In Case You Missed It, It Isn’t 2009: Pandemics Then and Now
Fear is a stinky cologne, blame is a lazy man’s wages, and both put together inside a health crisis and mixed with politics is just reality in the Year of Our Lord 2020 in America as the coronavirus unfolds.
Media and social media is spending a good chunk of their time on comparing and contrasting the current COVID-19/coronavirus to the H1N1/swine flu pandemic of 2009-2010. Supporters of the president are quoting the statistics from that outbreak — 60.8 million cases (range: 43.3-89.3 million), 274,304 hospitalizations (range: 195,086-402,719), and 12,469 deaths (range: 8868-18,306) in the United States — as a stark contrast to the current numbers for coronavirus. Others are pointing out that those are final numbers whereas we are currently in the early stages of the just declared COVID-19 pandemic. The right is decrying that then-President Obama didn’t get blame for the crisis because “the media” shielded him from such unpleasantness, the left is decrying that piece of groupthink whataboutism as a deflection from the current President Trump’s performance thus far. The more extreme voices insist this is all a plot to make the president look bad, while others are fearful of an out-of-control pandemic with poor leadership to blunt it.
The only thing everyone agrees on is that this current crisis proves out all their priors about everything. Just kidding, there isn’t even agreement over that.
The numbers of H1N1/Swine Flu from 2009-2010 are a stark contrast considering in America we don’t know how this is going to go yet, and are just now starting to really test. Also, there are all sorts of differences between the two, such as who it affects (H1N1 was worse for youth, COVID-19 is worse for elderly), how it spreads, where it originated, and a dozen other things. Yes, President Obama presided over the country when all those illnesses and deaths occurred. Sure the media treated him differently than they do President Trump, for myriad reasons too long to detail here. No, we don’t know what course this outbreak will take, nor the toll it will extract, or for how long. Anyone claiming different is selling you something and should be avoided. We are not even entirely sure about the medical aspects of this illness yet, though we will know in time. Nobody knows, because we have never done this before, even though there are lessons to be learned and some parallels from other events. Things that are different are not the same.
But the president being different, and the media acting different, and the reaction to this current pandemic compared to the last one, aren’t the primary variables in the current situation.
We are. Us, the American people.
The American culture and society as a whole has changed tremendously in the 10 plus years since President Obama publicly got his flu shot and embarked on his own strategies to quell health concerns to various results. Even using the nebulous “the media” isn’t the same because of the changes not just in consumption and coverage, but in how media is geared toward the audience. By the time President Obama took the needle in December to assure the country, the crisis was already past its second wave. The vaccine developed for H1N1 only became available in November of that year, too late for most of the 60 million cases in the United States from April, 2009 to April, 2010.
Many using H1N1 in 2009 are quick on social media to point out folks don’t remember widespread panic or mass closings, and the current cancelling of all sorts of things is going to surpass 2009, but that’s also somewhat the product of not correctly remembering, or distorting, or at least not Googling before you hit send. More than 700 schools saw closures from various H1N1 protocols, cruise ships were quarantined, commerce interrupted, and other things changed to adapt to the pandemic. While it is now apparent disruptions to everyday life are going to be more widespread this time, it just isn’t true there was no impact last time.
But there were other changes profoundly affecting the difference in how this current pandemic is playing out than in 2009.
2009 was a different world from 2020, especially social media wise. When 2009 started, Facebook and Myspace were neck and neck in users. Twitter was coming off a 2008 in which tech folks were laughing at it for constant server failures that would follow the platform into 2009. YouTube was a little over a year into its experiment with overlaid video ads, an attempt to answer questions as to how the media platform based on uploaded content would ever make any money. By the time the White House nurse inoculated the president for the benefit of the cameras at the end of the year, Facebook had gone from 59 million users to 350 million and was well on the way to social media dominance. Twitter found footing by fixing the server issues, introducing the built-in re-tweet, and by the end of the year had become the bridge between celebrity and common folks, news consumers and newsmakers. YouTube carved a place in the interwebs and exploded in content, passing 100 million views for the first time in March of 2009, and in April of that year the Vevo service debuted. Also in April, a kid named Justin Bieber was introduced to the platform for the first time. You might laugh at that, but 820 million views of his “Baby” song was an example of the impact of such media on YouTube and how it is now used as a platform to launch folks from home computer to international stardom.
Today, in 2020, 73% of US Adults use YouTube, 69% use Facebook, and Twitter is the bedrock of both news breaking, news making, and news consuming from the President down to the Twitter rando, far more than even just ten years ago. How we get information, consume it, and share it with each other has changed dramatically. For comparison, less than 50% of people now get their news primarily from television, and that number is falling. Network news is more sensitive to social media now than the other way around. We can all joke about “Twitter ain’t real life” and “it’s just a post on Facebook” but the fact of the matter is those things influence greatly. Most people get their initial information of events from friends and family, mostly through social media, and then seek out traditional news outlets for more information, not the other way around. There isn’t a run on toilet paper because of an expose on CNN, but because folks see other folks doing it through social media postings and adjust, or in this case overreact, accordingly. Social media means we are not just watching the story, but can be part of it, and no one wants to be left out. Coronavirus and the societal reactions to it will be a shared, ongoing event, horrible as it is for those directly suffering.
Before we just blame the usual suspects of politicians and media and conspiracy theories for the heightened fear and loathing over coronavirus, maybe we need to consider ourselves.
In the last decade social media went from hot new trend to inculcated methodology of living our lives. Coronavirus 2020 is going to be a shared experience, despite quarantines self-imposed and otherwise, because that is how many folks do everything now. Sewing circles, social clubs, and the telephone have been supplanted as the primary conduit for gossip by Facebook. TV shows are not just watched, they are discussed online, live tweeted, and reax’d over and over after they are done. Major events like the Super Bowl, presidential elections, and holidays are not just celebrated, but choreographed to put forth the best possible face on folks’ social media profiles.
So when breaking, worldwide events occur, all that learned and repetitive behavior is the dominant trait whether we think of it or not. That seeking out news sourcing AFTER hearing about things through the social media gossip tree means folks bring their first impression biases to even breaking news. Since social media is mostly curated to taste, those initial biases are going to be heavily weighed to the individual’s priors. Add in the interconnected cliques of like-minded folks, and you have groups of people cocooned from outside information in short order.
No wonder you get folks who spend every waking minute on presidential politics immediately filtering a health scare through the ongoing election. Not that those heavily invested in those elections mind that. While there are malicious bad faith actors that intentionally stoke such things, there are wide swaths of people who aren’t actually trying to do damage, but have fed themselves a steady diet of only what they want to hear for years on end and couldn’t tell the difference between drinking water and drinking sand in their information desert if they wanted to.
Technology has made it to where we have the entire depth and breadth of human knowledge in the palm of our hands with a simple search engine query. We live in a time where we can speak knowledge into existence by simply asking Siri, Alexa, or Google to tell it to us. Social media can be a profoundly useful and powerful tool in spreading information, connecting people, and jointly sharing a world otherwise divided. It’s also filled with flawed human beings with their true selves cranked to 11 with the false courage of keyboard immunity.
Social media can be good medicine for those needing to expand their world. It can also be the spoon on which troubled folks heat up all the hate, misery, and wickedness that can be found online before shooting it into their veins as a daily dose of addictive self loathing about how awful the world is. The latter is a self-fulfilling prophecy. The former can save the world, or at least make you a friend or two online.
We as a people are not the same as 2009, and not just because of who is president, or how the media covers things, or how things work out in the wider world. We have more tools and information now than we had then to decide whether we are going to be greater than or less than in our response to this current challenge of outbreak.
Rising above and overcoming can not be found at the store, among the empty aisles of hand sanitizer and toilet paper. But it could be found online, among our social media friends, if we put our minds to it. It’s up to us. No one else to blame if we don’t. The president, the media, the CDC, nor anyone else controls what you do now for your friends, family, neighbors, and social circles both online and in real life.
Remember, crises like viruses come and go, but the internet is forever. Be mindful what we do with it, since it will all be online for folks to look back on and judge.
Speaking of YouTube (and covid-19), I want as many people to see this as can:
https://www.youtube.com/watch?v=Ey08XMOisiwReport
Also, 2009 wasn’t an election year.
Oh, and the president wasn’t a complete piece of shit.Report
“…in America we don’t know how this is going to go yet, and are just now starting to really test.”
I have a question for everyone. What do you predict will happen over the year?
Here are some specific questions.
1) Will total flu (all strains) deaths in the US go up or down or stay about the same from the pace of prior years? (Measuring from March to December of 2020 vs the last three year average)
2) What will the impact be on the US economy in terms of GDP?
3) What will the impact be on finance in terms of year end stock market? (Let’s say S&P500 and NASDAQ compared to End of Feb)Report
Olga Khazan over at The Atlantic has a brief summary of why America is lagging behind the world in testing:
https://www.theatlantic.com/health/archive/2020/03/why-coronavirus-testing-us-so-delayed/607954/
In short, Trump is not responsible for all of this; Some of it is the lack of cooperation from China in giving out specimens of the virus for analysis, some is lack of equipment, some of it is bureaucratic inertia, and yes, some of it is the national leadership.
But what seems glaringly obvious is that even something as vague as “bureaucratic inertia” isn’t like some artifact of nature, eternal and unchangeable.
Even the most massive bureaucracy like the Pentagon is nothing more than individuals, each of whom is empowered to make decisions.
There isn’t a regulation or rule or protocol that can’t be overruled by someone somewhere, if they so choose.
There isn’t some iron law that says that large organizations are incapable of speed and effectiveness. We see governments around the world reacting faster than ours, with more effectiveness than ours, with more transparency and success than ours.Report
The large countries are China, India, Russia, and the EU as a whole.
None of them are models of speed, effectivenes, transparency, and success.Report
I was thinking of South Korea and Singapore, where their centralized bureaucracy is currently outperforming ours.
There, you can get tested for free, get the results in 10 minutes, and they are performing something like 10,000 tests per day.
Our bureaucracy is performing poorly because the American citizenry has chosen to allow it.Report
Heck, the American citizenry has chosen to *ENABLE* it.Report
Singapore is a city by our standards.
South Korea is a mono-cultural state.
Size matters, both in land and population. Diversity matters. The cultural war matters. Race relations and the history there of matters.
If you want a totally efficient government, then take off the table the idea that one part of the country will use the gov to cram it’s views on how life should be onto another part of the country.
There is no consensus in the US on what the gov should be doing, what level those services should be provided at, and there probably CAN’T be considering we have too many groups.Report
As I said, we Americans have freely chosen to be this way.
There isn’t any structural or systemic force that compels us to have a crippled public health administration.
We have plenty of wealth, plenty of expertise.
It was the American public health bureaucracy that stopped polio in its tracks and helped eradicate smallpox around the world.
It was our expertise that was the envy of the world for decades, as American medical experts fanned out across the globe to help impoverished nations become healthier and safer.
Here is a good article discussing how Korea’s public health administration was crippled by religious cults and cynical political actors:
https://thediplomat.com/2020/03/clandestine-cults-and-cynical-politics-how-south-korea-became-the-new-coronavirus-epicenter/
“Members of the group were told to refrain from wearing face masks as their belief in Lee and God would shield them from the virus, in some cases they were told to endure disease and attend church services. ”
…
While cults can be attributed to the spread of COVID-19, the cynical tactics of conservative politicians can be blamed for stifling the government’s containment policies. Still recovering from the dramatic downfall of their leader, Park Geun-hye, conservatives have desperately waited for an opportunity to exploit a breach in the liberal government’s armor. Conservative politicians have been relentless in criticizing Moon for not imposing a blanket travel-ban on Chinese visitors, a decision which would have had devastating impacts for a country so reliant on Chinese commerce.
Conservative populists also ignored government warnings against large scale congregations and continued to hold rallies in Seoul. The conservative firebrand, Jun Kwang-hun, falsely mislead his followers – most of which are elderly and susceptible to infection — that the coronavirus outbreak was impossible to contract outdoors. “
Does any of this sound familiar?
There is nothing forcing Fox News from spreading misinformation and ignorance; Nothing that compels evangelicals from indulging people like Jim Bakker from peddling quack medicine.
The Trump administration disbanded the epidemiology team on its own volition.
These are choices freely made. These choices weren’t forced upon us by diversity or heterodox culture or city planning or plastic bag bans or millennials eating avocado toast.Report
So roughly half the country is going to get this virus because of Trump.
But if a Dem were in the White House, and hadn’t cut that team, then roughly half the country would get the virus in spite of his efforts.
We have had 20k people die from the flu so far this year. Without this virus we could easily have another 30k die from the flu and it wouldn’t even be news. Instead a lot of those 30k people will die from this instead.
We are in the middle of serious scaremongering by the media because that’s what they do.Report
I guess the conservatives haven’t figured out which party line to cling to:
That its no big deal, blown out of proportion, or its a big deal but the fault of Obama- Ebola-Open Borders.
Meanwhile, the adults in the room are concerned:
https://www.usatoday.com/in-depth/news/investigations/2020/03/13/us-hospitals-overwhlemed-coronavirus-cases-result-in-too-few-beds/5002942002/
“Unless we are able to implement dramatic isolation measures like some places in China, we’ll be presented with overwhelming numbers of coronavirus patients – two to 10 times as we see at peak influenza times,” said Dr. James Lawler, who researches emerging diseases at the University of Nebraska Medical Center and the Global Center for Health Security.
Lawler added that “no hospital has current capacity to absorb that” without taking crisis care measures, such as postponing elective procedures and reserving finite resources for those coronavirus patients most likely to recover.”Report
We lost 650k people to heart disease last year. The big counter for that is excerise, the big way to get lots of bad things is a lack of excerise.
We’re telling everyone to hide at home. We’re closing health clubs. If the number of people we “save” comes at the cost of a tiny increase in sedentaries’ various diseases and side effects, then we’ll be a net loser.
And that is ignoring the economic damage we’re inflicting here. People are losing their work because of this panic. That translates into less money and less healthcare (and less everything else we consider “good”).
Ignoring that this is coming from a fearmongering news source trying to sell eyeballs, yes… and?
Clearly in other situations we’d have unlimited resources for healthcare? Or is it that the extremely sick 70+ year olds who are at most risk for dying would be in the peak of health with out this situation? Or is it that what is happening is simply cost free?
These evaluations don’t even attempt to make anything like a cost benefit evaluation.Report
You realize you aren’t arguing with me, but almost all significant experts in public health and epidemiology in the world?
Why retreat into auto-didactics and barstool expertise instead of accepting the authority of people who actually study and know things?Report
Thinking is hard. It’s so much easier to rely on the expertise of Chinese Communist Party officials, who are in their important positions because they know vastly more than ordinary workers.Report
Go to an expert surgeon and you discover you need surgery. Go to an expert plumber and you discover you need to hire a plumber. Go to an expert in epidemiology and we discover how to shut down the disease.
Is shutting down all public events and the rest of the various prices we’re being asked to pay worth it?
I see nothing that even attempts to address that.Report
“… occurs because is a monoculture” is just another way of saying “We can’t do… because we’re racist”
Which is probably true…Report
Picture the EU trying to decide on ONE social net and set of social spending for the entire area.
Simplying the resulting problems to “racism” is a way avoid dealing with talking about the problems and isn’t useful.Report
“Diversity matters. The cultural war matters. Race relations and the history there of matters.”
“Simplying the resulting problems to “racism” is a way avoid dealing with talking about the problems and isn’t useful.”
I’m really struggling to grasp the argument here.
I mean, I can’t even paraphrase it so as to snark on it.
We are talking about having an effective national response to a viral pandemic threat, and you’re saying that somehow racial diversity is preventing this?Report
If you want to showcase what an effective national gov looks like, then you need to point to something other than a gov the size of a city governing a mono-culture and claim we could totally do what they do.Report
The government of the United States circa 1960 comes to mind.Report
Back then the states were allowed to come up with their own solutions for various issues and the federal gov did FAR less. Federal spending as a percentage of the GDP was something like 11-12%, the bulk of that military.
I suppose there’s an argument that various groups threw sand in the gears after they learned that one-size-all solutions could be crammed down on them, but I don’t understand where you’re trying to go with this.Report
The federal government, by itself and in coordination with state governments, eradicated polio, built the interstate highway system and the space program.
I mean, it was effective, really effective at doing these things. We debate today which of these things were better or worse, but no one stood around back then whining “We can’t do it!”
Its bizarre, almost Soviet, this constant excuse-making for failure to do things which other governments manage to do easily.Report
Yes, we’ve constructed a Soviet style bureaucracy and done a lot of empire building with the Federal government.
And yes, we get Soviet style problems with that.
And yes, if we got the gov out of the business of building these huge bureaucracies the rest of the gov would be a lot more efficient and able to focus.
The Conservative answer to this is to shrink the government. The Progressive answer to this is… what? I have never observed the party of government even attempt to make it work better.
The only politician we’ve had who has done more than lip service to making the gov more efficient is Trump.Report
You’re just reciting a catechism of faith.
There isn’t an example of your proposal anywhere in history or the present.
In every successful campaign of public health, whether combating cholera, typhus, polio or influenza, the machinery of centralized government control was used.Report
We argued, a million years ago, whether the FDA was too restrictive.
It’s weird how every single discussion about how we need to have a more European health care system doesn’t think that the FDA needs to be more like the European equivalent.
The FDA is too restrictive.Report
Seriously, this is insane. I read this tweet and I do *NOT* say “Good move, FDA!”, I ask “Why in the hell did the FDA not allow this before?”
Report
The article I linked by Olga Khazan talked about this at length, that red tape (American red tape) was one of the factors preventing us from effectively testing more people.
If the argument here is that we need a more effective FDA, then I wholeheartedly support that.Report
“More effective”.
Seems to me that the problem is that it’s too goddamn effective already.
It needs to be less effective.Report
Of course, it depends what you mean by “effective.” If effectiveness is evaluating drugs and tests in a timely and accurate manner, then yes, I would very much like a more effective FDA.
However, there’s always going to be a trade-off between type A and type B errors. If effectiveness is defined as minimizing at all costs the number of applications that the FDA erroneously approves, no matter how many lives are lost due to delayed or erroneously rejected applications, then it’s too effective.
But I don’t think the latter is a very good definition of effectiveness.Report
I’m arguing that a smaller, more focused, less micromanagey gov would be more efficient. That a gov that attempts to be everything to everyone results in armies of paper shufflers who don’t add value.
You’ve taken that argument and are claiming I’m arguing against any gov at all.
Claiming you’re in favor of a more efficient gov is a no brainer, but how do you suggest we do that if you’re not in favor of making it smaller, more focused and so forth?Report
“Smaller, more focused less micromanagey” government is a bromide.
It can’t be falsified- (are there people arguing that government should be larger, less focused, and more micromanagey?)
And what metrics would we use to determine such a goal?
Like, should we split America up into oh, lets say, 50 different regions called “states”, each with their own government, and then split them up into hundreds more regions, called “counties”, then further divide them into “cities”?
I’m snarking, but even the most massive federal bureaucracy, from the Dept. of Defense to the FDA to the Customs and Border Patrol is divided up into regions and sub regions and individual agencies and departments which are capable of acting independently. They can be as nimble and responsive and focused as the department chooses to let them be.
Are they all acting perfectly? Of course not!
Could any of all of them stand reform and adjustment to their performance? Absolutely!
But a sweeping statement that they need to be “smaller” is nonsensical.
And see, there is actually a field of study called “Public Administration” and entire schools of government study which look at this very subject in far more detail than you and I.
But the same voodoo skepticism of expertise that tells us that the most ignorant person on twitter is equal to the most experienced physician at the CDC, tells us that government should be run by amateurs and show business performers.Report
Perhaps it can’t be falsified, but if people were arguing that the FDA was too restrictive years ago and did stuff like pointing out that Europe had 8 epipens to the US’s one or pointed out that Peru is, somehow, able to make affordable insulin despite being Peru, it might be worth looking at whether the whole “too restrictive” thing might, in fact, be keeping the US from having multiple epipens or affordable insulin available.
The alternative is a weaponized skepticism that says “I don’t know if the FDA is too restrictive AND YOU DON’T EITHER!”Report
Yes, and we can point out that South Korea is somehow able to test 15,000 people per day while America somehow is not.
Is the alternative a weaponized ideology that says the FDA shouldn’t exist?
Of course not.
Maybe the response should be a desire for a public health agency with sufficient power and scope to protect our health, which is also effective at measurable metrics?
We didn’t respond to the loss in Vietnam by deciding to abolish the military; Instead the American military and political establishments, to their credit did a lot of analysis and came up with better metrics for the use of force.
But those reforms were, themselves, measurable in whether they were effective.
And subsequently were reformed again after 9-11 in ways which are still debated.
One of the things that often gets overlooked in discussing bureaucracies is that their cumbersome red tape and rules are just words on paper, which can be waived with a stroke of a pen or a phone call, if those in power choose to do so.
We see a lot of discussion over at LGM about how the structure of the Constitution hobbles democratic action by empowering Mitch McConnell to blockade the will of the people.
Which may be true but it also overlooks how Mitch is not acting alone; He has the full support of 53 Senators, who in turn have the full support of 40% of Americans;
With a simple choice on the part of 3 Senators, the government could behave very differently.
Turning every question into a theological argument over the structure and organization of government makes the individual actors into mere passive instruments without agency.
This is why I keep coming back to the American people and our choices. The FDA could be as nimble and effective as we want it to be, provided we made it a priority.Report
“Yes, and we can point out that South Korea is somehow able to test 15,000 people per day while America somehow is not.”
Yeah, we pointed out how the FDA forbade independent labs from coming up with their own tests.
“One of the things that often gets overlooked in discussing bureaucracies is that their cumbersome red tape and rules are just words on paper, which can be waived with a stroke of a pen or a phone call, if those in power choose to do so.”
I don’t understand why this is considered so much more reasonable than that red tape not being there. Like, to the point where it’s not even questioned.
“The FDA could be as nimble and effective as we want it to be, provided we made it a priority.”
Remember when you and I discussed epipens?Report
The FDA could be as nimble and effective as we want it to be, provided we made it a priority.
George and Dark come at this from a different angle than I do, but what you wrote up there is naive to the point of being willfully ignorant. Institutions are comprised of people (as you say) but *even moreso* they are determined (read: constrained) by a type of decision-making which both reinforces the continued viability of the institution while (hopefully) achieving that institutions putative goals. One thing more or less precluded a priori (hah!) from institutional decision-making is that its agents – ie., people playing the role of representing and promoting the institution – will willingly reduce that institutions scope or power, since doing so, given the institutions internal logic, constitutes reducing the likelihood of achieving the institutions (putative) goals. ERGO!, there is no “we can do whatever we want with the FDA” precisely because the FDA is an (existing) institution with a mission and (putative) goals which individuals achieve by playing a specific role within it. That’s a lot of (institutional) inertia to overcome before anyone can meaninglfully say “we can do whatever we want” with it.
There’s a great book on this, written in the 50s I think. I’ll see if I can track it down.Report
{{I looked for the book, couldn’t find it – but I will eventually! – but really no one would read it anyway… 🙂 }}Report
Right, but almost every agency has emergency protocols allowing the suspension of rules and order.
Especially agencies like the military, National Guard, first responders, and public health agencies.
Its almost like these agencies have thought about things like pandemics and hurricanes and earthquakes, and made plans ahead of time for how to react to them!
These triggers- Declarations of public health emergency, declarations of national emergency, decisions to allow or not allow this or that testing protocol; These are willful acts by executives of the various agencies.Report
That doesn’t address anything I wrote. In fact, it appears to concede everything I wrote by doing a “yeah but”.Report
“We’ll just take our chances”
“Oh, you WILL take your chances, Lafleur!”
“That’s what I just said.”
“And that’s what I’m saying to you!”
“I don’t know where you’re going with this.”
*pause*
“TOUCHE!”Report
Pretty simple, really. You said “The FDA could be as nimble and effective as we want it to be, provided we made it a priority”, and I said no, it couldn’t. Then you said yeahbut.Report
We have yet to figure out how to deal with the agent problem.
Get an expert, put him in charge, and somehow what is needed to be done magically matches up with what is good for the expert and his field.
We can see this most clearly with how the messages from the God of Good match up with what is good for the Priests.
Change the God to “Public Health” and while the reality of the source changes, the agency problem does not.
You mean other than you?
Right this minute we’re dealing with a public health emergency and the “experts” who run the FDA have managed to prevent the existence of tests to tell us who is sick. Them serving as gate keepers and power seeking was more important than the overall public good.
I’ve pointed out that maybe they shouldn’t be uber gate keepers, you’ve equivilated that to getting rid of the government all together.Report
If I said, “The government should be made larger” a natural question for you to ask is:
“Larger in what way, Chip? Which agencies should be made larger? All of them? One in particular?” What sort of goals would we be trying to do with making them larger?”
Those are all perfectly reasonable questions.
Which should be asked when someone says “The government should be made smaller”.
Maybe there are plenty of rules within the FDA which need to be temporarily overridden; Or maybe abolished altogether. Or maybe revised with more exceptions, or with different stakeholders.
Those are perfectly reasonable suggestions.
In one sense its unfair of me to demand you come up with a point by point analysis of how the FDA functions and a bullet pointed list of how it should be improved.
But its unfair for precisely the reason that you and I are laypeople, unable to really speak with expertise on how public health agencies should be designed.
There are in fact experts on public health, who have written articles and offered public commentary.
People like Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, who is advising Americans on how to cope with the pandemic;
Or the former director of the CDC who is calling for an investigation into what went wrong:
https://news.yahoo.com/former-director-cdc-calling-investigation-231900018.html
So yeah, maybe after listening to people who know what they are talking about, we as citizens will change the scope and structure of the FDA and CDC to be more effective in the next pandemic.Report
Other than FDR thinking he had polio and founding a charity to fight it, what did the government have to do with its eradication? Salk didn’t work for the government, he worked for a private charity which raised money from the public, kind of like a “Go Fund Me.” Once the vaccine was ready, testing was run by millions of volunteers.
Of course the government did build the space program – by by relying on Nazi scientists, but that was a side effect of developing faster and surer ways to vaporize Soviet cities.Report
He’s wanting a repeat of the Hong Kong flu pandemic of 1968? I had that, by the way.
Interestingly, our widespread flu vaccination programs are quite recent, and oddly enough don’t seem to affect the death rate, which is the same it was back in the 50’s and 60’s, per capita.
The flu fatality rate has dropped significantly from the rate prior to the 1940’s, and it’s thought that perhaps better overall personal health and better care for severe cases might be the reason for that.Report
https://lh3.googleusercontent.com/proxy/0ZZ_xNpSrzqPW4YoQk2N1x1CgeVMgr6aVM41ouuo7Hto5vVMq-9UIRg-qYs6Gb5Si_Paj9xmRdtsGFQcabI_QIZjvCj-J-Sy1UsReport
That’s a graph of the flu’s mortality rate over the years.Report
There isn’t some iron law that says that large organizations are incapable of speed and effectiveness.
Actually, there is. The Iron Law of Institutions:
The Iron Law of Institutions is: the people who control institutions care first and foremost about their power within the institution rather than the power of the institution itself. Thus, they would rather the institution “fail” while they remain in power within the institution than for the institution to “succeed” if that requires them to lose power within the institution.Report
I used the term deliberately with that in mind.
The Iron Law is a really really terrific excuse for failure by almost any institution in any event.
Because really, it wasn’t that the wrong people were in power; Because no matter who was in power hey, its the structure that prevents good results!
Child abuse in the Church or Boy Scouts?
Well, see the Iron Law states that these institutions are large and the people in them only care about their own power, so really, there isn’t anything that can be done, outside of disbanding the institution.
A military failure? A losing football season? A poor product launch? Iron Law, baby!
The Law isn’t wrong. It’s very correct.
But its like Econ 101 or the law of gravity; Its one descriptor of a very complicated field.
You know that leadership is a very extensively studied field, right? That since the time of Alexander, military organizations have grappled with how to be both large and nimble, how to have centralized decisionmaking, and yet local autonomy.
How to have a top down command structure which is also flexible and open enough to allow transmission of new ideas and dissent.
The failure at the FDA isn’t novel or sui generis; Its a common occurrence and is treatable with better leadership and a citizenry that demands better.Report
The Iron Law is a really really terrific excuse for failure by almost any institution in any event.
It’s not an excuse for anything. It’s a description of human behavior within an institutional structure, and either true or false.
The Law isn’t wrong. It’s very correct.
Then why are you arguing that it isn’t?Report
If you need perfect people to run your organization, then that’s a problem that should be faced right on.
For Child Abuse, we’ve seen this story often enough that the solution CAN NOT be to replace one guy who used to wear a halo with someone else who currently does and expect different results.
The institutional solution is to hand out 9 and 10 digit fines until leadership understands that “successful leadership” includes dealing with this issue and not ignoring it.
As far as the FDA is concerned, the epi pen and various other issues happened on Obama’s watch, this test was on Trump’s.
Maybe “reform” should include giving the FDA less power and less authority and not think Trump can find a perfect person to run it while Obama couldn’t?Report
Isn’t the customary response of businesses which suffer large fines, to replace their leaders until they find one who is able to fix things?
Wasn’t that Lincoln’s approach to the Civil War losses?
Sure, I’m not claiming that individual behavior is the miracle fixall; nothing is.
But individual leadership skill matters every bit as much as proper structure.Report
We have seen this dance often enough to understand that the core problem is the leadership, institutionally, doesn’t think fixing that problem is part of their job.
Large fines is an effort to point out to the institution that, yes, it is. It’s how you convert a “successful” leadership history into an unsuccessful one… because “successful leadership” means “did this person make money for the institution.
That’s why the head of Michigan State could step down and STILL be congradulated and celibrated for her successful multi-decade leadership, even if she did let a child rapest do his thing for years.
So then, what kind of “large fine” can we drop on the FDA to convince it that various things are problems?
Replacing the leadership isn’t going to do it by itself, just like having that University President step down isn’t enough. We need to convince the institution that this behavior is unacceptable. Since we can’t “fine” a gov body, the only solution I see is simply restricting their ability to misuse that power.Report
Absolutely, just replacing heads isn’t going to do the trick by itself, just as restructuring by itself won’t do it.
But both tools really demand the same thing of citizens, which is to hold the executive (in this case the President) and the management board which establishes the structure (In this case the various heads of the FDA) and even the body which establishes the basic scope (In this case Congress).
So really, in order to do as you say, restrict their power, we have to fire and re-appoint better Presidents, FDA heads, and Congresspeople.
Which is really how the republican system works, isn’t it, where we hire people to create the structure of government.
Our entire power as citizens is the power to hire and fire people. So we should probably work on making better hiring choices.Report
And yet your nominees to replace Trump make him look like Albert Einstein. Joe Biden had a disastrous town hall, so bad that they pulled the plug on it. At times he’d doesn’t seem to know what office he’s even running for.
Bernie is just as bad, and the empty shelves at Costco are a preview of what normalcy under Bernie would be like. He doesn’t even think we need more than one toilet paper manufacturer.
One of the reasons Trump was elected was that a large swath of the public realized that the country’s leadership class was staggeringly incompetent. Everything since just confirms that opinion, so running two senile candidates in their 70’s who’ve been in Washington for a combined total of 80 years isn’t going to sway anybody.Report
“Heckuva job, Brownie” was far more Bush’s epitaph than anything he did in Iraq. The people can and will come together to demand better.
Now, granted, it may not be a perfect change, but sometimes you gotta take your Ted Strickland over your Ken Blackwell.Report
“we should just TELL the FDA what to do, and MAKE them do it, and if they still don’t want to then FIRE PEOPLE until they DO”, says the guy who I’m quite sure thinks that Donald Trump is an authoritarian dictator who believes his word is God’s law and throws tantrums when he doesn’t get his way.Report
The comparison I keep going back to is Ebola.
I can understand people who freaked out about both. I have a lot of respect for people who think of them differently based on expertise. But I’m having trouble with the people who overreacted to one of them and made fun of people who overreacted to the other one, simply based on the sitting president. That’s shamanism.Report
I agree with the general sentiment… I did some research on the “coronavirus emergency bill” and the double speak on where the points of contention were was distressing.
But, the problem with coronavirus is that it doesn’t actually present like a plague or Ebola, it presents with a huge lag and a spike that requires collective action *before* any of us can see a need. That’s really counter-intuitive.
By comparison, here’s how the WHO describes Ebola spread:
The incubation period, that is, the time interval from infection with the virus to onset of symptoms, is from 2 to 21 days. A person infected with Ebola cannot spread the disease until they develop symptoms.
From a response point of view, this makes a massive difference. Which isn’t so much to disagree with you as to point out that Ebola response is driven by 25% – 90% mortality plus a disease that presents starkly and only becomes infectious when it does.
So, a good Ebola response is a bad Coronavirus response.Report
Great piece!! Very insightful and I enjoyed it a lot!Report
Thank you KristinReport
I’m vaguely wondering if the virus is a chimera (that is, touched by humans beforehand) and, if it is, if that’s something that we will ever be allowed to find out.Report
The short answer is no, we won’t be allowed.
There’s no upside to acknowledging that it was humanly manipulated since the simplest (and ealiest) reports were that it was an “accidental” release from a research lab which is legitimately working on SARS research. Thus the rational calculus will be that there’s nothing to be gained by publicizing such a mistake, since it is already understood that mistakes like that simply cannot be made. So what’s the point of pointing out the mistakes? That would be seen as a huge mistake.
And, if it was simply a naturally occurring mutation and cross-species jump… then there’s nothing to report. Either way, we just have to accept it as an act of God.Report
Rational Calculus for the group as a whole is different from “I become famous if I step forward”.
If it’s man made, too many people would need to keep it’s secret. Ergo it’s not man made.Report
“I become famous if I step forward”
In Xi Jinping’s China.
Ergo, the calculus is inconclusive.Report
Well, on January , 2009, I had a first date with a beautiful lady. She’s n ow my wife. So I have pretty fond memories of 2009.Report
“Social media means we are not just watching the story, but can be part of it, and no one wants to be left out.”
As the song goes, “Everybody’s a dreamer, everybody’s a star…”Report
Great piece, Andrew.
I went shopping after work and I caught an insight on the “toilet paper rush.” Seeing all those empty shelves (but a full produce section??) kind of freaked me out, and I found myself making a mental inventory of “stuff that I should really pick up while I have the chance before it’s all gone.” I quickly realized what I was doing, collected the stuff on my list, checked out, and went home. What a strange experience.Report
(but a full produce section??)
This. No toilet paper (or diapers), but the produce section looked just like it always does. Similarly for the frozen vegetables section.Report
Fresh vegetables generally don’t keep, so there’s not much reason to stockpile them, and people are already out of freezer space. Besides, it’s a national emergency, so who the heck is still eating vegetables?
I saw an amusing picture of bare shelves beside the still fully stocked vegan section, so maybe this is a real thing.
Imagine you were part of a group that was escaping from an apocalypse that hit your city. As you finally settle down to make camp, each of you shows what critical items you managed to bring: MRE’s, dehydrated foods, bottled water, canned meats, weapons, ammunition, radio gear, a crossbow, and some whisky and C-4 (keep an eye on that guy). Then Chad grins and says “I brought fresh carrots!” and waves them around with their tops still attached, and Karen chimes in and says “I brought Swiss Chard!” In the back of their minds, everybody knows it’ll end badly for them. Don’t be Chad and Karen.Report
I don’t understand the need to horde toilet paper. It’s not like covid gives people diarrhoea. (Plus there’s also water)Report
Me neither, but women apparently use it. They also use cotton balls. I’ve used maybe three cotton balls in my entire life, as improvised bore scrubbers. Anyway, if you live with a woman you apparently have to buy toilet paper and cotton balls.Report
Exactly, as they say on the twitters:
Broke: Stockpiled Toilet Paper
Woke: Socially acceptable extra Toilet Paper
Bespoke: New Toto toilet
https://youtu.be/U8KyBlGWI2kReport
My Friend TotoTo(ilet)?Report
Stayed at a resort that had the Toto toilets… when you walked in the room a light went on (in the toilet), the seat opened up and the warmer (or fan as the case may be) turned on and a scented mist spritzed… AUTOMATICALLY.
We came home and I could only think, “Man, our toilet *sucks*”
It was a Russ Hanneman moment.Report
https://www.youtube.com/watch?v=g6fu7XB7qbsReport
Yesss.Report
“No wonder you get folks who spend every waking minute on presidential politics immediately filtering a health scare through the ongoing election.”
There’s a reason people are freaked out about this. And like you said, it IS because we have a different president. But it’s not for the nefarious reasons you suggest (an evil media, a crazy social media platform). Have you listened to the president’s response to this? Does he make you feel better about any of this? Did you see him in the Rose Garden yesterday?
I was 26 during the swine flu, and I remember it well. I do not think this is comparable because we were testing on a much wider scale. Swine flu was a variation on the old one. There was a vaccine by the end of the year. As you noted, we’re still in the dark about how many people have the virus, as well as how many have died as a result.
We have a “different president” and a “different media” doesn’t make up for how inadequately prepared we are. Seems to me that “President Trump Closed The Pandemic Office” would be something to reference in an article about how folks are treating swine flu and coronavirus differently. https://www.washingtonpost.com/outlook/nsc-pandemic-office-trump-closed/2020/03/13/a70de09c-6491-11ea-acca-80c22bbee96f_story.htmlReport
Why did the NSC have a “pandemic office” and what did it ever do? We handled the latest Ebola outbreak without it, and the office probably didn’t exist until halfway through the prior Ebola outbreak, when Obama put idiots and political hacks in charge. Remember Ron Kain, the Ebola Czar who was Obama’s “health expert”? His qualifications were being Al Gore’s lead lawyer in the 2000 recount saga. Yeah, that guy was head of Obama’s pandemic response, and he later went on to be the debate-prep expert for Hillary in 2016 and now for Joe Biden.
To run things the way Obama did, Trump would have to put either George Papadopoulos, Paul Manafort, or Roger Stone in charge of the pandemic response team.Report
I purposefully steered away from the president’s actions in this current outbreak for a couple of reasons; I wanted to focus more on the general population since focus has been predominantly on the president/government, it’s ongoing and changing, and the politics involved are what they are. I have plenty of criticism for the presidents handling, and the points you bring up are fair just setting that aside for a different discussion from the point I was making here, and the thing that is more controllable than the president, our perceptions and reactions to things.
We are much of an age, I was 29 during the H1N1, but was living in Germany at the time where the death toll was like 30 compared to the 3K some odd in the states. I watched that from afar, so perhaps that viewpoint skews how I view this time as well.Report
If you do the math, the H1N1 fatality rate of about 0.02% (12,000 deaths of out of 60 million cases) is well below that of the normal seasonal flu. The key difference, for those who are wondering, is that about 85% of deaths in the US occurred in people under the age of 65, resulting in a higher number of life-years lost despite an ostensibly lower mortality rate.Report
https://www.lawyersgunsmoneyblog.com/2020/03/what-if-being-governed-by-incompetent-racist-authoritarians-is-bad
https://www.lawyersgunsmoneyblog.com/2020/03/when-a-death-cult-is-in-power-during-a-pandemic
Moe people then necessary are going to get sick, suffer, and die because the current administration is composed of incompetent assholes who just can’t resist using the pandemic to spread their xenophobic agenda rather than doing the right thing. Likewise, the Senate is dominated by a Death Cult rather than a political party. They are delaying a vote on a relief bill negotiated by the Democratic House and the White House simply because they can. It wouldn’t surprise me if Moscow Mitch just shelves the bill.
I’m just completely furious at this freaking administration and all their bloody enablers down to the lowest one. They just come up with excuse after excuse on why we simply need to mess up this entire thing and everything else. Anybody who doesn’t vote Democratic in November 2020 should just be regarded as grossly immoral. They either belong to the repulsive fascist Death Cult or are so wielded to something that won’t ever get power in the United States that they would rather everything die.Report
To review, in a situation in which every day legislation is delayed means more sick and dead people, McConnell is delaying the passing of legislation Republicans have agreed to, contrary to the political self-interest of his own party, solely because he can.
As explained in this excerpt, that’s rather puzzling behavior. I’m curious as to what the explanation is. Scott Lemieux, it seems, is not. “Mitch McConnell is a cartoon villain who leads a death cult” does not strike me as a reasonable conclusion to jump to without further investigation.
I remember a media meme from the early 2000s, where, because there are roughly five people in the news media capable of coming up with original ideas, everybody was saying that that George W. Bush was “uncurious.” That’s the word that comes to mind here.Report
This definitely ISN’T 2009, because the current occupant of the Oval Office is doing shit like this:
Trump offers ‘large sums’ for exclusive access to coronavirus vaccine
https://www.theguardian.com/us-news/2020/mar/15/trump-offers-large-sums-for-exclusive-access-to-coronavirus-vaccine
According to an anonymous source quoted in the newspaper, Trump was doing everything to secure a vaccine against the coronavirus for the US, “but for the US only”.Report
You have to read past the reporter’s blindness on such stories.
If they make the vaccine “for the whole world” it likely means they’ll produce it in small quantities and ship and let the usual UN committees controlled by Cuba, Iran, China, and North Korea decide how to distribute it. Most of the people who get vaccinated will be dictators and their internal security forces.
If the US gains control of it (thus the word “exclusive”) we’ll let everyone mass produce the living daylights out of it.Report
That is… certainly a take.Report
Ouch:
https://www.rawstory.com/2020/03/norwegian-university-tells-students-in-us-to-return-home-due-to-poorly-developed-health-services-report/
In a post on Facebook, the Norwegian University of Science and Technology advised some international students students to return home.
“This applies especially if you are staying in a country with poorly developed health services and infrastructure, for example the USA,” the post said, according to reports.
They didn’t actually say “shithole country” but still…Report
you lost me at “In a post on facebook…”Report
Nobody should return to Norway. They have 20 times as many virus cases per capita as the US, almost as many as Italy and Switzerland, and worse than South Korea, even though the virus likely arrived there much later. Currently they rank #3 in the entire world on the list of bad places to be in this outbreak.
Perhaps their idiotic Facebook snark from a major university explains why.Report
No one knows how many cases America has.Report
If Biden or Bernie had been in charge, we’d probably be up over 100,000 because neither would have stopped flights from Wuhan. Biden’s corona plan still doesn’t stop flights from China. The Democrats are still ranting about xenophobia and demanding that we tear down the wall. Amusingly, Mexico is going to love that wall because they’re going to bar entry from the US so they don’t get infected.
Almost half of all Chinese tourists visit either the US or Australia and New Zealand (25% and 20% of total). Australia and New Zealand immediately followed Trump’s lead on barring entry to anyone who’d been to China in the previous two weeks. As a result, even though the three countries get far more Chinese tourists than Europe (37.6% of Chinese tourists), the US, Australia, and New Zealand have less than 4,000 cases while Europe has over 55,000 cases.
Had China’s socialist government not kept the outbreak a secret for two months (from November 17th till mid January), it’s quite possible that it wouldn’t have even spread much in Wuhan, much less gone on to become a global pandemic.Report