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Miscalculation at every level left U.S. unequipped to fight coronavirus
- 11thEarlOfMar 6y agoWhat are the disaster vectors that the government should plan and equip for? What scale should be prepared for each?
- jakeogh 6y agohttps://www.washingtonexaminer.com/washington-secrets/new-warning-covid-19-nothing-compared-to-emp-295-million-dead https://www.washingtonexaminer.com/washington-secrets/new-wa...
- vikramkr 6y agoI still remember how when the pandemic was breaking out, I and my colleagues in the lab were not taking this seriously because we were so confident we'd be able to get it under control. All we had to do was test rigorously, and, like c'mon. It's just qPCR. I remember overconfidently asserting that, like, the USA invented PCR - we know how to do it. laugh out loud. Hell, I had a plate in the machine as I was speaking! Colleagues agreed. After all, it only got so bad in china because they were covering it up, right? We just gotta run more tests, trace, and isolate. The stuff we were working on the lab was hard fundamental questions - the science needed to stop the pandemic was some PCR and quarantining people. And, the CDC was developing our own diagnostic instead of using the WHO's, but that makes sense, they're the CDC. What were the odds that they'd screw up so badly that the FDA would describe conditions as so bad they'd be reason enough to shut down the lab if they weren't the CDC? What were the odds that our friends in testing labs would find themselves describing the CDC as having "simply failed at molecular biology" [0]? Of course, I use the past tense when describing our feelings about our research since we're certainly not working on it now. It's all nonessential. We're not allowed to go to the lab now unless you really need to water the plants or feed the mice. Just to keep a sustaining gene pool of our model organisms alive, so we can breed back what we need when we get back. We really learned a lesson in humility. Part of miscalculating is having the wrong set of assumptions to derive calculations from. I don't think we were the only people who should have known better that were arrogant and overconfident. We're hearing from some local labs that they have enough reagents to run tests, they have the right primers, they have what they need. But they can't get the cotton swabs they shove all the way up your nose and the little plastic collection things they need to administer the test. Cotton swabs. And little plastic vials. We're talking about developing a vaccine, a cure, privacy-respecting contact tracing, fighting a once in a generation pandemic, keeping the hospital system from being overwhelmed. And we don't have the cheap disposable plastic and cotton things we need to run a test. Truly a lesson in humility. [0]https://www.nature.com/articles/d41586-020-01068-3 https://www.nature.com/articles/d41586-020-01068-3
- throwaway894345 6y agoAdding to the list of CDC failures was their utter failure to procure masks. You know, those things that would be absolutely vital for just about any epidemic or pandemic (never mind the respiratory variety that we knew would be the most likely). It’s not like preparing for an epidemic is the raisin d’etre for the CDC or anything. I’m normally not this snarky, but I too thought the CDC was the one functioning agency but it turns out that it’s closer to the opposite. And not only that, but their utter incompetence killed tens of thousands.
- Consultant32452 6y agoThe CDC, US Surgeon General, and WHO have all claimed with a straight face that masks don't protect you from getting the virus. I guess that's why they didn't see any value in stockpiling them. /s
- ashtonkem 6y agoI too assume that surgeons wear those masks for funsies. Of course the “masks don’t work” was pure, transparent, bullshit from the very beginning. It didn’t even pass the smell test. Now if the argument was “please save masks for healthcare workers first, they’re higher risk” that would be fine. But “they don’t work”? Fuck off. Edit: I’m referring to the CDC here, not you personally, dear HN commenter.
- WrtCdEvrydy 6y agoIf you tell people to save masks for healthcare workers... then the hoarding would have been worse. At least by telling people masks don't work... peer pressure would keep them from buying them?
- ashtonkem 6y agoIt doesn’t look like anyone bought it, masks still sold out quickly and health care providers are still reusing N95 masks. And in exchange the CDC spent a large amount of their credibility; a real lose lose.
- chihuahua 6y agoIt amazes me that the entire strategy of the U.S. government is "Everybody stay inside and wait until this goes away". Two months into this, that still seems to be all there is. "And what if it doesn't go away by itself?" "Then we stay inside for another month!"
- vikramkr 6y agoWe're not waiting for it to go away by itself. We're keeping the rate of spread below the threshold where we overwhelm our hospital capacity. This buys us time to scale testing and develop things like contact tracing, drugs, and vaccines that will be our weapons in the next stage of this fight.
- jimbob45 6y agoHow is this getting downvoted? This is the strategy. We're not gonna wait out the vaccine but we certainly won't have overwhelmed hospitals like Italy.
- deadmutex 6y agoI was wondering the same thing...
- kmonsen 6y agoThe problem is the public patience is running out and we have not really used the time well.
- vikramkr 6y agoWe didnt overwhelm hospitals, we have contact teaching apps developed, we have a drug that's likely to be approved tonight or tommorow, and we have multiple vaccines in trials. We should have done a far better job early on, especially with testing, but the biopharma sector has risen to the challenge to move faster than basically every before.
- vikramkr 6y ago
- fermienrico 6y agoI am not great at markets, startups, business ventures, etc. But I feel like these things are broken: * Governments and only governments can and should prepare for national emergencies, because saying Hospitals don't have enough PPE for pandemics is like saying your local farm doesn't have enough stockpile of rice to server the public during a famine/war. Private institutions have no incentives to serve the greater good of the country. * Manufacturing is an industry every nation should invest in. If labor is expensive, the government should subsidize it so that the essential skills to manufacture and the infrastructure to do so remains functional even though market forces tells consumers otherwise. "Made in Switzerland" marketing can only do so much when the T-shirt costs CHF 120 vs. CHF 11.99 on Amazon which is probably made in Bangladesh. I am not saying govt should subsidize T-shirt manf, just trying to make a point. * Dismantle short-term capitalism that exists in the stock market. Public companies should disclose their financials on a yearly basis or even every other year. Capitalism needs to be refactored to orient itself for long-term gains. Also making it illegal to not act in the interest of share holders is an insane law - CEOs should have the ability to put moral, environmental and other concerns in front of their priority list and not just creating value for the shareholders. This whole system is messed up. * Executives sold off their country's soul to China, made a bank, cut corners, fucked consumers and went to the bank laughing. They paid off senators and govt officials, created a greater divide in the income distribution around the world. Limit executive pay for public and private firms. * Reliance on China needs to change, diversify manufacturing supply chain. Just making sanitizer in US doesn't help if 90% of the ingredients are shipped from China.
- solotronics 6y agoI don't think limiting executive pay is the answer, that would punish people who did nothing wrong. It's treason to sell out your country under foreign influence and it should be tried as such. China figured out our weakness is decision makers can be bought or coerced and we don't have the backbone to do anything about it. A good place to start would be enforcing the FARA https://en.m.wikipedia.org/wiki/Foreign_Agents_Registration_Act https://en.m.wikipedia.org/wiki/Foreign_Agents_Registration_...
- dnautics 6y ago> Private institutions have no incentives to serve the greater good of the country. What are the incentives for government to serve the greater good of the country, specifically, why should government be uniquely qualified to decide what is good for everyone. As the old joke goes, "democracy is the belief that the people know what they want, and they deserve to get it, good and hard". But nobody in the world really lives in a democracy, it's even worse! There's indirection. To believe that governments are qualified to serve the "greater good" is to believe that people are qualified to select people who are good at judging the greater good. And that's not even counting the next layer of indirection. You're really hoping people are qualified to select people (politicians) that select people (unelected bureaucrats) that know what the greater good is. There are many, many cases, when private enterprise (often, but not exclusively, for-profits operating in a nonprofit/goodwill capacity) has been the most effective responder in national emergencies, for example Walmart immediately providing tons of supplies in the wake of Hurricane Katrina. There is a wide window of human activity between a selfish money grubbing capitalist firm, and the government.
- colmvp 6y agoI live in Canada and our response between January - mid March was in line with the U.S. where the government said things like "the risk to Canadians was low" and "asymptomatic people are not main drivers of epidemics." That laissez-faire attitude perpetuated the belief that we didn't need to screen people at airports, or force people coming in from hot zones to self-isolate for 14 days. Meanwhile, a country like Vietnam which doesn't have the same technological or financial resources as North America managed to quell the spread through mass quarantines and aggressive contact tracing done as early as February. They literally fenced off a village that had one known infection. Taiwan acted quickly and decisively throughout the key time periods of the crisis. Things like stockpiling and producing more PPE in January, making quarantine taxi's ferry potential infected to their homes instead of allowing them to take public transit, using technology to aid with contact tracing, mandatory use of masks in public spaces, thermal screenings at airports and stations... Looking back, I think we both woefully under-estimated the potential for asymptomatic/pre-symptomatic individuals to spread the virus. As a society we looked at the low numbers and scoffed at the idea of doing proactive preventative measures... until it all hit the fan and we had to hard stop.
- Ididntdothis 6y agoi think there is a lot of superiority feeling in Western countries over Asia and then in Western countries against each other. For example when things started happening in Italy the Germans thought that it's an Italian problem. As far as the US goes it was pretty clear that the administration didn't want to deal with this at all at home. So they were constantly behind the curve and did things only when basically forced.
- davidw 6y ago> For example when things started happening in Italy As someone who lived in Italy and now lives in the US, this was driving me absolutely crazy. They have a great health care system, and are a transparent democracy. When things started to happen rapidly there, it was very, very clear that the same situation would play out in the US, and yet there were still a lot of "just a flu" people.
- jakeogh 6y agoThe US beat every single expert pre-peak total deaths prediction; by a lot. There are supply chain issues to fix, and the few spots that could not deal with the case load need to be fixed, but by any scientific measure against the predictions, we did excellent. https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf https://www.imperial.ac.uk/media/imperial-college/medicine/s... p16: "In the most effective mitigation strategy examined, which leads to a single, relatively short epidemic (case isolation, household quarantine and social distancing of the elderly), the surge limits for both general ward and ICU beds would be exceeded by at least 8-fold under the more optimistic scenario for critical care requirements that we examined. In addition, even if all patients were able to be treated, we predict there would still be in the order of 250,000 deaths in GB, and 1.1-1.2 million in the US." EDIT to rrss's comment: First, note that ~60k is how many people died and tested positive AND were coded as COVID-19. It's not necessairly how many people died because of a COVID-19 infection. We will not know the real #'s until all-cause death is examined. There appears to be a significant drop in "normal" pneumonia deaths for example. It also ignores the error bars on the testing false/positive/negative rates. Second, I'll restate: The US beat every single explicitly enumerated via a integer expert pre-peak total deaths prediction; by a lot. If the authors had given a table for the US, we could see what their model predicted, but they did not, and _you_ assuming that the US is a linear relation to GB may or may not be accurate.
- icelancer 6y ago>> The US beat every single expert pre-peak total deaths prediction; by a lot. This is mostly because the UW IHME model was brutally terrible as was the Imperial College modeling. They predicted insane amounts of death that had no chance of happening while baking in social distancing orders. We massively overreacted and the convenient out is "well, we beat the models, that's a good thing!" Not if the dose was more poison than antidote. I could have predicted 5 million deaths pulling it out of my ass and I shouldn't get credit for the US coming in under that estimate.
- jakeogh 6y ago"We massively overreacted" I agree, but that was not an accident. Cui bono? Seems worth repeating: "We can't let the cure be worse than the problem itself" https://twitter.com/GPIngersoll/status/1255564315891032064 https://twitter.com/GPIngersoll/status/1255564315891032064
- neonate 6y agohttps://archive.md/qrkt3 https://archive.md/qrkt3
- hanniabu 6y agoI think calling it a miscalculation is beyond extremely generous.
- avs733 6y agoIt's the wall street journal. They want to blame government...not a lack of leadership by the party they best align with. The pervasive use of passive voice is a dead giveaway.
- dirtyid 6y agoEveryone should read: The ‘Red Dawn’ Emails: 8 Key Exchanges on the Faltering Response to the Coronavirus https://www.nytimes.com/2020/04/11/us/politics/coronavirus-red-dawn-emails-trump.html https://www.nytimes.com/2020/04/11/us/politics/coronavirus-r... Full emails here: https://int.nyt.com/data/documenthelper/6879-2020-covid-19-red-dawn-rising/66f590d5cd41e11bea0f/optimized/full.pdf https://int.nyt.com/data/documenthelper/6879-2020-covid-19-r... It seems like experts at least at an exceedingly clear grasp of the situation, with fair accurate predictions based on available data on the time. It doesn't seem like there was much "miscalculation" by subject matter experts, but bureaucratic incompetence on many levels that still persist.
- 0xddd 6y agoWhy is this downvoted? I'm about a quarter through and have found this totally intriguing. Their concerns in late January seem spot on. I'm glad it got shared.
- RickJWagner 6y agoOf the sources I read for coronavirus news is a daily chart posted on RealClearPolitics. Per today's chart, the US has the most confirmed cases, the most tests taken, and one of the lowest deaths per million. It's tough to judge which countries are doing well and which aren't, even given stark contrasts in policy. I don't think it's possible to harshly condemn (or praise) anyone at this point.