3 ms·

> That's not the same as "no strategy", because this level of decentralization is how nation-states work today. It's one thing to leave pandemic response to me

by aazaa 6y ago

> That's not the same as "no strategy", because this level of decentralization is how nation-states work today. It's one thing to leave pandemic response to member countries like the EU does. Each country knows it's responsible for its own response. Money is budgeted and spent specifically for this purpose. That's not the system in the US - or hasn't been. The Federal government maintains what, until recently, was the world's premier infectious disease-fighting organization - the CDC. The implication was that pandemic response occurs through this organization. In the past, this is exactly what happened. You may recall the one state (Washington) earlier this year whose brave scientists decided to test for COVID on their own. They were told in no uncertain terms from the feds to stand down or else. So the idea that this pandemic response is up to the states doesn't hold water. Had the states known that they'd be left twisting in the wind, they could have taken steps beforehand. That's one likely outcome of this event (assuming it has a clean endpoint): states realizing they really are on their own - and acting like it.

bhupy 6y ago
> That's not the system in the US - or hasn't been. The Federal government maintains what, until recently, was the world's premier infectious disease-fighting organization - the CDC. The implication was that pandemic response occurs through this organization. In the past, this is exactly what happened. While you're right that the Federal government has the CDC, every single US States has its own infectious disease/health agency[1]. Furthermore, the EU also has its own centralized disease agency[2]. Structurally, both the US and EU are very similar in this regard. The only key difference is that (to your point) the EU States may override the ECDC, whereas US States may not — certainly a worthwhile policy change for the US. > So the idea that this pandemic response is up to the states doesn't hold water. Had the states known that they'd be left twisting in the wind, they could have taken steps beforehand. But this is factually incorrect, States did take steps beforehand. By March 23, every single State declared a state of emergency, and 48/50 States closed their schools. By as early as March 9th, the States were doing the VAST majority of COVID testing[3]. As of right now, the US has administered more tests per capita than Belgium, Australia, Ireland, Italy, New Zealand, Canada, Switzerland, Germany, Austria, Norway, and Sweden (to name a handful). This is not because the US has a nationwide testing regime, rather it is because testing systems have been administered at the State level[4]. [1] https://www.ehdp.com/links/us-shas.htm https://www.ehdp.com/links/us-shas.htm [2] https://www.ecdc.europa.eu/en https://www.ecdc.europa.eu/en [3] https://twitter.com/balajis/status/1238574921346732032/photo/1 https://twitter.com/balajis/status/1238574921346732032/photo... [4] https://www.worldometers.info/coronavirus/country/us/ https://www.worldometers.info/coronavirus/country/us/
- detaro 6y ago
  Random anecdote about the difference: I (in Germany) can't really remember seeing anything about what ECDC said or thinks in the past months in the media, only about country-level (and lower) authorities. Whereas US-CDC seems quoted quite a lot in US media.
  - bhupy 6y ago
    Oh for sure, the CDC is certainly more talked about by the media, but the power and structure of the agencies is fairly similar. It's only a matter of time until EU's agencies impose supremacy on its Member States. The EU supreme court is already starting to penalize member States for violating policies[1]. [1] https://www.reuters.com/article/us-ecb-policy-germany-ecj-idUSKBN22K1HC https://www.reuters.com/article/us-ecb-policy-germany-ecj-id...
    - detaro 6y ago
      ECDC has primarily the "power" to coordinate data exchange between member states, and afaik no authority to force lower-level health authorities or healthcare providers to do anything, unless member states were to explicitly adopt their suggestions as binding in local law. The mess that's going on with ECB is an IMHO quite special situation (which also is an odd example for "already starting to penalize for violating policies". There is no "starting to", obviously EU law has enforcement tools - although the court itself can't use them)
  - aazaa 6y ago
    The budgets are not even close. See my sister comment.
- aazaa 6y ago
  > While you're right that the Federal government has the CDC, every single US States has its own infectious disease/health agency[1]. Those appear to be general public heath agencies with names like: "Department of Health Services"; "Medicaid"; and "Department of Health and Environment". I don't see one mention of the word "infectious" to indicate specialty. None appear to be a unit with a mandate along the lines of "Detecting and responding to new and emerging health threats" https://www.cdc.gov/about/organization/mission.htm https://www.cdc.gov/about/organization/mission.htm or "Leading research to understand, treat, and prevent infectious, immunologic, and allergic diseases" https://www.niaid.nih.gov https://www.niaid.nih.gov > Furthermore, the EU also has its own centralized disease agency[2] "ECDC has approximately 300 staff and commands an annual budget of over €50 million." https://en.wikipedia.org/wiki/European_Centre_for_Disease_Prevention_and_Control https://en.wikipedia.org/wiki/European_Centre_for_Disease_Pr... Compare with: "CDC's budget for fiscal year 2018 is $11.9 billion." https://en.wikipedia.org/wiki/Centers_for_Disease_Control_and_Prevention#Budget_and_operations https://en.wikipedia.org/wiki/Centers_for_Disease_Control_an... Similar population, very different numbers. > By March 23, every single State declared a state of emergency, and 48/50 States closed their schools. I was alluding to steps that might have been taken many years ago. Like, for example, establishing rapid response teams. Like, for example, giving states carte blanche to do their own testing when needed and not be forced to wait around for the CDC to do something. Certainly not reprimanded for taking the initiative.

by aazaa 6y ago

bhupy 6y ago

> That's not the system in the US - or hasn't been. The Federal government maintains what, until recently, was the world's premier infectious disease-fighting organization - the CDC. The implication was that pandemic response occurs through this organization. In the past, this is exactly what happened. While you're right that the Federal government has the CDC, every single US States has its own infectious disease/health agency[1]. Furthermore, the EU also has its own centralized disease agency[2]. Structurally, both the US and EU are very similar in this regard. The only key difference is that (to your point) the EU States may override the ECDC, whereas US States may not — certainly a worthwhile policy change for the US. > So the idea that this pandemic response is up to the states doesn't hold water. Had the states known that they'd be left twisting in the wind, they could have taken steps beforehand. But this is factually incorrect, States did take steps beforehand. By March 23, every single State declared a state of emergency, and 48/50 States closed their schools. By as early as March 9th, the States were doing the VAST majority of COVID testing[3]. As of right now, the US has administered more tests per capita than Belgium, Australia, Ireland, Italy, New Zealand, Canada, Switzerland, Germany, Austria, Norway, and Sweden (to name a handful). This is not because the US has a nationwide testing regime, rather it is because testing systems have been administered at the State level[4]. [1] https://www.ehdp.com/links/us-shas.htm https://www.ehdp.com/links/us-shas.htm [2] https://www.ecdc.europa.eu/en https://www.ecdc.europa.eu/en [3] https://twitter.com/balajis/status/1238574921346732032/photo/1 https://twitter.com/balajis/status/1238574921346732032/photo... [4] https://www.worldometers.info/coronavirus/country/us/ https://www.worldometers.info/coronavirus/country/us/

detaro 6y ago
Random anecdote about the difference: I (in Germany) can't really remember seeing anything about what ECDC said or thinks in the past months in the media, only about country-level (and lower) authorities. Whereas US-CDC seems quoted quite a lot in US media.
- bhupy 6y ago
  Oh for sure, the CDC is certainly more talked about by the media, but the power and structure of the agencies is fairly similar. It's only a matter of time until EU's agencies impose supremacy on its Member States. The EU supreme court is already starting to penalize member States for violating policies[1]. [1] https://www.reuters.com/article/us-ecb-policy-germany-ecj-idUSKBN22K1HC https://www.reuters.com/article/us-ecb-policy-germany-ecj-id...
  - detaro 6y ago
    ECDC has primarily the "power" to coordinate data exchange between member states, and afaik no authority to force lower-level health authorities or healthcare providers to do anything, unless member states were to explicitly adopt their suggestions as binding in local law. The mess that's going on with ECB is an IMHO quite special situation (which also is an odd example for "already starting to penalize for violating policies". There is no "starting to", obviously EU law has enforcement tools - although the court itself can't use them)
- aazaa 6y ago
  The budgets are not even close. See my sister comment.
aazaa 6y ago
> While you're right that the Federal government has the CDC, every single US States has its own infectious disease/health agency[1]. Those appear to be general public heath agencies with names like: "Department of Health Services"; "Medicaid"; and "Department of Health and Environment". I don't see one mention of the word "infectious" to indicate specialty. None appear to be a unit with a mandate along the lines of "Detecting and responding to new and emerging health threats" https://www.cdc.gov/about/organization/mission.htm https://www.cdc.gov/about/organization/mission.htm or "Leading research to understand, treat, and prevent infectious, immunologic, and allergic diseases" https://www.niaid.nih.gov https://www.niaid.nih.gov > Furthermore, the EU also has its own centralized disease agency[2] "ECDC has approximately 300 staff and commands an annual budget of over €50 million." https://en.wikipedia.org/wiki/European_Centre_for_Disease_Prevention_and_Control https://en.wikipedia.org/wiki/European_Centre_for_Disease_Pr... Compare with: "CDC's budget for fiscal year 2018 is $11.9 billion." https://en.wikipedia.org/wiki/Centers_for_Disease_Control_and_Prevention#Budget_and_operations https://en.wikipedia.org/wiki/Centers_for_Disease_Control_an... Similar population, very different numbers. > By March 23, every single State declared a state of emergency, and 48/50 States closed their schools. I was alluding to steps that might have been taken many years ago. Like, for example, establishing rapid response teams. Like, for example, giving states carte blanche to do their own testing when needed and not be forced to wait around for the CDC to do something. Certainly not reprimanded for taking the initiative.