The COVID-19 story: mistakes were made

by Fabius Maximus 

Summary: Surviving a national crisis requires a clear vision of the world, yet that’s the first thing we lose. Here are examples of our confused and politically biased perspectives on the COVID-19 epidemic. We can’t afford them.

Stop COVID-19
AdobeStock-324483863 by thanakorn.

(1)  Let’s use COVID-19 as a tool to attack Trump!

From the Daily Kos: “Along with CDC, USAMRIID has been defunded. This doesn’t look very bright. Updates.” Almost everything in this is false or in a misleading context, as should be obvious when the author opens by references to “Fthrump.” Leftist websites overflow with “stories” like these.

  • CDC was not “defunded.” Trump proposed reducing its budget by 16% (not “defunding” it), as he has done every year. But Congress – not being fools, as Trump is – instead increased it. See the details.
  • The story given about Americans evacuated from the Diamond Princess cruise ship is nonsense. The WaPo story gives actual information about the complex decisions involved. This LAT story describes their handling after return to the US (“All are under a federally mandated 14-day quarantine on the bases.”).
  • The statement that “It is of course extremely likely that one of these DHS or HHS people spread the virus” is just made-up. The San Francisco Bay area has hundreds or thousands of people recently returned from China (300 in Santa Clara County).
  • About the “index case” of community transmission. Headlines ignored the official statement that this was a “possible case” – the verdict comes only after completion of contract tracing (begun aprox. February 27) to determine whom the infected person came in contact with.
  • The story about USAMRIID is one-sided; the writer did not even try to find out the reason for the funding cut.

(2)  Mistakes were made!

This is a favorite “dog bites man” headline by journalists pretending to be indignant (I assume they’re pretending, and not just ignorant). Thousands of institutions around the world are dealing with possible cases of COVID-19 (it is difficult to distinguish from the flu). And mistakes were made. This Business Insider is typical: “15 mistakes by public health officials and ordinary people that helped spread the coronavirus around the world.” by Sophia Ankel. Only 15! That’s pretty awesome in a global epidemic caused by a new virus.

Ms. Ankel does not ask what level of funding would create the public health machinery capable of handling an epidemic like this with the near-perfect effectiveness that she feels appropriate. Or if anyone would pay it, especially in the world’s less-developed nations. Like China.

(3)  China is incompetent and corrupt and lying!

Naturally, after a decade of the US government’s propaganda demonizing China, the COVID-19 epidemic has brought forth a tsunami of hating on China. China screwed up its initial response. Would other nations with similar GDP per capita, such as Mexico or Argentina, have done better?

Poor nations have weaker public health systems than rich ones. China’s GDP per capita is $10k; America’s is $65k. Our standards cannot be their standards.

More importantly, while their initial steps were bungled – their response afterwards was best-ever-by-anybody. They quickly sequenced the virus’ genome and developed four diagnostic kits. Their quarantines have contained the epidemic to one province (so far), so that it appears to have peaked aproximately on February 1.

My guess is that history will not remember the inital errors, but will give accolades to what followed. Americans can mock, but this is the response of an emerging superpower. Will we do as well, with our greater wealth and resources?

(4) The CDC is incompetent!

See the CDC’s Fact Sheet to compare their responsibilities with their funding. The CDC’s 2019 budget was $7.3 billion dollars. Of their 2020 budget, $2.6B funds their “Protecting Americans from Infectious Diseases” operations.

  • $1.3B for HIV/AIDS, Hepatitis, STI, and TB (STI: sexually transmitted diseases).
  • $730M for Immunization and Respiratory Diseases (including those like the flu and COVID-19).
  • $509M for Emerging and Zoonotic Infectious Diseases.

For comparison, a Virginia-class submarine costs $1.8 billion (not including the massive R&D cost). Production is running over 10 months behind schedule.

Much of the public health machinery is at the State and local level. The CDC does not have God-like authority over them. Also, the FDA and Health and Human Services are major players, and often have little understanding of the imperatives of an epidemic. Coordination is often difficult. Rational decision-making is sometimes impossible, even before political appointees come to the table.

The big complaint against the CDC is that they choose not to use the testing kits developed in China, Germany, and Hong Kong – as most other developed nations have (many more kits are under development) – and then their kit produced too many inconclusive results. The FDA then (inexplicably) prevented the use of kits produced by others. See more about this in these articles: NY TimesNature, and Science. Here is a Twitter thread with one expert’s analysis of how this happened.

As explained at the CDC’s Feb. 28 media briefing, kits are now in mass production. Combined with other reagents that CDC has procured, there are now enough testing kits in the US to test more than 75,000 people. More are being rapidly manufactured. In addition, CDC has two laboratories conducting testing for the virus that causes COVID-19. CDC can test approximately 350 specimens per day.

Their February 29 status report says that “Commercial labs are working to develop their own tests that hopefully will be available soon. This will allow a greater number of tests to happen close to where potential cases are.”

The FDA has changed its policy, allowing hundreds of labs to test for the disease.

The big picture

Lost in all the hysterical finger-pointing is the big picture. This epidemic is a milestone in history in terms of the rapid and powerful response of the world’s public health agencies. China appears to have contained the epidemic to Hubei Province, and it peaked aprox. February 1 (of course, that could change). Ditto for the rapid development of testing kits. Kits were distributed a month after COVID-19 was identified. For comparison, it six months to do this for the coronavirus responsible for the 2002–2003 SARS outbreak (details here).

As for all those mistakes, epidemics are like wars. Each has unique challenges. They are infrequent, so there is little practice-makes-perfect. The pressures are immense to make fast decisions, with horrific consequences for being wrong. Mistakes are inevitable. As Clausewitz said at the start of Chapter 7 in On War …

“So long as we have no personal knowledge of war, we cannot conceive where those difficulties lie of which so much is said, and what that genius, and those extraordinary mental powers required in a general have really to do. All appears so simple, all the requisite branches of knowledge appear so plain, all the combinations so unimportant, that, in comparison with them, the easiest problem in higher mathematics impresses us with a certain scientific dignity.

“But if we have seen war, all becomes intelligible; and still, after all, it is extremely difficult to describe what it is which brings about this change, to specify this invisible and completely efficient Factor. Everything is very simple in war, but the simplest thing is difficult. These difficulties accumulate and produce a friction, which no man can imagine exactly who has not seen war.”

Unrealistic expectations ‘R US

Our unrealistic expectations – especially desiring services we won’t pay for – call into question our ability to govern ourselves. Airlines are an example of our values in action. A large number choose flights based on price, so that tiny differences in price mean big differences in an airline’s revenue. So they must cut prices to the bone, packing people in under circumstances no self-respecting farmer would inflict on his stock. Then we whine about the conditions.

This is the kind of thing that makes the 1% believe that they are better fit to rule than we are. But we can do better. Let’s respond rationally to this crisis and prove them wrong.