Saturday, March 28, 2020
A Few Thoughts on COVID-19 - Part II
One week ago, I wrote:
As of today, the global COVID-19 fatality rate (deaths divided by aggregate confirmed infections) is about 4.1%.
We know that the actual fatality rate is probably significantly lower than 4.1% because not everyone who has been infected has been tested.
There are a lot of other factors leading to uncertainty over the actual fatality rate from COVID-19 that I didn't write about. There is an excellent discussion of the "Coronavirus (COVID-19) Mortality Rate" that elaborates on those factors. I recommend it.
Today, the crude global COVID-19 fatality is about 4.6% per figures from the UW Novel Coronavirus (COVID-19) Infection Map. I still have every expectation that the final rate will be much lower than 4.6% globally, in Italy, the US, and elsewhere. However, because of the failures mentioned in my earlier post I still fear that "the progression of the COVID-19 in the US will likely resemble Italy's trajectory more closely than South Korea's or China's." Nothing that's happened in the last week has dissuaded me from that view although I remain hopeful something will change.
A week ago, I also wrote: "By the end of next week we may start to see how effective efforts to flatten the curve have been in Washington state." The Governor of Washington believes this may be the case but in my reading of the data it's still too soon to know for sure.
I want to elaborate a bit on the comparison I made between the US and South Korea. China, in my opinion, is the wrong place to look for comparisons. Although China has some aspects of a market economy, large and important entities are state-owned enterprises directly controlled by the Communist Party of China (CPC) and the remaining sectors are subject to indirect CPC control in the one-party authoritarian regime.
There is evidence that the Chinese government suppressed key information about the virus at least in the early stages. In contrast, South Korea has a modern, mostly private market economy with a political system that is, by one measure, at least as democratic as the United States' "flawed democracy" (but see here for a different ranking).
One of the big mistakes that many people will undoubtedly make in the aftermath of COVID-19 is to demand a larger, more centralized public health and medical system in the US. One of the big pitfalls of such thinking is that centralization creates the risk of severe consequences from a single point of failure.
We are actually seeing that play out in the US where state and local public health agencies and officials take their lead from the federal government and were slow to react appropriately to the threat of COVID-19. They were also hamstrung by their dependence on the Centers for Disease Control and Prevention (CDC) to roll out COVID-19 testing and misplaced reliance on supplies from the Strategic National Stockpile (SNS).
One counterargument is, yes, but if the federal government had done its job correctly then we wouldn't be in this situation. True enough but there are no guarantees that when a crisis develops there will be an able, humane leader at the helm of the large, centralized ship of state.
I am aware of no compelling evidence that, say a President Hillary Clinton, would have prepared for or handled the COVID-19 crisis markedly better than Trump. Speculatively, we can say she may indeed have risen to the challenge of COVID-19 but Clinton would have been under the same pressures by the investor class not to disrupt their profit-taking and to win re-election this year.
More crucially, the lapses in the CDC and the SNS, for instance, didn't develop under Trump alone. I have been unable to find a concise depiction of inflation-adjusted CDC annual budgets (there is this though) but it's clear that the Obama administration proposed significant cuts in 2011 (-11%). In 2013, the Obama administration again proposed more cuts in "biodefense and emergency preparedness programs" along with a $38 million reduction in the "allocation for the Strategic National Stockpile of emergency medical supplies".
And as NBC reports:
[The] U.S. strategic stockpile isn't intended to be the solution to a crisis. It's designed to be used as a stopgap during emergencies. The stockpile has limited resources, government officials and public health experts say, which weren't at full capacity even before the coronavirus was on the horizon.And:
The stockpile wasn't at full capacity before the COVID-19 outbreak in the U.S., in part because it never fully replenished some of the critical supplies used in the 2009 H1N1 pandemic response ...A 2016 report published by the National Academies repeatedly raised concerns about the SNS inventory and the logistics of distributing it in an emergency. The chair of the committee that prepared that report, Dr. Tara O'Toole, presciently told NPR in 2016:
"We have drastically decreased the level of state public health resources in the last decade. We've lost 50,000 state and local health officials. That's a huge hit," says O'Toole, who wishes local officials would get more money for things like emergency drills. "The notion that this is all going to be top down, that the feds are in charge and the feds will deliver, is wrong."My point is that the inability and failure in the US to implement the successful model of South Korea to tamp down COVID-19 via widespread testing, contact tracing, and isolation of the exposed or infected was born of a longstanding failure of the values and priorities of the bipartisan political establishment and by the servile dependency and doltish complacency of the American people who keep electing them. Trump surely deserves a lot of blame for his failures but much of the finger pointing by, for example, Michigan Gov. Whitmer, is simply not grounded in fact and is counter-productive, self-interested blame-shifting by culpable partisans in the midst of a major crisis.
It bears stating that governments weren't invented for the well-being of commoners and only servile fools would willingly depend upon them for that. Governments were created to secure and enhance the power of the already powerful and to provide rhetorical cover for that domination. That is not to say they cannot potentially be transformed by people to more closely reflect the rhetoric of, say, "life, liberty, and the pursuit of happiness" but we should never forget that decent treatment of ordinary people is, at best, a means, not an end, of government.
If we are to have a centralized state or any state at all then, ceteris paribus, one that could competently stop an COVID-19 epidemic, for instance, would be preferable but this is a false dichotomy. There are other, better ways for humans to organize themselves free from the coercive state if only we will imagine and create them.
See also: "A Few Thoughts on COVID-19"
Labels: anarchism, COVID-19, government, health, medicine, politics, science, Trump
PS would you still want a tracer app if it was made in Israel? Or the military to do tracing by interviews and deliver a compulsory vaccine? S. Korea does not have, shall we say, quite the same fondness for our bill of rights that I suspect you do.
: Sunday, May 24, 2020 12:07:00 AM << Home
