How did the U.S. end up with nurses wearing garbage bags?
newyorker.com
newyorker.com
A decentralized manufacturing system with distribution through regional warehouses was more resilient, if less cost effective.
Some states, California and New York among them, did create their own local stockpiles of ventilators and PPE after the bird and swine flu scares, but did away with them in the fiscal crunch after the financial meltdown.
https://www.msn.com/en-us/news/us/california-once-had-mobile...
https://www.propublica.org/article/how-new-york-city-emergen...
This spare capacity can be maintained on the cheap.
https://www.bloomberg.com/news/features/2020-03-25/3m-double...
This is 3M’s moment, one for which the staid, 118-year-old Minnesota manufacturing giant—the maker of Post-its, Scotch tape, touchscreen displays, and scores of other products—has been preparing for almost two decades. Coming out of the SARS epidemic of 2002-03, the company realized it wasn’t fully equipped to handle unexpected explosions of demand in the event of a crisis, or what it calls an “X factor.” It decided to build surge capacity into its respirator factories around the world.
And with terrorist groups and state actors realizing that animal viruses are potent biological weapons, and legitimate research centers working on making viruses airborne - chances of another screeching halt in the next 10 years due to malice or incompetence are not that low.
How do you imagine this to be implemented in reality? Does the Federal government send a random selection of people a letter that they are to be relocated to Wyoming for the next 3 months? The US is not a command economy.
No. They offer a solid wage to anyone who wants a job and is willing to be trained. Like we did by the millions to build our national parks, dams, roads, and other infrastructure in the 30s and 40s.
"Spin up production for X units of Y product for Z weeks per year and we'll give you $N. In the event that we need you to swap over for a national emergency, we'll pay you $M per week of production."
You can't run long-term planning like this in a country where one party has short-term gains as one maxim, and limited government as the other.
> On March 1, 2018, Trump announced his intention to impose a 25% tariff on steel and a 10% tariff on aluminum imports. > Trade Act of 1974 allows the president to impose a 15% tariff for 150 days if there is "an adverse impact on national security from imports
>NAFTA originally required automakers to use 62.5% of North American-made parts in their cars to be imported duty free
You can just require that 25% of PPE purchased by the government has to be made domestically. That would give you 3-4 factories. You make a requirement so they are 1000 miles away from each other and be able to 4x capacity within 2 weeks.
It's like my company. We used to have a robust DR capability. We replicated our data to another site, and could have that site up (with all the servers/services running) within a 24 hour period. We had plans and equipment for running our call centers, for staffing at the secondary site, everything all bolted together in an annual exercise that helped us catch changes.
Then new IT management comes in and sees what they think is wasteful spending and view the annual exercise as disruptive. So they start to gut the entire process, instead relying on sandbox exercises for specific applications. Not taking a holistic view of our computing environment.
So now this manager gets promoted 2x for reducing "unnecessary costs", as well as improving productivity because IT no longer has to focus on that wasteful DR stuff...
Just throwing pasta against the wall here.
There are plenty of people who foresaw this. But there are hoops to jump thru which deterred those people from being proactive. I'd like any post-mortem to propose structural, systemic remedies. So we're not just reliant on savvy leadership for future crisis.
Like we know that destroying all insects and and global warning are not sustainable. We know we can't have 7 billion humans eating meat. We know we should let not power concentrate too much into some entities. But we keep it up.
Since we don't react unless something forces us to, I'm starting to believe we need some medium crisis to happen like the covid19 so that a bigger one won't wipe us out in the future.
I suspect one outcome will be a long term reduction in civil liberties
The economy is both critical and far too complicated for anyone to understand exactly what is going on at the moment. We could be looking at anything from a temporary wobble that disappears in 6 months to a long-rolling 20 year catastrophe.
This is bad, but not bad enough to cause WW3
I can't imagine what would have happened if patient zero had been in new york.
Now of course, they handled that the way a dictatorship handles it.
[0] https://www.worldometers.info/coronavirus/worldwide-graphs/#...
Reported scandal is similar "confirmed" case testing as Italy and US. (only those showing severe symptoms).
20x population of Italy with ~1/2 the cases (so far)
4x population of US with ~1/5 the cases (so far)
Much more impoverished.
Virus originated there, so 2-3 months less warning.
It seems to me that planet earth, and the various interconnected societies that live upon it, can be viewed as a system, like any other. Vastly more complex than any other system we deal with, but a system nonetheless.
Normally when an undesirable incident occurs in a system, we would get a group of people who have a good understanding of the system (or, systems in general at least) together to perform an appropriate post incident analysis, with a goal of identifying the various root causes, solutions to the causes, and an implementation plan. The space shuttle Challenger disaster [1] is a good example of such an analysis, in that it has many similarities (and at least two particularly noteworthy differences: number of deaths, quality of analysis) to the current pandemic.
It is fairly well known that when the people doing an analysis [2] of a system also happen to be participants within the system being analyzed [3], a number of unusual and undesirable behaviors can manifest (a very worst case example may be that, if the system is too complex, people may not only fail to realize that it is a system that can be analyzed, but may even be vehemently opposed to simple consideration of the notion. Rather, they may insist upon using a far simpler, non-technical (and therefore inaccurate) approach of casting blame according to a combination of personal heuristics[4] and in-group dynamics[5], at times going so far as ostracizing any person who may advocate for a standard engineering approach. For these reasons, outsiders (notable in this case, Richard Feynman) are often included in the analysis team.
I wonder if something useful could be learned from comparing and contrasting these two scenarios.
[1] https://en.wikipedia.org/wiki/Space_Shuttle_Challenger_disas...
Incident
The Space Shuttle Challenger disaster was a fatal incident in the United States space program that occurred on Tuesday, January 28, 1986, when the Space Shuttle Challenger (OV-099) broke apart 73 seconds into its flight, killing all seven crew members aboard. The crew consisted of five NASA astronauts, one payload specialist, and a civilian schoolteacher.
Investigation
In the aftermath of the accident, NASA was criticized for its lack of openness with the press. The New York Times noted on the day after the accident that "neither Jay Greene, flight director for the ascent, nor any other person in the control room, was made available to the press by the space agency." In the absence of reliable sources, the press turned to speculation; both The New York Times and United Press International ran stories suggesting that a fault with the space shuttle external tank had caused the accident, despite the fact that NASA's internal investigation had quickly focused in on the solid rocket boosters. "The space agency," wrote space reporter William Harwood, "stuck to its policy of strict secrecy about the details of the investigation, an uncharacteristic stance for an agency that long prided itself on openness."
The Presidential Commission on the Space Shuttle Challenger Accident, also known as the Rogers Commission after its chairman, was formed to investigate the disaster. The commission members were Chairman William P. Rogers, Vice Chairman Neil Armstrong, David Acheson, Eugene Covert, Richard Feynman, Robert Hotz, Donald Kutyna, Sally Ride, Robert Rummel, Joseph Sutter, Arthur Walker, Albert Wheelon, and Chuck Yeager. The commission worked for several months and published a report of its findings. It found that the Challenger accident was caused by a failure in the O-rings sealing a joint on the right solid rocket booster, which allowed pressurized hot gases and eventually flame to "blow by" the O-ring and make contact with the adjacent external tank, causing structural failure. The failure of the O-rings was attributed to a faulty design, whose performance could be too easily compromised by factors including the low ambient temperature on the day of launch. The O-rings would not work properly at ambient temperatures below 50 °F (10 °C)- and it was 36 °F (2 °C) on the morning of the launch.
More broadly, the report also considered the contributing causes of the accident. Most salient was the failure of both NASA and Morton-Thiokol to respond adequately to the danger posed by the deficient joint design. Rather than redesigning the joint, they came to define the problem as an acceptable flight risk. The report found that managers at Marshall had known about the flawed design since 1977, but never discussed the problem outside their reporting channels with Thiokol—a flagrant violation of NASA regulations. Even when it became more apparent how serious the flaw was, no one [citation needed] at Marshall considered grounding the shuttles until a fix could be implemented. On the contrary, Marshall managers went as far as to issue and waive six launch constraints related to the O-rings. The report also strongly criticized the decision-making process that led to the launch of Challenger, saying that it was seriously flawed: "failures in communication...resulted in a decision to launch 51-L based on incomplete and sometimes misleading information, a conflict between engineering data and management judgments, and a NASA management structure that permitted internal flight safety problems to bypass key Shuttle managers.
Richard Feynman
One of the commission's members was theoretical physicist Richard Feynman. Feynman, who was then seriously ill with cancer, was reluctant to undertake the job. He did so to find the root cause of the disaster and to speak plainly to the public about his findings. Before going to Washington, D.C., Feynman did his own investigation. He became suspicious about the O-rings. “O-rings show scorching in Clovis check,” he scribbled in his notes. "Once a small hole burns through generates a large hole very fast! Few seconds catastrophic failure."[70] At the start of investigation, fellow members Dr. Sally Ride and General Donald J. Kutyna told Feynman that the O-rings had not been tested at temperatures below 50 °F (10 °C).[71] During a televised hearing, Feynman demonstrated how the O-rings became less resilient and subject to seal failures at ice-cold temperatures by immersing a sample of the material in a glass of ice water. While other members of the Commission met with NASA and supplier top management, Feynman sought out the engineers and technicians for the answers. He was critical of flaws in NASA's "safety culture", so much so that he threatened to remove his name from the report unless it included his personal observations on the reliability of the shuttle, which appeared as Appendix F. In the appendix, he argued that the estimates of reliability offered by NASA management were wildly unrealistic, differing as much as a thousandfold from the estimates of working engineers.
"For a successful technology," he concluded, "reality must take precedence over public relations, for nature cannot be fooled."
U.S. House Committee hearings
The U.S. House Committee on Science and Technology also conducted hearings and, on October 29, 1986, released its own report on the Challenger accident.[75] The committee reviewed the findings of the Rogers Commission as part of its investigation and agreed with the Rogers Commission as to the technical causes of the accident. It differed from the committee in its assessment of the accident's contributing causes: "the Committee feels that the underlying problem which led to the Challenger accident was not poor communication or underlying procedures as implied by the Rogers Commission conclusion. Rather, the fundamental problem was poor technical decision-making over a period of several years by top NASA and contractor personnel, who failed to act decisively to solve the increasingly serious anomalies in the Solid Rocket Booster joints.
[2] https://www.merriam-webster.com/dictionary/reflection
- a thought, idea, or opinion formed or a remark made as a result of meditation
- consideration of some subject matter, idea, or purpose
[3] https://dictionary.cambridge.org/dictionary/english/self-ref...
- the activity of thinking about your own feelings and behavior, and the reasons that may lie behind them:
- He seems to be *incapable of* self-reflection
- It is only in *quiet moments of self-reflection* that we can *really address such problems*
Heuristics are simple strategies or mental processes that humans, animals, organizations and even some machines use to quickly form judgments, make decisions, and find solutions to complex problems. Heuristic processes are used to find answers and solutions most likely to work or be correct. This does not mean however, that heuristics are always right. In situations of risk, heuristics face an accuracy-effort trade-off where their simplified decision process leads to reduced accuracy.
[5] https://en.wikipedia.org/wiki/Group_dynamics
Group dynamics is a system of behaviors and psychological processes occurring within a social group (intragroup dynamics), or between social groups (intergroup dynamics). The study of group dynamics can be useful in understanding decision-making behaviour, tracking the spread of diseases in society, creating effective therapy techniques, and following the emergence and popularity of new ideas and technologies. Group dynamics are at the core of understanding racism, sexism, and other forms of social prejudice and discrimination. These applications of the field are studied in psychology, sociology, anthropology, political science, epidemiology, education, social work, business, and communication studies.
The three main factors affecting a team's cohesion (working well together) are: environmental, personal and leadership.
Human beings are complex, inconsistent, and many other things. Put them all into an interactive systems (cities, nations, global, cultures/ideologies) and the complexity increases.
Nurses in China was also wearing garbage bags in February. There's a PPE shortage for >2 months
https://i.imgur.com/PgDWgs5.jpg
The reason for this global shortage is China was celebrating Chinese New Year, when every production simply stopped. It happens every February. And Covid-19 kicks in and workers are effectively locked in their towns and can not travel. Local governments organized some emergency hires from local but still struggles to meet the demand.
If Covid-19 happened in other months it would be totally different.
The US has a government agency called BARDA (Biomedical Advanced Research and Development Authority), that estimated at some point that there are 10000 gaps worldwide when it comes to pandemic prevention. And to close these gaps one would need a budget of $10BN/year. They didn't get that.
Now, after a few trillion down the drain, I think they'll get it.
How would temperature and subjective screening prevent these asymptomatic patients from infecting many others?
Doing widespread spot testing across the country would've identified the communities where the virus was extant. From there we would've known where to focus the brunt of universal testing, tracking and quarantining.
Just the fact that we are still fiddling with estimates of what percentage of CV infected people are asymptomatic is a travesty. We should have long ago conducted enough statistical sampling to have a very clear picture what was happening in our communities.
There has been a spectacular difference in various nations' performance during this crisis. As a Scandinavian I'm a bit skewed in my judgement, but I'm especially in awe at Denmark and Norway's actions, given their lack of recent history with infectious disease:
Quickly discover from external evidence what the new reality is, that it's much worse than anything seen during the lifetimes of current leaders, that it requires extreme measures normally only deployed during times of war, and then use science-based leadership and a broad array of expertise to choose what measures to apply. Then apply them with vigor and competently deal with the fallout.
This is not trivial - crucially, it requires that the central leadership avoids dogmatic and heuristic reasoning adapted to conditions that no longer apply. Because even if you have such top leadership, there will be leaders on the second tier of this hierarchy that are not used to reasoning on a war footing. They will act or give advice that's normally sound, but counterproductive in the new and extreme reality. Top leadership needs to catch onto this fast, and strike down or disregard advice that's not applicable to the crisis at hand.
You can see these phenomena in a plethora of fields. Scientists grasping for N=100,000 double-blind randomized peer-reviewed studies for a novel phenomenon, rather than make the best educated guess from reasoning and available evidence. National leadership trying to solve a health-induced economic crisis by printing money and nothing else. Politicians infighting and posturing by old routine, as if the enemy army isn't already banging down the gates. Reasoning by analogy, let's do the same as we do in a bad flu season. Blame the other party, has always worked before.
Or a subtle insidious variant that's currently responsible for Sweden's problems: let the experts handle it, and dictate public policy without regard for what happens outside of their field of expertise. Turns out an expert in a narrow field with an IQ of 120 and a track record of success is a very dangerous leader. They often aren't aware of their blind spots.
Granted, most problems are manageable with excellent leadership, but the whole point about a good system is it works fine with mediocre leaders - and there's a corollary - if your organization requires talented leadership to function, it's a bad organization.
You see, as of today we have 2,473 confirmed cases and 33 deaths in Thailand. Denmark, on the other had 5,819 confirmed cases and 247 deaths as of a couple of days ago. I am sure the data is noisy and that testing here is not nearly widespread enough. But the bodies are not piling up and we don't really have the kind of censorship here that would keep it hidden if there were a lot of deaths from Covid-19. And most importantly, the words "competent government leadership" and "Thailand" should never be uttered in the same sentence.
So I guess leaders have done some things right by listening to the right experts (a form of competence I suppose). Or maybe it's the weather (popular theory that seems to have been dismissed). Or cultural habits have saved Thailand. Because I look to more advanced countries, especially in Scandinavia, and don't understand why they are doing so much worse than where I live.
This is the most important form of competence for a leader of government. There is no chance any leader would have adequate expertise in every subject they would need to be versed in in order to lead their nation. They _must_ bring in and rely on SMEs to make informed choices. (Of course they still have to make the choice.)
Climate, general health, age distribution and other unknown factors certainly play into it, and could easily affect the rate of deaths by such a factor. But I smell a rat when I hear that Norway get 5% positives and NYC gets 25% when they test. Also, Italy makes it clear that even with a relatively consistent approach to hunting down the corpses, a big factor can get lost in the noise. Way above 2x.
So it's not trivial to compare this between countries, but it seems feasible to (by critical judgement) at least distinguish between a wildly incompetent and a good response.
For instance I'm sure there are tons of serious terrorist threats that the government has prevented, but when one acctually happens, everyone complains how the government doesn't know what to do about terrorists. I'm definitely not saying they shouldnt have prevented it....just be aware of the bias.
Then all those programs were eliminated.
That "deescalation" is separate from all the missteps which have happened since.
Force most countries to adopt freemarket, remove trade barriers, remove import and export duties (except for extreme situations like pandemic)
Right now lots of market imposes duties on import of American goods, this reduces American exports.
Some countries like India, Brazil play extremely unfair - this only helps few industrialists in these countries but overall public suffers usually as they are forced to buy substandard goods from local providers, instead of someone internationally competitive. But yes, it helps the politicians who usually get their money from those handful of those industrialists monopoly setup through import taxes.
In hyper competitive market, local producers will usually figure out the niches worth exploiting and they'll build long term advantage there rather than aiming for some generic niche where they've no competitive advantage.
This prevents countries like India or Brazil from becoming Taiwan
Who wants that? Just look at the US and the trade war. As soon it realizes it can't compete/lead in the said industry it declares it a national security issue, be it communications(5G) or raw materials. I don't even want to mention the millitary procurement or oil. It was never about a free market. It was always about a market ruled by the most powerful where everyone can make a buck but not too much.
Politicians should understand that there are many things which can't be locally produced and penalising local businesses from importing those things from other countries is only going to disrupt the value add chain and lower their net exports.
This is something developing countries like India need to learn.
Get bad quality local machine = product crap quality end product = can no longer compete in international market = business goes bankrupt = local machine manufacturer is also dead in long term.
Reciprocity and fairness? Seems like a basic diplomatic concept but apparently it only applies to "important" countries who have enough leverage to warrant it. How can developing countries develop the leverage necessary to negotiate favorable trade agreements with established super powers like the US and Europe?
We need the ability to say "we don't actually need you but we're willing to entertain your proposal if we find it to our benefit". Anything less is actually exploitation. The fact the US can just send an aircraft carrier to somebody's coast to project some force prior to negotiations doesn't help, does it? It was never a level playing field.
Of course is not true. You can't compare the US with NK or China. Proof is the simple fact that you could write that comment without being censored and/or thrown in a jail cell.
however, who cares that i can tweet the president whatever i want within reason? is that freedom? i don't have any power or any effect.
in the u.s., politicians cannot say what they want. everything they say is couched in layers to appease others in government. a former presidential nominee is basically an outcast for voting in a well-reasoned manner against party lines. people have been removed from office for even being perceived to be going against the president.
don't equate choice of words and what products to buy with freedom.
if you watch the documentary hypernormalization by adam curtis, you'll see that the west has created a different kind of control. it's a sort of chaotic control. if you increase the chaos, you reduce people's ability to differentiate between truth and not truth, which in turn increases the ability to control and manipulate. in my opinion, this method of control is much more sinister because it hides behind "look how we free are" and a supposedly free media.
there is no one setup that defines all authoritarian powers.
I care. Of course it is freedom and it has power. Why do you think the authoritarian governments don't like it? What freedoms you have in China and not the US or Europe? Of course democracies are not perfect but they are a step forward compared with dictatorships. It's a big difference between manipulative politicans and dictators who put you in jail or even kill you if you don't agree with them.
No thanks. I'd rather not have US laws imposed on my country via trade agreements just so it's easier for them to sell their stuff here. If they want to expand to our markets, they should have to establish a real presence here and play by our rules.
Also, import taxes don't matter much compared to currency fluctuations. I remember a time when USD 1 ≈ BRL 1.6, importing consumer goods was a relatively simple matter despite taxes. Today USD 1 = BRL 5.11 and prices have become prohibitive even without any taxes.
> Some countries like India, Brazil play extremely unfair - this only helps few industrialists in these countries but overall public suffers usually as they are forced to buy substandard goods from local providers, instead of someone internationally competitive.
I used to think that way but the truth is it was a massive gain for our industry. Computer technology was licensed from foreign companies and produced here. Only large scale computers could be imported. This is great and continues to this day: companies pay less taxes if they manufacture their products here instead of importing. Software was a similarly protected industry and that is part of the reason why Lua exists.
Japan, USA and many other countries employ protectionism to great effect but when we do it we get sanctions from the USA? Because they want "compensation" for the losses american companies suffered due to the policy? Where's our compensation for the american agricultural subsidies?
This is why so many people say trade agreements are just modern day imperialism. It's obvious who's being favored by the agreement.
> This prevents countries like India or Brazil from becoming Taiwan
Why should we want to become Taiwan? If anything we should want to be more like China: heavy industrialization, access to the intellectual property of established international players, sells directly to markets they couldn't care less about (like us), will one day be in a position to compete directly with if not undercut them, etc.
This is only good if you want to work for big government granted monopolies where you are just a cog in a big machine.
To create a culture of export and value addition, every person should have ability to import the best machine they can afford from abroad without government eating into budget through import taxes.
For example, imagine I am creating fishing line and I found that best way to go about is to import a German machine through which I will be able to create high quality fishing lines.
Government imposed 200% duty on German machinery and now my competitor who is in Singapore can easily import that machine because he isn't paying 200% import duty on importer machine.
How is my product going to be able to compete in international export market when my investment is already double of my competitor.
This is the process of niche discovery. Big companies are slow at finding new niches to exploit. Small companies can do the exploration work and if they find something which works, they can become future big companies.
And if I am not able to import German machine guess what I am going to do? I am going to import end product form someone who is able to create the end product at cheaper cost then put my label on top of it and sell locally. What did I learn? Just slap label, market and print money?
I gained no manufacturing expertise.
When you add useless import taxes, you increase import of "final product" over import of "intermediary product". This way your country can't add value and you fail to capture value from a supply chain
People I met who lived in that era didn't describe it that way to me. They were prideful of what they'd accomplished.
> Government imposed 200% duty on German machinery and now my competitor who is in Singapore can easily import that machine because he isn't paying 200% import duty on importer machine.
Best way to deal with this is to get the local industry to reverse engineer the machine and produce a copy. Intellectual property be damned. This boosts local industry, improves the local economy, allows independent innovations, reduces the nation's dependence on foreign markets, etc.
Obviously, the established players don't want this. They want developing countries to buy their stuff instead of making their own. Intellectual property is the true government-mandated monopoly.
> How is my product going to be able to compete in international export market when my investment is already double of my competitor.
The point is to focus on the needs of your people first and foreigners second. The fact is companies don't care all that much about their secondary markets. I've seen products for sale here with labels printed in spanish: they didn't even care enough to create labels for us.
The trick is to make your own people your primary market. The US does this, Japan does this. Why should other countries be any different?
> I am going to import end product form someone who is able to create the end product at cheaper cost then put my label on top of it and sell locally. What did I learn? Just slap label, market and print money?
It's a lot easier to develop an existing industry than to create one out of nowhere. Industry could start by simply assembling parts. When the industrialists see a return on their investment, they can expand the scope of their operations and perform R&D.
It means that states on the east coast would have needed far more acute preparation than states on the west coast. The fact that there could be such a difference in timing implies that this should be handled at the federal level -- or all major cities must prepare to be ground zero, which sounds very inefficient.
We got lucky. Covid19, while deadly, is not as deadly as it could be. If we'd run into Spanish Flu, we'd be in a world of hurt right now. The more deadly pathogens out there are just not to be met with half measures. If you're talking Spanish Flu, you don't want to be putting Dallas on lockdown, and still have who knows how many people on the road to Norman, or Tyler, or Nacogdoches. All because they left before the city of Dallas was able to close the city. The city of Dallas would not even have the ability to know where those people are, or where they are headed, or what planes they are on, or what cars they are in. There really are no other options here, if you want to ensure maximum survival, you must have the coordination be at the federal level.
Again, with something like covid19, it probably doesn't make much difference. Sloppiness is not going to kill 10 or 20 percent of your population in the case of covid19. So we can tolerate the kind of Keystone Kops thing we've got going on right now. But if something comes along like Spanish Flu? I'm sorry, but we shouldn't be pussy footing around with a bug like that.
and as I understood it the spanish flu was rough but mostly it was so deadly because there were no antibiotics to treat secondary infections. And don't forget about lack of respirators.
If you take the original example, how would the state of Texas know where the kids who drove to Norman, OK are? They would need to, at a minimum, ask the state of Oklahoma. You scale that up and it's obvious that there has to be some mechanism for public health and law enforcement to act across state lines. That mechanism is obviously best implemented at the Federal level.
The government of Alabama can't be diddling about trying to find out who to call in Minnesota when they realize one of their residents left Birmingham just before a lockdown headed for Minnesota. Even worse, if the person was in a car, they'd have to check with every possible state, along every possible route to Minnesota. That's incredibly inefficient. We need Federal control of that stuff.
You want a strong team of experts (epidemic experts, medial, logistical) at the federal level advising everyone what they should be doing (and perhaps making some federal funding available) and then the city and state responsible for implementing.
Otherwise you get a bureaucratic mess beholden to particular politics (eg WHO). The current version of the CDC is a good plan structurally, just poorly implemented.
All major homes preparing to be ground zero, independently, is how you get toilet paper and hand sanitizer hoarding.
It's only through some super fuzzy altruistic mechanisms that such work is supported.
I straddle the protect-the-consumer vs let-the-markets-decide chasm. The best heuristic I can come up with is "it depends". Not very useful.
To wit, here's some disjoint things I've been pondering:
A- Disaster preparedness is a tension between price (or efficiency) and resilience. We don't want to waste resources. But we also don't (or won't?) manage risk very well.
B- Why are different states bidding against each other for scarce resources? I thought it was illegal to charge different people different prices for the same stuff.
C- Something like price controls are preemptive. Are there rear facing anti-incentives? Something like windfall taxes? Let's say a scarce resource becomes very expensive in a bursty fashion. Spinning up N95 production capacity is capital intensive. So though price goes (way) up, but profit margins don't. I'm ok with that. But if profit margins skyrocket without any other changes in the fundamentals, that's a problem for public health.
B. Because of the incompetent actions of the federal government. But even given that, why wouldn't you expect different actors to bid against each other? It's not illegal, in general, to charge different prices to different entities. In any case, that wouldn't apply to foreign companies.
C. Price controls lead to shortages. Anti-incentives lead to shortages. "Rear-facing anti-incentives" or the uncertainty of not knowing whether the capacity you build today will be confiscated in an emergency leads to shortages.
Also see: https://marginalrevolution.com/marginalrevolution/2017/02/pr...
Heck this is the reason we don’t have onion futures in the commodity market. People corner markets under stress and profiteer without adding any efficiency or price discovery.
Regarding the onion futures: I don't know the story behind that, but there are plenty of commodity futures traded for commodities which you'd expect to have less physical product than onions. Like mustard seed, guar gum, coriander, etc.
That video is ok primer for price discovery, substitution. I'm not an economist, so I don't know how to articulate my questions.
The idea knocking around my head is to create some kind of insurance to address supply arbitrage situations.
Our nations have strategic reserves for many commodities (oil, cheese, whatever). How do policy makers figure out proper amounts? Whatever that calculus, can we generalize it?
Some way to extend NPV to account for risk and volatility.
Surely this must already exist.
A- My go to example are the chip supplies. IIRC, a tsunami wiped out the production in Thailand. Seems to me some customers would have paid a small premium to better weather supply shocks. But I don't know what that'd look like.
C- What to do about hoarding? I've been stuck on ticket scalping for a while, which is my analog for today's PPE. Obvious remedy is to increase supply. But it doesn't happen. Another analog is famines are generally caused by hoarding, not lack of supply.
Of course, a lot of current woes are because key people ignored the early warnings, and then messed with the production and supply. I don't know how to counter balance those two phenomenon.
Thanks again.
(Edit: very much a distraction. Completely sidesteps what the article is saying. Very dead cat on table. I should have been suspicious a bit earlier).
If you were to really get to know most people, you will find they have (obviously) the same basic needs and desires. Amusingly, this is even illustrated by the large percentage of Trump supporters who are heavily dependent upon government services (i.e. handouts).
At the end of the day, we all want food, shelter, safety, and some amount of personal privacy and freedom. These things probably comprise at least 70% of our needs and desires. The remaining bits get divided up somewhat, and I daresay only the last 10-20% are "identity". Identity really just means what you and your peers/neighbors think.
Nobody wants to be sick, or hungry, or in pain, or unappreciated, or discarded. Much of the politics we see is thrust upon us by a narrow few (powerful) interests with their own agendas.
That may be the case, but different policies and social norms will result in different people getting more or less of those things.
Uh he gave pretty clear reasons why the US is different. the population density of populations hubs like New York, and the level of international economic activity are very concrete reasons why the US would be significantly more affected than some locales
https://www.usatoday.com/story/news/world/2019/07/11/the-50-...
Beyond that, US cities are usually not dense at all due to people living in single family homes rather than apartments.
See I am in India, if it runs out of food supplies, people will raid our farms and take whatever they can find and we'll not even have guns to defend our food supply.
Imagine having a farm and having several towers with snippers guarding farm during crisis.
E.G. "Imagine being a peaceful farm owner family and a bunch of preppers with assault machine guns who spent lifetime secretly hoping for a zombie apocalypse come to steal your food." etc.
Defenders have to fight whatever battle is brought to them.
The thing to hope for in "If we run out of food" situation is that some people at least will co-operate. Once it gets to "Angry mobs", and most importantly "who does and doesn't have a gun" - peaceful people will lose, one way or another.
Again, it's a personal & subjective perspective (which is why I've vouched/upvoted your comments - we're all allowed a personal & subjective perspective and it tests our ideas:), but it also means it's less theoretical than for most folks - having been variously in a civil war, starving situation, and facing angry mobs, turns out, last thing I personally wanted to have is a gun - it's just another highly desirable item for an angry mob and paints me as a bigger target.
So I try to have a reserve of food and medicine and important things at all times - but a gun has never joined the list. I know vividly from experience that if it comes to defending my stash, I'll loose very soon - if not to the very first "wave of angry mobs", then very very shortly thereafter. Popular SciFi movies and series notwithstanding :-/
And my point is that it doesn't really matter that much if the angry mob is armed or not, whereas you having one can have a huge impact on the outcome. There are a lot more of them than you. They can very easily kill you with a gun or without one. But you cannot possibly hope to dissuade any angry group of people from attacking you without at least a gun. Obviously it won't make you invincible, and gets less likely to help as the size of the mob increases (for that situation, you'd want to have a bunch of other armed people at your side), but that's not the point.
>which is why I've vouched/upvoted your comments - we're all allowed a personal & subjective perspective and it tests our ideas:
Downvoting to show disagreement is pretty sad behavior.
Actually I'm pretty sure almost any previous US government, rep or dem, would have done a much better job than this one.
BTW if you want to 'save yourself', what are your personal plans for developing a vaccine?
True in that no government can save everyone and prevent all infections. Therefore all government is shit, even thoughthey clearly all aren't.
How's your plans for creating your own vaccine coming along, have you started that virology and epidemiology course, and how's the new laboratory progressing? And that new supercomputer, and the chemicals (better not buy from anyone else, make your own!), and the various other kit that only a prepper can do properly. Fill us in, do.
The more likely answer is that you would be one of the many people that gets to die alone in your home.
Though the article goes into more detail to the question that the title asks, I thought this part was pertinent.
How did we end up with nurses in garbage PPE? The same way they still are in them. The problems that existed a month ago still exist today and are likely to continue to exist.
My takeaway from the 9/11 debacle is we learned that the Clinton Admin had a "shaking the tree" process. In response WTC bombing, USS Cole, embassy attacks, etc.
There are always organizational problems. Reasons data isn't shared. Legal, turf, bureaucratic, inability to correlate with others, whatever.
Their workaround was to have a daily standup where all the agency heads shared info.
Bush Admin (eg Condi Rice) discontinued such nonsense, choosing to focus on Russia (ending bans on nuke testing, chemical weapons, missile defense).
Trump Admin didn't choose to discontinue Obama Admin's preparedness so much as outright rejected anything and everything Obama related, and pandemic stuff was swept away with the rest.
It is not hard to imagine an alternative reality where the CDC-FDA testing fiasco did not occur, there was some test-and-trace early in the epidemic, and the cost and extent of the shut-downs were lesser and far fewer deaths occurred.
It is a bit dismaying to say this: but CDC and FDA have a lot of blood on their hands.
"To be fair, what’s on display here is a broader institutional malady. The US version of the WHO, the CDC, took a similar stance with another controversial topic—quarantines for health care workers returning from treating patients with Ebola. Four states—New York, New Jersey, Florida, and Illinois—instituted policies to quarantine anyone who had contact with someone infected with the Ebola virus while in west Africa, including medical personnel who cared for patients. No less than the Obama administration, backed by the CDC, attempted to squash these policies, arguing that this would serve as a disincentive for US health workers to travel to Africa to combat the disease at a time this help was sorely needed."
B: "no, there's zero debate to be had because this one judge was caught taking bribes"
One is a question about purpose and design, the other is a bug in the implementation.
EDIT: I looked up; the Department of Health or the Department of State would be more fit for purpose. Not the Department of Homeland Security, because TSA is actually a Travel Security Agency despite it is named Travel Safety Agency.
In spirit I don’t disagree but how can the Department of the Interior do this? What is the specific action?
Also why would The Department of the Interior be responsible for travel conditions rather than something like The Department of Transportation?
E: I still don’t follow, what action can be taken by any agency to make travel fearless in time of pandemic?
Department of State carries out U.S. foreign policy. What can they do to change the reality of a pandemic?
Government information advertisement (something like you still have right to life and freedom of travel, pandemic doesn't change that, followed by advice on safe travel without risking someone else's health), conscription, personal protective equipment distribution.
What?
We need to ramp up testing and find a vaccine. We do not need to encourage travel. Quite the opposite.
[1]: https://fas.org/blogs/secrecy/2019/05/defense-contracting-fr...
I live in a state that's barely being touched by this, and not because we don't have it, but because there are two large cities that have maybe 100+ cases or significant hospital load, and the spread is insignificant because its very easy for people to avoid each other and take basic precautions during interaction to prevent the spread. If you live in apartment buildings, 6 feet from your neighbor with only a wall to separate you stacked stories high with shared elevators, stairwells, hallways, and the majority of transport requires people to be in close proximity on sidewalks, buses, or trains, the factors and extreme measures needed to stop its spread are very different than someone living in Alaska or Idaho. Those people don't need to stay in their homes, they just need to avoid going anywhere unnecessary with large groups of people and wash their hands and cover their mouths.
Some states have higher rates of obesity or other risk factors, some states have higher populations of elderly than others. One size fits all measures doesn't work, you need focused precision efforts determined by locals and the only thing they need from the umbrella governments is support in their efforts for needs they've determined are necessary.
https://nypost.com/2020/03/17/cuomo-de-blasio-clash-over-pos...
Trump is an easy scapegoat for obvious reasons, so politicians and local people use him when not wanting to accept personal responsibility for the consequences of their own actions, or lack there of. If you already take the position that the President can't be relied on and should be out of office, why would you delay taking action yourself to prevent a scenario where you're waiting on hospital ships and the US Army to assist, or acting like you're the only place in the US that needs help, then complaining later that the President didn't do more? It's schizophrenic and hypocritical.
This idea that states with smaller populations aren't at risk is a foolish one. Sure you may not end up with death counts like NYC, but you'll still end up with some; hopefully you won't overtax your healthcare system.
We know how many people are in the hospital. Honestly, that's all that matters, if we have less people in the hospitals relative to our population, then we have less spread. We have less capacity relative to population size, and they're not being overrun. You don't need testing to know if your hospitals and ICU's are overrun.
>This idea that states with smaller populations aren't at risk is a foolish one.
I never said that, I said the risk factors are different and the actions you need to take to prevent spread might be less drastic. I'm arguing against the idea of a one size fits all solution, something that needs to be done to stop the spread in a place like NYC is unnecessarily restrictive and dampening in the local economy in a small town, where people can just wash their hands, avoid going anywhere but work and shopping for necessities, and businesses taking basic precautions like WFH and avoiding direct interaction where possible, and avoiding gatherings of large groups.
I can leave my house, go out in my yard, and walk down my street and possibly not even see anyone else out, much less come within 6 feet of them. I can get in my car and go somewhere else and not have to come in contact with anyone. You can't do that in a city center, people have to stay in their apartments for two weeks, without leaving or wear protective gear when they do leave, because leaving their residence without interacting with people is impossible, you're liable to run into someone in the hallway, stairwell, elevator, sidewalk, bus, or train/subway, all of which are rolling the dice on infection. If you're in the same apartment building, its possible you're breathing the same air, and have the cruise ship effect. Someone in Oklahoma doesn't have those same risk factors, they don't interact with the same number of people going about their daily business, just avoiding travel is enough to keep the whole community isolated. Nothing much is gained by having them restricted to their house at all times, they just need to avoid certain things that would put them in more interaction with others than normal, or traveling outside their region and vice versa.
What is being done now is probably best, you set baseline restrictions for the nation as a whole, and then each regional government increases or adds on to those restrictions based on the needs of their area.
So unless you want to turn the state into a country, its power of negotiation is limited.
I'm not sure how much single-country purchasing has also happened.
https://ec.europa.eu/commission/presscorner/detail/en/ip_20_...
> During the Corona crisis, Chancellor Angela Merkel, in talks with China's President Xi, created the conditions for Germany to gain direct access to a state-owned Chinese manufacturer of protective clothing. This is stated in a paper with which the Federal Ministry of Health informed the Bundestag about the procurement of protective clothing.
> The paper for the Bundestag states that after a discussion between Merkel and Xi and subsequent talks between the Chinese Ministry of Commerce and the Federal Ministry of Health, "direct access to a state producer (Moheco) could be established" at the beginning of April. Moheco promised a "higher level of quality and delivery reliability". In addition, an "air bridge" between China and Germany will be established with unused Lufthansa passenger planes to transport the masks.
As a non-German EU citizen I find this type of tactics very, very wrong and fundamentally detrimental to the future of the Union.
[1] https://www.sueddeutsche.de/politik/schutzausruestung-merkel...
And this is to say that the states are not prepared act as nations at a moment's notice and without the expectation that they will act independently, they don't have either the resources or the experience (but I guess they're learning fast).
Even more, if you live in the US, you might have noticed you pay far income tax to the Federal Government than to your state government. A lot of this money goes back to the states but only for particular, mandated purposes. This makes it rather difficult, again, for states to suddenly offer their own emergency management system, especially when Feds have a fully budgeted emergency management agency (FEMA, the, uh, Federal Emergency Management Agency) where the states don't agencies with equivalent funding. So when FEMA doesn't actually act, we have a serious problem.
This may work well during normal times but it has limitations, which show in times like what we're experiencing now.
It was mentioned on the BBC recently that the federal government has no power to impose lockdowns, for example.
The larger issue (and we're seeing it with the current crisis) is that many things are broken at the Federal, State and local levels and each level is busy pointing fingers at another level(s) in an attempt to redirect blame.
The US is a federal republic. That structure is one of its great strengths. Wishing it was a unitary state at this time does not get us anywhere.
Consider the CDC bungling of getting out the initial test kits and the regulations that kicked in that prevented states from developing tests for a few weeks. That was some critical time wasted in the name of "efficient centralization".
Regardless, I think part of the problem is visceral reactions like this. Understandable, considering the scope of the problem we're facing, but I'd ask people to exercise a little empathy for the other side, consider that our instincts may be wrong in at least limited situations, and generally do more listening. COVID had exacerbated the political problems in our country, but it didn't create them, and they'll still be here when COVID has been exterminated. Something for us all to work on.
In Australia the powers of the states and federal government are set by the constitution. The feds don't have jurisdiction in many areas. It has to be a team effort. So they have whole of government meetings to work out a common, co-ordinated approach. We see a common message and have federal government support for the states but each state is free to implement measures appropriate to their local situation.
I think this consensus driven approach is the only way it can work. The federal government implementing border security, helping with international trade, mobilising military, providing funding. States legislating isolation, enforcing law and order, organising hospitals and testing. Australia has a much smaller population, fewer states and less political extremes. It would be easy to dismiss our relatively good performance in this crisis as due to our isolation and geography. But I think our political system has worked well for us. Even though I don't like some of our political leadership and don't consider them very effective normally, even their worst efforts are looking good compared to what I see elsewhere in the world.
I think in a crisis like this if you rely too strongly on a quarterback to take control you can get into a lot of trouble if your quarterback turns out to be useless or even detrimental. The elected king model is too risky. An executive controlled by the legislature is far more responsible and effective.
When you restrict prices to below a arbitrary level of any good, you get shortages during those periods when the price should be above that level.
https://www.businessinsider.com/coronavirus-uk-nurses-forced...
so, doesn't really work no, but is a desperate measure which is at best better than nothing.
Until it doesn't work and it takes down all of production.