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Comment by rsj_hn | Hacker News Reader

I sympathize with this view, but it does make it harder to respond quickly with nationwide lockdowns, which is the flip side of living in such a connected world.

Long term, I think some mechanism to mandate more social isolation is going to be needed.

For example when travelling from California to Arizona, there is currently no quarantine area or checkpoint, and that's fine if you want free movement, but then it's harder to say that states should run their own pandemic policy as long as there is free movement between states.

And this is a general trade off. More interconnected world => localism is less viable as a means of countering global threats.

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Practically, yes, the states these days won't do anything until the federal government tells them to. It'll work out in a nationwide lockdown, but such obedience hurt us in february when the CDC had a monopoly on test kits and nowhere near enough capacity to supply the whole country. We seem to be making all the wrong decisions in this emergency.

Those are valid points. As to the test kits, I keep hearing conflicting info -- e.g. that there was a shortage of ingredients, too much FDA red tape, etc. There will plenty of root cause analysis in the future, but I think we have to reshore critical infrastructure and there is lots of red tape to cut in both CDC and FDA.

My personal theory is that someone in the executive branch wanted to secure an exclusive contract for a personal friend. Something similar happened in the first few months of the Kuwait oil fires, with certain american fire fighting firms being given exclusive contracts to fight the fires, despite lacking the technology and expertise to extinguish them.

But I'm just a cynical man. It could very well be something else and I'll be very interested to read about this emergency once it's all behind us.

Even with an exclusive contract, a nation such as the US should be able to quickly ramp production of all the test kits, masks, latex gloves, respirators, oxygen concentrators, antibiotics and other pharmaceuticals that we need.

Yet we can't.

That's crazy and it has to change.

Oh we certainly can. "We" have decided not to, for now. One day we might find out the who/why/how of this decision. That will be an interesting day.

The who is pretty much everyone in government, egged on by the business community with the tacit approval or at least disinterest of the public. The when is constant over the past half century. The how is outsourcing much of our productive capability around the globe. The why is the race to the bottom for the cheapest production cost.

I don't think so. This is not a case like where we need a bunch of steal but the steel mills are closed so we have to buy the Chinese steel so (as any good business-folks will do) they raise prices 8-fold (see Oakland Bay Bridge Fiasco). The reagents for these tests are all made in america, or would take a few days to ramp up. I once made enough Taq polymerase in 12 hours to supply a lab for 12 years doing 200 PCRs a day. A single person can make gram quantities of the required oligos (enough for 100,000 PCR reactions) in any one of 500 labs in the Bay area alone in 12 hours. RT takes an hour. Amplification takes 4 hours. The readout for a sample can be done 1500 at a time in one second. There are no excuses.

Could be, think of Homeland Security and those new(er) airport scanners. Mike Chertoff, formerly Secretary of Homeland Security, was instrumental in making them happen. He also happened to own a huge stake in the company that made them, since acquired by BAE Systems (who later made him a Chairman).

https://en.wikipedia.org/wiki/Michael_Chertoff

> exclusive contract for a personal friend

Similarly in Puerto Rico after Hurricane Maria, a politically connected one-man "energy company" called Whitefish, with no experience or skills, emerged out of nowhere and was given the contracts to rebuild the entire Puerto Rican grid.

Months later nothing had happened other than he hired a few people as unskilled as himself who were just dorking around down there, while people died.

So they fired that guy and hired another company called Cobra, with the same terrible terms, and the same ineffective response. Eventually it was found out that Cobra people had paid massive bribes to officials to ensure the deal.

https://www.nytimes.com/2019/09/10/us/puerto-rico-fema-arres...

Whitefish was getting stuff done. It was more than one man. It had the needed skill, which was subcontracting. Whitefish got numerous teams operational in Puerto Rico before being yanked off the job by politics.

The whole story of Whitefish being unqualified is just corrupt politics. Subcontracting is a legitimate way to get the work done.

The red tape thing is nonsense. What was lacking was/is political will. CDC/FDA/States could increase testing 100-fold overnight if they really wanted to. A decision has been made to proceed differently. Hopefully this decision is reconsidered over the next few days or things are going to get much worse. Currently, as far as I can tell, we are doing about 1000 tests a day nationwide. I can order the necessary reagents and a few water baths and a cheap microtiter plate fluorometer for overnight delivery and do a 1000 of these tests a day by hand.

I have read somewhere that CDC was trying to make a 3-in-1 test kit for SARS, MERS and this new SARS-Cov-2 virus but it was giving bad accuracy and false positives, and now they are making the one for the sars-cov-2 only.

They were making a 3 in 1 kit, but that's because the 1 was an internal control and the other 2 were two different places in the viral genome in case one mutated and became silent.

Can you cite anything to back this up?

Any standard first year undergrad level biology book will describe how to run an RT-PCR test (which is what they are doing). None of the reagents and processes are difficult to make or source.

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