Our regulatory state is broken, installment #1837

Americans returning from China landed at U.S. airports by the thousands in early February, potential carriers of a deadly virus who had been diverted to a handful of cities for screening by the Centers for Disease Control and Prevention.

Their arrival prompted a frantic scramble by local and state officials to press the travelers to self-quarantine, and to monitor whether anyone fell ill. It was one of the earliest tests of whether the public health system in the United States could contain the contagion.

But the effort was frustrated as the C.D.C.’s decades-old notification system delivered information collected at the airports that was riddled with duplicative records, bad phone numbers and incomplete addresses. For weeks, officials tried to track passengers using lists sent by the C.D.C., scouring information about each flight in separate spreadsheets.

“It was insane,” said Dr. Sharon Balter, a director at the Los Angeles County Department of Public Health. When the system went offline in mid-February, briefly halting the flow of passenger data, local officials listened in disbelief on a conference call as the C.D.C. responded to the possibility that infected travelers might slip away.

“Just let them go,” two of the health officials recall being told.

Here is the full NYT piece, thorough, excellent, and scary throughout, and it shows a first-rate understanding of bureaucracy.  Don’t forget the CDC budget has risen steadily in real terms.

Comments

Surprise surprise surprise!

Fire the entire management team.

Those excellent scientists deserve better, as do we.

Next up, FDA ...

Its very hard to fire anyone in government service. That's a major problem.

The government in particular is very bad at tech. It doesn't surprise me if little of that budget went toward information systems.

All you need is an app right? Garbage in, garbage out as they say.

What about those coming from Italy to New York, carrying the European mutated strain of covid. Was anybody concerned about Europe in addition to China? Were choices made not to quarantine against Europe because of the economic effect.

Ask Larry Kudlow. "National Economic Council Director Larry Kudlow tried on Tuesday to assuage concerns over the cornavirus and its impact on the U.S. economy.

“We have contained this. I won’t say [it’s] airtight, but it’s pretty close to airtight,” Kudlow told CNBC’s Kelly Evans on “The Exchange.” He added that, while the outbreak is a “human tragedy,” it will likely not be an “economic tragedy.” https://www.cnbc.com/2020/02/25/larry-kudlow-says-us-has-contained-the-coronavirus-and-the-economy-is-holding-up-nicely.html

"When he finally reached the coronavirus checkpoint near baggage pickup, Siebert reported his prior symptoms and described his exposure in Spain. But the screeners waved him through with a cursory temperature check. He was given instructions to self-isolate that struck him as absurd given the conditions he had just encountered at the airport.
“I can guarantee you that people were infected” in that transatlantic gantlet, said Siebert, who tested positive for the virus two days later in Chicago. “It was people passing through a pinhole.”
The sequence was repeated at airports across the country that weekend. Harrowing scenes of interminable lines and unmasked faces crammed in confined spaces spread across social media.
The images showed how a policy intended to block the pathogen’s entry into the United States instead delivered one final viral infusion. As those exposed travelers fanned out into U.S. cities and suburbs, they became part of an influx from Europe that went unchecked for weeks and helped to seal the country’s coronavirus fate.
Epidemiologists contend the U.S. outbreak was driven overwhelmingly by viral strains from Europe rather than China. More than 1.8 million travelers entered the United States from Europe in February alone as that continent became the center of the pandemic. Infections reached critical mass in New York and other cities well before the White House took action, according to studies mapping the virus’s spread. The crush of travelers triggered by Trump’s announcement only added to that viral load.
“We closed the front door with the China travel ban,” New York Gov. Andrew M. Cuomo (D) said last month as officials began to grasp the magnitude of the failure. In waiting to cut off travel from Europe, he said, “we left the back door wide open.”

https://www.washingtonpost.com/world/national-security/one-final-viral-infusion-trumps-move-to-block-travel-from-europe-triggered-chaos-and-a-surge-of-passengers-from-the-outbreaks-center/2020/05/23/64836a00-962b-11ea-82b4-c8db161ff6e5_story.html

All the white people who came take land from the first peoples came by way of the back door?

I guess the first nations were like Trump, securing the front door they used while ignoring the back door, letting in criminals carrying disease....

Sorta poetic that white people entered the back door spreading disease, and then left the back door open so white people could come in the open back door and spread disease.

>Sorta poetic that white people entered the back door spreading disease, and then left the back door open so white people could come in the open back door and spread disease.

Get this white supremacist drivel out of here, you actually think Europe and the US are only white people?

The heck is wrong with you.

Another example of a news report documenting policy mistakes with zero attempt to explain why the mistakes were made.

Disingenuous people like you are THE problem.

https://www.google.com/amp/s/www.bbc.com/news/amp/world-us-canada-51846923

Note the EU and Democrats screamed bloody murder at the time.

Murder indeed ...

Why don't you venture outside and burn some cop cars?

It hurts, doesn't it, when you link to and quote articles.

So, Ed, when you say the Dems were screaming bloody murder, you cited the BBC article which says

"Senior Democrats said it was "alarming" that President Trump had not addressed a shortage of coronavirus testing kits in the US.
"The best way to help keep the American people safe and ensure their economic security is for the president to focus on fighting the spread of the coronavirus itself," House Speaker Nancy Pelosi and Senate Minority Leader Chuck Schumer said in a statement."

I hope you understand that I will post what you cite as authority for your proposition and call you out for your claim. But, I have no doubt that both Republicans and Democrats were surprised, but also that they were concerned that there were inadequate masks. But, to cite a post which does not contain the support you claim is far from honest, which is a polite way to say something that everyone can guess. Keep posting your sources though.

Susan Rice is a Democrat. You are half correct - my link did not support my claim that Democrats screamed bloody murder when the EU travel ban was announced. The link aside, I stand by my claim.

https://www.google.com/amp/s/www.independent.co.uk/news/world/americas/us-politics/europe-travel-ban-coronavirus-trump-reactions-us-uk-twitter-a9396146.html%3famp

What is left of the claim?

I accept your correction and acknowledgment.

From BBC NEWS

Coronavirus: Trump Suspends Travel from Europe to the US

https://www.google.com/amp/s/www.bbc.com/news/amp/world-us-canada-51846923

Of course there was the wailing and gnashing of teeth as the usual suspects used it as an opportunity to exercise their TDS. They were against it before they were for it.

Browser does not open your link: it appears to be a Google search entry. I assume it is the same article you cited one up in which case my reply and comment is there.

It's fascinating that Trump's apparently wishful thinking was completely shared by the Swedish health experts. Sweden adopted a policy consistent with the wishful thinking and wound up with a lot of dead people. The responsible bureaucracy now sees that, kind'a:

https://www.bbc.com/news/world-europe-52903717?intlink_from_url=https://www.bbc.com/news/topics/c77jz3md4rwt/sweden&link_location=live-reporting-story

Do you think that was the CDC's advice to let the virus go unchecked ala Sweden or do you think they would have advised a different course?

From the NYT description, I infer that the CDC was asleep. Probably still is.

I remember their first "no masks needed" advice. I knew it was about scarcity, not effectiveness. They just damn lied to cover their asses.

Good. Let's have some oversight hearings and ask CDC officials about what they advised the White House or what was sent up to Health and Social Services. I'm glad we can agree on this. We won't have to speculate and we will find out the truth. Thank you.

I'm sure they covered their asses in written communications! :-)

What do you think that means. They forwarded their recommendations and they were not followed.

Yeah, I am sure they did "covered their asses" for a reason.

I remember the first public recommendation: No masks needed. Morons.

So, are we supposed to stick to something when new evidence becomes available?

That would be more moronic.

You change with the evidence.

Let's stay distant.

Masks for doctors but not for us on account they are unnecessary! What, one way filtration? Gimme a break. They messed up, big time.

If you know I higher level of masks works, why didn't you reach in your reserve and create one. Jared said that there are sufficient amounts for the Federal Government. Didn't you know you are on your own, just like the states?

I did and I knew. It's the flow for everybody else that the CDC discouraged and the FDA hindered.

Over and out.

I accept you retreat. Over and out.

"Scarcity" is not a reasonable hypothesis. Their has never been a scarcity of cloth to cover the nose and mouth. Presumably (and I agree that it is an egregious failure to leave us to presume) the no-mask recommendations was based on knowing that wearing a mask provides little if any protection to the wearer and that at the time the chances of a wearer having an asymptomatic infection was so low that wearing a mask provided near zero protection to other people. As the prevalence rose, at some point wearing a mask to protect other people became worth the trouble.

Sure, sounds, and was, awful. Lots of complaining in this "regulatory state failure" series on this blog. Mighty short of solutions however.

Big Business will handle it.

It's a funny heading "Failed Regulatory State" when the Failure is of the head of the state to act correctly as a manager. But, if Tyler would call it something like: We Have the Regulations And the Commander In Chief Does Not Faithfully Execute Them" that would not be too kind, and would signal that someone is suffering from an enlightened form of TDS, which, if you google search the term, is a form of television service. Which makes sense, because it is, after all, the Trump Show that we are all watching.

Last episode of the Trump Show, which we just watched, was entitled: "Trump Teargases Clergy So He Can Walk to Church and Hold a Bible Upside Down for a Photo Op."

“ Last episode of the Trump Show, which we just watched, was entitled: "Trump Teargases Clergy So He Can Walk to Church and Hold a Bible Upside Down for a Photo Op."”

For a person who claims to place a lot of weight on evidence and proof, you sure post a fair bit of sheer lies and opinion mongering. There’s almost nothing true about your latest contribution, reposted above. It looks like it was copied from a Twitter thread.

Of course Trump is going to stage a photo op. One of his jobs is to waddle out in front of cameras and seem to be reassuring. I don’t like him and I acknowledge that he’s got to do this. Why not in front of a riot-targeted Church? You partisans are all alike; I bet you snickered when some said Trump hid in a bunker. Well which is it? Should he hide in a bunker and get mocked or give a speech in front of a venerable building and get mocked?

Dear God,

Lucifer may have taken your name to do a post,
As I recall, and you must also,
The Headline in the Episcopal News Service
Which Reads:
"Outraged Episcopal leaders condemn tear-gassing clergy, protesters for Trump photo op at Washington church"

Dear God, I pray you bring vengeance on those who use your name in vain,
And,
As Nancy would say,
I pray for you.

At least one Episcopal priest was among those tear-gassed. At least 20 priests and a group of laypeople were at the church earlier in the day “to serve as a ‘peaceful presence in support of protesters,’” handing out water, snacks, and hand sanitizer. The Rev. Gini Gerbasi, rector of a different St. John’s Episcopal Church (in Washington’s Georgetown neighborhood), was packing up – dressed in clerical garb – when she and a seminarian were tear-gassed by police in riot gear, she said.

“I was suddenly coughing from the tear gas,” she told Religion News Service. “We heard those explosions and people would drop to the ground because you weren’t sure what it was.”

Gerbasi said she heard people crying out in pain, having been hit by rubber bullets, as she fled.

“They turned holy ground into a battleground,” she told RNS.

Here is the link: https://www.episcopalnewsservice.org/2020/06/02/episcopal-leaders-express-outrage-condemn-tear-gassing-protesters-for-trump-photo-op-at-washington-church/

And, Dear God, here is some more:

But sometime after 6 in the evening, when volunteers were packing up supplies, Gerbasi said police suddenly began to expel demonstrators from the park — before the 7 p.m. curfew announced for Washington residents earlier in the day.

“I was suddenly coughing from the tear gas,” she said. “We heard those explosions and people would drop to the ground because you weren’t sure what it was.”

The Rev. Glenna J. Huber, rector of the Church of the Epiphany, another downtown Washington church, was at St. John’s but left as the National Guard arrived. She said she watched as police rushed into the area she had just fled. Concerned, the priest sent a frantic email to clergy at the church urging them to be careful.

Back at St. John’s, Gerbasi said she was dressed in clerical garb and standing on church grounds as police approached.

“I’m there in my little pink sweater in my collar, my gray hair up in a ponytail, my reading glasses on, and my seminarian who was with me — she got tear gas in her eyes,” she said.

Gerbasi said that as she and the seminarian watched, police began to expel people from the church patio.

“The police in their riot gear with their black shields and the whole bit start pushing on to the patio of St. John’s Lafayette Square,” she said, adding that people around her began crying out in pain, saying they had been shot with nonlethal projectiles.

Gerbasi and others eventually fled the scene, leaving emergency medical supplies behind. By the time she reached K Street several blocks away and checked her phone, Trump was already in front of the church holding a Bible.

https://religionnews.com/2020/06/02/ahead-of-trump-bible-photo-op-police-forcibly-expel-priest-from-st-johns-church-near-white-house/

Dear God, post below if you want more proof. I am happy to provide and post it. I am happy to be known as a person who demands proof.

Post below your request for more support. Otherwise I will assume you have suffered enough.

He could have chosen a different venue or waited until protesters did not have to be displaced in order to walk to the venue.

"It's a funny heading "Failed Regulatory State" when the Failure is of the head of the state to act correctly as a manager."

Alas, precisely that cannot be. No dictator, no matter how efficient, can make all those decisions. That's why we have bureaucracies of experts! [We even have a market! :-)] 'Cept the US of A has some damned bad ones. That's structural, built over many years, connived in by many.

Yep, and Bill is part of the regulatory state. He posts passionately on this topic, almost like his job depended on it!

So, Anon and Dismalist, the logic is that" No dictator, no matter how efficient, can make all those decisions" . I don't see the logic of that for several reasons.

First, you assume that the recommendations of CDC were what the "Dictator" did. You must prove that the CDC recommendations where what the "Dictator" adopted.

Second, I stand out of the regulatory state: I am a critic, and labeling someone as part of what you call the government--the "regulatory state"-- is just an emotional tag which conveys no information and simply tries to confuse and disorient the reader from clearly and objectively assessing the situation.

Thank you for giving me this opportunity to elaborate and respond to your comments. I eagerly accept the challenge and look forward to more of this opportunity to respond to these type of comments.

God Bless.

Alas, your logic is wanting: "First, you assume that the recommendations of CDC were what the "Dictator" did. You must prove that the CDC recommendations where what the "Dictator" adopted."

First, no, not at all.

And, we do not have a dictator! Thank god, for he could not do all this good stuff.

Over and out.

You said we had a dictator. I'm quoting you from above. Did you forget what you said: " No dictator, no matter how efficient, can make all those decisions. That's why we have bureaucracies of experts! [We even have a market! :-)] 'Cept the US of A has some damned bad ones."

Second, you offer no evidence as to what the CDC recommended, so how can you criticise them for their recommendation when all we know is what the White House released after they modified it.

Please post below recommendations by the CDC before they went to the White House. If you cannot post them, admit that, and acknowledge that what you have is the White House (in your words, Dictator) statements.

It struck me, that their number one issue, once they got personalities and testing out of the way, was an outdated computer system.

We have a great tolerance that the government runs a bunch of old COBOL systems, and as long as they seem to keep working, we don't care. Old programs, spreadsheets, things handed around on DVD (at least not CD!).

So how many of you libertarians campaigned for cutting edge computer systems in government? Or were you too busy demanding that everyone justify their existence?

(Maybe it's the "bureaucrats" fault for not re-implementing everything on the cloud with money raised at bake sales.)

Yes, they added other health initiatives, but that doesn't change the fact that requested funds to improve and modernize these systems never arrived.

Never heard of JEDI? "The Joint Enterprise Defense Infrastructure, or JEDI, cloud computing contract could be worth up to $10 billion for services rendered over as many as 10 years." Signed last year. Also there is AWS GovCloud. https://aws.amazon.com/govcloud-us/faqs/ I've actually used the latter.

Does the CDC get any part of that?

I think it's open to all agencies, but I'm sure implementation varies quite a bit. The agency I sometimes contract with isn't particularly behind with technology, most of the issues are just bureaucracy.

I don't see it connecting to anyone outside the defense department.

https://en.m.wikipedia.org/wiki/Joint_Enterprise_Defense_Infrastructure

You have a plausible hypothesis. Why did the authors of the piece not ask CDC why they have an inadequate computer system? When did they request funds to update it and who turned them down?

To be slightly harsh, maybe you should stop using "our" in these titles Tyler, unless you're actually willing to own it.

What other word should he use? We’re all paying for it.

Did you spend your energies looking for improvements, or fighting that same spending?

Neither...I don’t try and improve American Bureaucracies because they are mostly decayed, bloated and beyond saving.

Enjoy DARPA because it’s the best thing we’ve got as a civilization!

Well, my thought for the day might be that more people should work on improving institutions like the CDC.

Rather than just reserving the right to bitch later.

No doubt your opinion is based on your extensive experience turning around massive recalcitrant federal government bureaucracies.

I didn't think so ...

My experience as a citizen supporting solutions!

And observing people who oppose solutions then complain later.

Yeah right, virtue signaller.

That is the bankruptcy of the modern right and a nutshell.

I say solutions.

He says solutions are just signaling.

Oh gosh no wonder there hustling DVDs around with CDC data.

I’m sorry I was being lazy before. Here’s a better right wing argument. I think good bureaucracy is endogenous to certain societies for certain reasons.

So Scandinavia is Scandinavia and their bureaucracies are more legitimate and higher functioning than the US.

In the US, the party of bureaucracy, the Democrats, will probably not deliver us high functioning bureaucracy even if the sabotaging Republicans are out of power.

Why? For reasons of
1. Social trust
2. Public Choice
3. Price signals and work opportunities for the best minds.
4. Previous performance of the Democratic Party-Let’s face it, they’ve been given free reign in a ton of major American cities for over forty years, free of the shackles of republican saboteurs. And they’ve done somewhere between a mediocre and miserable job.....

I'm old enough to remember when we did not have to rely on Democrats to fix things when Republicans are out of power.

#4 is an interesting point. One would think that after a generation or more of Democratic control, there would be at least a handful of these cities which would be obvious exemplars of excellence, world class benchmarks to be recognized and emulated - in everything from police operations to road maintenance to schools to public pension funding. Not a single one comes to mind.

Except Sweden, which followed a scientifically founded Trumpesque program.

Not easy to do, the thieves will even set you up for impeachment if you try.

And I'm still downgrading every article that doesn't touch bases by naming the division of HHS actually responsible for pandemic response, as opposed to pandemic investigation.

https://www.fiercehealthcare.com/hospitals-health-systems/members-congress-express-concerns-over-strategic-national-stockpile-as-cdc

The Assistant Secretary for Preparedness and Response is managing to keep his head down.

There are not that many US airports with direct passenger flights from China. They could have just mobilized people with clipboards to take the particulars (home address, phone, ...) of each one as they landed. But some bureaucrat at the top would have had to take responsibility for changing the system ...

Not a single passenger flight enters U.S. airspace without having all PNRs cleared - the information was available, it simply was not provided.

"U.S. law requires air carriers operating flights to, from, or through the United States to provide the Department of Homeland Security (DHS), U.S. Customs and Border Protection (CBP), with certain passenger reservation information, called Passenger Name Record (PNR) data. This information is transmitted to CBP prior to departure and used primarily for purposes of preventing, detecting, investigating, and prosecuting terrorist offenses and related crimes and certain other crimes that are transnational in nature. ... These statutory and regulatory authorities require each air carrier operating passenger flights in foreign air transportation to, from, or through the United States to provide CBP with electronic access to PNR data to the extent it is collected and contained in the air carrier’s reservation and/or departure control systems."

The article in the NYT, which is about the CDC, is more nuanced than Cowen suggests. What the article presents is an apolitical agency, the CDC, up against the most political administration, the Trump administration, the former trying to present the facts, the latter trying to manipulate the facts. One may criticize the CDC for not standing up to the administration, but blame voters not the agency for electing an unqualified president.

Where the hell were you from 2008-2016? Either way, welcome back to earth.

+1

The incompetence of Trump and his chosen leaders at the CDC cost us lives and tons of money. The response is "but Obama did something."

Steve

Dysfunction at the CDC predated Trump.

Post the support for your claim that there was dysfunction at the CDC predating Trump.

Second, if, as you claim, dysfunction at the CDC predated Trump, explain why he did not correct that dysfunction during the three years of his term.

Third, I agree that the CDC failed to create test kits in time and that they failed to follow good manufacturing practices this time, when they had created test kits for other communicable diseases previously.

And, to the extent that you are claiming that the CDC

By the way, I do accept that the CDC had IT problems and manufacturing problems this time, but, I also want to ask: were they adequately funded to do their job when there was a fiscal cap place on all government agencies.

We have to look at oversight; we have to look at funding requests and reallocations to other agencies, and we have to make changes, and we have to realize that public health is an asset, not a liability, and there will be another virus sometime in your lifetime, unless you die from covid.

My personal, professional experience has been that the CDC has been undergoing drastic mission creep and diffusion of core responsibility for years.

If that is not good enough for you, I refer you back to Ebola in 2014 when the CDC's Ebola PPE guidelines were wrong (in spite of having CDC folks on the ground and working with Ebola for literally decades). Their Ebola coordinator elected not to talk directly to hospitals which lead to several near misses. And the CDC was talking up how they successfully managed to contact trace 90% or so of the people entering the country who had direct contact with Ebola patients.

All of that was crap. MSF called it crap at the time (i.e. the docs with the most experience fighting Ebola in the developed world).

As far as cleaning up the place. How? The folks inside have civil service protections. And when their single biggest failure has been being too uncritical of the WHO, how exactly should you go about changing that? Mass firings? Put out an executive order to no longer take WHO guidance?

The CDC suffers from the problem that most of the time nobody cares about them. So they find "important" things to do and that is not going to change whatever marching orders they are given. Yeah maybe next time we look the WHO in the eye and say "Show me the data", but most of the CDC stuff is hard to prove is "wrong" and harder still to "fix". I mean we had a massive Charlie Foxtrot with Ebola and nobody cared because there were not a bunch of dead bodies in the news.

I guess you've proven that Trump has not been a good manager and was unable to correct the deficiencies you identified in the last three years.

Congressional oversight. Public testimony. GAO audits. External review.

Which of those did not formally occur with Ebola?

"As far as cleaning up the place. How?"

Congress. This business about civil service protections is an excuse. After 9/11, an entire federal agency -- INS -- was abolished and replaced with three new agencies. Congress can move mountains if it is filled with half-competent people who care about serving the public.

"Congress can move mountains if it is filled with half-competent people who care about serving the public."

Republicans will push for reform at the CDC, the Democrats will line up to protect it. We've lost social trust and so, CDC incompetence will most likely not be rectified.

After 9/11, the most consequential and emotive disaster of a generation, Congress managed to redo the org chart about a year and half after INS had screwed up.

It did not change many problematic INS behaviors. It did not replace incompetent people or reign in empire builders (thanks to the political machinations of the era, it actually helped multiple hacks expand their remit). If you idea of "mountain moving" is just shuffling the org chart, the CDC is utterly doomed.

But even if we granted that some dog and pony show about who reports to whom actually mattered. Do consider what you are saying. The only time we could get reform of a system, known to be broken since at least the 80s with regards to immigration enforcement. Was after the most media heavy event in history. If that is the impetus, nobody can hope to reform a place like the CDC in under a generation absent such.

I mean seriously, all the CDC talking points today are about how Trump cut funding and reshuffled the org chart inline with recommendations from the Obama administration. And most all of those are specifically to decry Trump. When you have an agency outgrowing inflation on its budget and failing at its core job, there should be a strong bipartisan plan for reform. Instead we get theatrics for November.

If changing government policy was easy, Gitmo would be closed. The Department of Education would be remanded to the states, and FEMA would have been remade any of a half-dozen times in the last few decades.

Whenever I have seen radical change in a large organization, be it a military unit, a large corporation, or a large health system it has invariably involved lots of people being reassigned, more quitting because they cannot stomach the changes demanded of them, and wholesale changes in SOP. None of those are remotely possible for federal bureaucracies.

Delivering services is not "regulation".

That the CDC is tasked with delivering services is either because service delivering parts of government have been cut or eliminated, eg, public health, not just in the Federal government but also in State and local government, and then the CDC told to fix the problem caused by cutting services.

Additionally, businesses are told to cut costs and focus on profits instead of focusing on, for example healthy workers who are healthy consumers, so businesses no longer attempt to keep people healthy. But when unhealthy customers can't buy enough or unhealthy workers can't produce enough, businesses demand government fix their problems of too little revenue and declining profits. Legislators then tells agencies like the CDC to fix the problems causing businesses to be unprofitable.

It's always "get government out of the way of monopoly profits" followed by "government must fix the problem of falling profits" caused by businesses harming the economy by harming workers and consumers.

The myth is government caused health care be delivered by employee benefits, when instead, businesses needed healthy workers and government was too busy with war, then education and housing returning vets, that government wouldn't provide all the healthy workers businesses need.

If government shouldn't provide healthy workers and customers to cruise companies, then Disney should be monitoring nature for emerging deadly and not deadly airborne disease, developing vaccines and effective treatments, or at a minimum instant tests, so it can sell lots of product to customers at high profits. Its Disney's failure to prevent many diseases, whether food borne, airborne, or otherwise, diseases that interrupt crowded cruises, or days at crowded resorts or big crowds at big shows.

Except businesses today demand the free lunch of government provide healthy workers and customers at no cost to businesses like Disney so disney has really high monopoly profits.

The monopoly profits require jack boot regulation like the Mickey Mouse Protection Act to incentivize Walt Disney to keep creating from his grave.

Note, eliminating big government regulations that block people from competing with corporations paying former elected officials to lobby are seldom demanded by people like the Trump administration who rails endlessly about government regulations even as he seeks to exert global regulation on producing vaccines and drugs to protect corporate monopoly profits.

Especially jack boot patent regulation on drugs and vaccines developed by CDC, BARDA, NIH funded workers. Public costs, private profits.

Wow, with respect you had me at 'Public costs, private profits'.
Where have we heard that before - yet when will it change.....

Not mentioned in the NYT piece is that this problem wouldn't exist except for the business lobby that continues to encourage unlimited exchange of both people and goods from a primary geopolitical rival.

most of these regulatory failure posts are little better than cherry picked click bait.
trolls

they really would work better as tweets

This is old news: cable was showing the airport queues in February/March.

IDK what the point of calling out all these government failures is. I think anyone reading this blog knows the government is either unintentionally incompetent or intentionally incompetent depending on how bad corruption and regulatory capture is. It isn't like a marginal change in response would have made a difference. There would have to be a revolution in government administration to have made a major difference in outcome.

We literally would have been better off if we never had a CDC.

We would like Brazil instead.

Exactly. Brazil has had way fewer COVID-19-related deaths and was able tomstockpile enough chloroquine to last years.

do academics have eyeworms?
free eye test no6
can you see the line where rosenstein said the fisa warrants were flawed&dodgy?

But Trump cut funding to the CDC! That explains any and all institutional failures.

This article focuses on bureaucratic myopia and inefficiencies, which have been made worse by crisis and incompetent political leaders.

This is not a "regulatory" story. It's a bureaucratic politics story. And yes, there's a big difference between the two.

Public heath is a joke.

https://slate.com/technology/2020/06/protests-coronavirus-pandemic-public-health-racism.html

Australia's political response to the Coronavirus was incompetent. To see that it's only necessary to look at the long delay in putting public health measures in place and the Ruby Princess cruise ship debacle that led to 10% of Australian infections.

So why did Australia do so well with the virus when our political response was so bad? Probably due to the lack of executive power and the presence of a public health system that was able to oppose federal politicians and force them to take effective steps to limit viral spread. In the US this didn't seem to be a thing. At the time Australian doctors were forcing the government's hand I was reading about US doctors being suspended for upsetting people by wearing masks in public. That's why the US looked like a madhouse to me.

And the scientific response in Sweden led to many deaths as well. We can take our pick.

Scientific response? Not unless you are saying Sweden volunteered to be the control group.

Look it up.

I'm afraid the only way I can use the internet to find out what you mean by "scientific response" is to ask you.

If you wanted to say Australia's approach was "evidence based" I'd say -- yeah, more or less. But there was no time to work out a scientific response and it certainly wouldn't be ethical to attempt a robustly designed one. Also, there would also be various criminal charges that could be laid.

Indeed, Crikey - look it up. The Swedish approach was decided more or less completely by public health civil servants.

Yes, they gave sensible advice. But it wasn't followed enough.

And you wonder why, maybe since we have IYI politicians like these directing technocrat policy:

"Let's be clear about something: if there is a spike in coronavirus cases in the next two weeks, don't blame the protesters.

Blame racism."

-Mark Levine Chair of New York City Council health committee, Council member for the 7th District of the New York City Council

I guess white supremacy was the real virus all along!

I spent many years in different federal bureaucracies. What is missing from the NYT article is what happens when bureaucracies take on missions that are not related to the core mission. Even a good leadership team has trouble managing the ever-widening nest of hungry mouths, all competing for attention, resources, awards, etc.

Mission creep, especially mission overlap, chews up a lot of management energy and tends to distract from what is really important.

As others noted, I wouldn't describe this as a failure of "regulation." It is more of a failure to execute and is reminiscent of some of the failures uncovered in the law enforcement and security apparatus after 9/11.

For instance, anyone who has traveled within East Asia knows it is common practice to set up quarantine checkpoints in airports when there is even a hint of a pandemic. You have to fill out a separate health declaration form and give your contact details so that health authorities can contact you in case they find out someone on your plane was infected. And, as someone pointed out above, even without health declaration forms, basic cooperation and information sharing across agencies should have given CDC (and state health departments) access to all of the information DHS has on who arrived and when and what address they provided to U.S. Customs.

This is filled with facts about the failure, but almost no explanation of the why's. Maybe the authors have "a first-rate understanding of bureaucracy" but they do not communicate that understanding to readers. How did "bureaucracy" lead to the Epi-X system not working?

"The agency’s routine in past emergencies was to hold press briefings almost daily; Dr. Thomas Frieden, Dr. Redfield’s predecessor, was highly visible during the Ebola and Zika crises. But in this case, medical workers and the public were left to make sense of often-opaque postings on the C.D.C.’s website after ​its leadership stopped holding regular briefings on March 9." How did "bureaucracy" lead to the poor communications and then suspension of briefings altogether? Did anyone ever ask CDC why they suspended, why Epi-X did not work or CDC's explanation any one of a multitude of other apparent failures?

As a secondary matter, the authors might have prioritized the failures they document. Why bring up ventilators in an article published in June, when it turns out that ventilators were never a problem?

And what is the relevance of repeating the President's mis-statements if they are linked to any specific policy failures.

The article is good. Two things points that are hardly unique to the "regulatory state":

- Poor communication and coordination - CDC says one thing on their website and the White House is drafting something that says something different. This speaks to mediocre management and is something most people who have worked in the real world have experienced.
- Outdated processes for gathering and consolidating data. This has as much to do with an inappropriate level of federalism in public health as it does with bureaucracy, though. The federal government needs to standardize and enforce a single platform for all state and local health authorities, much in the same way that law enforcement agencies share information on people who are arrested or in custody.

Federalism has frequently been cited as a weak link in the U.S.'s pandemic preparedness and it is the President and Congress who need to address this.

Overall those are good points, but they fail to address two specific issues:

1) The CDC insisted on creating their own test and botched the process badly.

2) The CDC/FDA actively suppressed state and university attempts to create and run their own testing.

As you pointed out above, Congress should restructure the CDC and FDA to provide a long term fix for these obvious competency issues. However, I believe are system has become too confrontational. Hopefully, I'm wrong.

Monopoly institutions evolve into self-interest groups who only follow the prime directive of institutions "survival and growth". Their official objectives and purpose become irrelevant as their incompetence increases over time. Only a real threat of bankruptcy keeps the same evolutionary forces in check in competitive market situations.

Some personal experience as someone who travelled to Canada from China, via Thailand, in early April.
When I arrived in Canada a terminal asked me if I'd been in Wuhan in the past two weeks (I hadn't). I said pressed no.
No other questions about travel history were asked.
A week later I returned to China, a few days before the country was closed to international travel.
Everyone was interviewed at the airport about travel history, and passports examined. I was then taken to be given a coronavirus test. When that came back negative (after four hours, during which I time we were given rooms in a hotel), I was allowed to do 2 weeks of at home quarantine in my apartment.

Seems like a pretty different response.

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