault for not each independently creating the procurement vetting and results tracking capacity at the local level, so they can thoroughly make informed buying choices for everything they buy.

Each freaking hospital is supposed to vet every single supplier of everything. Rather than rely on a single central authority to do this process efficiently.

I know of zero states that have effectively combated COVID-19 by taking a laissez faire attitude and letting the free market solve the problem. Meanwhile, many states have handled it quite well by taking very aggressive action. (In other words, mask shortages from poor regulation is bad, but what's really hurting states that aren't handling this well is lack of central quarantine and test-track-trace.)

This statement says so much: "When the CDC pooh-poohed masks early on, or botched their testing kit thereby delaying U.S. testing by weeks or maybe months, did the permanent staff of the CDC rise up and rebel and leak howling protests to the media, realizing that thousands of lives were at stake? ".

Is anyone going to be fired or lose his pension? Those staffers knew that proper PPE (personal protective equipment) including masks for public health workers actually works very well. Note that the number of new cases per incoming case in a medical setting gives a reproductive rate of the virus (R) as 0.05 which proves that PPE works and masks work most of the time. Any business, or organization with an internal effective R for the virus < 1.0 by a reasonable amount will not experience a significant cluster of cases and is effectively resistant to infection as an institution. Let's hope Tesla is competent and has a solid science-based biosecurity plan.

The bureaucrats also created the regulations that say that PPE must be disposable and go into a bio-hazard waste system which eliminates the possibility of having the majority of the population using PPE and eliminating most of the risk of contact with other people. The left hand of the organization did note that this virus is very temperature sensitive and can be inactivated by simple relatively low-temperature heating (140ºF) for 30 minutes (a dryer or oven on very low or food warmer). Being able to heat treat PPE and make it re-usable for citizens would allow all citizens to have and use PPE which would stop the virus cold.

The right hand of the CDC created the disposable standard which allowed PPE to be used with all pathogens but forgot that the public is dealing with a temperature-sensitive virus, not TB. Being blind to the reality that their regulations scientifically didn't apply to citizens PPE with this viral pathogen they lied to the public about mask usage.

Where Trump is to blame is for trusting the civil service. He criticizes the Swamp, but he doesn't seriously try to fight them. Around March 1, he did put Pence in charge of overruling the FDA and CDC, adn that's when things started going better.

I thought the Swamp was not the civil service but something like heads of agencies who were tied to the persons they were hired to regulate.

As for seriously trying to fight the civil service, perhaps you are looking for a model like someone in, say, Hungary, Poland or Turkey, rather than a US president who has traditionally coexisted with the long term civil service.

If you are looking for a Hungarian, Polish, or Turkish president, count me out. And, if you are looking for a President who refuses Congressional oversight of his administration, count me out again.

Dear Professor Cowen:

Blaming Trump for the Coronavirus is like blaming Hoover for the Depression.

In both instances the President relied on the best experts available. Turns out they were, shall we say, not as well-informed as they might have thought.

In February and March, the experts suggested masks were unnecessary and counterproductive. Now they're saying everyone should wear one.

Trump closed down air traffic with China before anyone thought it was a good idea. In fact he was roundly denounced for doing so. Now everyone's accepting that was a good idea.

Trump backed the hydroxychloroquine-erythromycin-zinc treatment and--again--was roundly denounced for it. Then it turned out to be effective even on patients who'd been given up for dead.

Trump also gave the governors a great deal of latitude in dealing with the problem, which--under the Constitution--is as it should be.

Some of the governors behaved stupidly as a result. In particular--and for all the pearl-clutching about Kemp in Georgia and DeSantis in Florida--Cuomo really does have the deaths of thousands on his hands as a result of mandating that nursing homes had to take in COVID-positive patients DESPITE everyone knowing that the folks in those nursing homes were the most prone to dying of the virus. Only now--after thousands have perished as a result of that policy--is he finally bringing it to an end.

...Was that also Trump's fault?

I live in the Commonwealth of Virginia, which has almost exactly the same population as New York City (both have about 8.5 million souls). As of a day or two ago, the Commonwealth had reported between 750 and 800 deaths (I don't remember the exact figure). New York City has over 20 THOUSAND.

Both states have Democratic governors and legislatures. And of course New York City has a Democratic mayor and City Council.

So...is it Trump's fault that New York has 25 times the death rate we have in the Commonwealth? Inquiring minds would like to know!

You yourself, professor, agree that much of the blame is on the bureaucracy and its regulatory infrastructure.

Both Dr. Fauci and Dr. Birx are lifelong members of that system. But it's THEIR alleged expertise Trump has been relying on.

Yet you still think Trump is somehow the guy who's failed ?!? I don't get that.

Very respectfully,
David

The only thing that I would criticize Trump for is that he gave too much airtime to 'experts'. And in doing do, he allowed the media (who have NO expertise in anything) was able to take small talking points and blow them into huge issues.

Experts, from all walks of life, need to be reined in - one of the problems with experts is that they really have a very limited range of vision. They can see the trees but not the forest. We see it in the global warming push, and in most anything else where experts are given any amount of free rein.

But Trump played the game that the media set him up for ('why are you not using science') and hopefully he learned from that. I'm surprised he allowed it to happen in the first place.

The reality is that, covid19 turns out to be like more viruses - attacks those with compromised immune systems (mainly the elderly) and while there may be a vaccine at some point, it will probably be as effective as the season flu vaccine - meaning not very much.

All countries ignored the on-going warnings that more viruses would be coming down the pipe, mainly because people travel a lot these days. At one time, viruses took a long time to arrive from so backwoods place because people didn't travel as much.

I doubt any lessons will be learned and the next virus that hits will again take people by surprise and they will wonder why care homes and the elderly are dying. Shocking!

?Experts, from all walks of life, need to be reined in - one of the problems with experts is that they really have a very limited range of vision. "

That's a hilarious thing to say on a blog run by a tenured professor who writes for Bloomberg as an expert economist.

Regulations usually either constraint the choice set or require a governmental review. Hence, by their nature, they tend to slow things down. This is true regardless of your position on whether or not a given regulation is socially beneficial or not.

When a crisis hits that requires quick action, some regulations may become an impediment. It seems too difficult to write all contingencies into the regulations ex-ante, so practically speaking it seems we are stuck with trying to change, supplement, or amend regulations so that they produce a better response to the crisis. And the responsibility to make these changes lies with our political leadership.

Therefore, if indeed we are failing this crisis, I think it is very hard to disentangle how much "our regulatory state is failing us" versus how much our leadership is failing us. Leadership can of course include the executive branch, but also the legislative branch--for example, manifested through an inability to compromise drive by polarization and a lack of trust. (Although, personally I feel that Congress has been able to compromise relatively well through this crisis.)

Presidents who want to get something done can get around all sorts of regulations and procedures. Don't blame the bureaucrats. They can't cut the red tape. The president can. If he can't do it alone, he can do it with Congress, and he can do it quickly. Our current president is either on COVID's side or can't be arsed. I'm leaning towards the former.

Maybe the regulatory state wouldn’t have failed America if it hadn’t been sidelined by Trump and Kushner, eager in March to push happy talk about the booming stockmarket and American pandemic leadership of the world. Ed Luce in the FT May 15 ‘Inside Trump’s coronavirus meltdown’ supplies detail.

Tyler, you seem strangely eager to downplay the poisonous incompetence of your president.

This is not a good take. Yes, the regulatory state is failing us--it's been failing us for years--but in times of crisis we need good leadership to galvanize the federal bureaucracy in a certain direction.

Yes, an uber competent regulatory state would help. Yes, multi-disciplinary experts would help. But in the end you *must* have good leadership to to synthesize a plan, break through the organizational inertia, and coordinate a coherent response.

When there was a problem with testing back in March, we needed someone *above* the FDA and CDC to bang heads together and come up with a solution. These kinds of coordination issues always come up in a crisis, and it's foolish to think they will resolve themselves without strong top-down leadership.

We didn't have good national leadership, so the state governors eventually stepped in to fill the void, when it the federal abdication of responsibility became fully apparent. The first two months of the lockdown can be seen as a time when state governments geared up to fill the void created by the federal abdication of responsibility. Now we have testing, now we have tracing, now we regional coordination on policy and purchasing, and all these things took time to set up. States haven't needed this capacity before, and it took a while first to realize it was necessary and then to actually acquire it.

It really does come down to a failure of leadership. Leadership is the force multiplier in a crisis situation, and unfortunately our top leadership abdicated responsibility early on and left a gaping void for states to fill.

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