How a Competent Administration Might Have Contained C19

Pacific Rim nations have demonstrated an uncomfortable fact about the C19 pandemic. It was manageable. Dotted with super-dense cities, close to the original outbreak, with less time to prepare, developed countries in Asia have suffered relatively little from this pandemic.

Eight of the ten countries with the highest C19 death rates are NATO members. The other two are Sweden and Switzerland. Meanwhile among Pacific Rim countries closer to China, death tolls have been small. As of May 15, 2020, the US has suffered 262 C19 deaths per million people. Japan, 5. South Korea, 4. New Zealand, 4. Australia, 4. Singapore, 3. Hong Kong, .5. COVID-19 has demonstrated the degree to which the US has become the center of global political dysfunction, also highlighting the cost to those who depend on us for leadership.

It didn’t have to be this way. Disease is personal. Pandemic is politics.

We know what could have been done to stop this pandemic in its tracks because the people who organized our successful responses to previous emergencies analyzed their results, refined their playbook to incorporate lessons learned, and built a sophisticated infrastructure for the next pandemic. They went so far as to reduce their recommendations to a 70-page flipbook of guidance, submitted by the White House’s office for pandemic response in December 2016.

The guide is simple enough for a layman to follow, a necessity since we don’t count on our Presidents or legislative leaders to be experts in infectious disease. It breaks down threats by type and severity, literally color-coding its categories and required responses into a format that even an intern could have followed and implemented.

How might a competent administration have responded to the C19 pandemic? It’s possible to piece together an answer by consulting this simple guide. More suggestions can be found by analyzing steps taken by other governments in response to this outbreak and those adopted by previous US administrations in response to others. Without resorting to hindsight, it’s still possible to sketch how an administration of average competence might have responded, and how they might have prevented the disaster that’s left us locked in our homes.

Our start date for any review should be January 3, 2020. That’s the day CDC officials were warned by their Chinese colleagues of the coronavirus outbreak in Wuhan. This information was immediately communicated to the HHS Secretary, Alex Azar. The President was not briefed.

Details of that exchange have not been released, but it was publicly known that dozens of people had contracted a novel respiratory virus which was resulting in dangerous pneumonia. Researchers were not yet certain that the virus was being transmitted via human contact and no one had yet died.

Consulting our pandemic playbook, on January 3 we were in category 1c, orange, defined as “credible threat.” We had confirmation of multiple human cases of a PPP (pandemic potential pathogen) somewhere in the world. As a respiratory illness, it would already be suspected of being a Tier 1 pathogen, the most dangerous category which includes such infamous killers as SARS CoV viruses, specifically called out in the playbook for their high attack rates and mortality ratios.

Response requirements at 1c begin on page 19. They include a long list of assessments of the target country’s capabilities, assessments which must be carried out across numerous agencies from Homeland Security to State and beyond.

Here at home, this stage triggers plans for border screening and travel controls outlined on page 21. No single agency can perform the tasks outlined in this playbook, that’s why this playbook was assembled in the White House and stored there for future Administrations. A response as straightforward as screening travelers to the US, for example, requires the CDC determine the nature of the screening. Homeland Security (TSA and Border Control) have to determine the screening process. FAA has to be consulted to handle potential changes to flights and communicate controls to airlines. The State Department has to collaborate with passport screenings and political issues. The list goes on.

There’s only one person in the US Government with the authority to coordinate a response across all of these entities, the President. All pandemic response begins in the White House, usually by the President designating someone to act in their name, usually also accompanied by a task force of relevant experts. We know what that might look like, since we watched it play out just a few years ago.

In the H1N1 pandemic, which was first detected here in the US, response was swift. The CDC received its first report that the disease existed on April 18, 2009, and its first report of transmission on April 21. President Obama was immediately notified. On April 26 the Administration declared a public health emergency and began releasing medical supplies from the national stockpile, including respirators. The FDA and CDC issued the first available public test on April 28. That’s ten days from first known case on the planet to a test available on a mass scale.

We did not get this quality of leadership from the Trump Administration. In response to the January 3 notification of this pandemic, the Administration took no action and the President was not notified. On that date, the US still had almost three weeks before the disease would be detected here, and two months before it began to spread broadly beyond travelers.

Though the Trump Administration did nothing, other countries didn’t wait. On January 3 Singapore and Hong Kong began screening passengers from Wuhan for illness and launching their broader pandemic response.

Why is a rapid response important? With a novel disease, testing and tracing is the only means of containment. Unlike a bacteria which might live, breed and thrive on surfaces on in the environment, a virus (like SARS and MERS previously) can be eradicated by cutting off its capacity to spread among humans. The SARS virus that killed hundreds of people has been eradicated. It was eliminated by identifying and isolating its hosts and tracking down all potential infections. There isn’t another way. Testing and tracing get harder the longer you wait, but the requirement never goes away. It will remain the only method of eradicating C19 even after a vaccine is developed. Vaccines merely make this testing and tracking process easier. Fail to isolate the disease and a pathogen can become so widespread as to be endemic, a background element of the microbial biome which will roam and kill at will, indefinitely.

Five days later, on January 8, the source of the infection was identified as a novel coronavirus. Though Chinese authorities were still hedging on whether widespread human-to-human transmission was possible, and no deaths had yet been tied to the disease, it was becoming clear that this was a more serious outbreak than previously acknowledged. By that date, researchers who work with coronaviruses were already sounding the alarm over human transmission. Still, without demonstrated, sustained human-human spread, our pandemic playbook would leave us at 1c, where the President should have been notified and initial planning begun, including airport and border screenings and preparation for testing and tracing. The President was not notified and we did nothing.

On January 10, China announced its first death from the coronavirus. A Chinese researcher released the full genome of the virus on January 11. Also on January 11, a German scientist made available the first reliable mass test for the virus, which was immediately and successfully deployed in Taiwan. Our government had still taken no action.

On January 15, authorities in Thailand and Japan announced they had detected C19 cases in travelers from China who had not visited the Wuhan market. This is the date when a reasonably competent Administration would escalate its response to Phase 2a, as human-human transmission was confirmed. Some of the questions faced by the President at 2a (pages 26-30) for an outbreak abroad include whether an overseas military deployment should accompany the civilian response, how to implement stringent screening requirements, what potential medivac operations might be necessary for US citizens abroad and whether a disaster declaration would be appropriate. The Administration took no action and the President was not informed.

On January 17, the CDC issued its first public briefing on the virus, announcing temperature screenings for passengers at only 3 US airports. Those screenings were only intermittent, with no effort to track travelers who has been to Wuhan, and were never widely deployed. When efforts were made to tighten screenings they were so chaotic that they were quickly abandoned.

On January 18, President Trump was notified of the outbreak by HHS Secretary Alex Azar. The President’s response was to change the subject, asking when limits on the sale of vaping products would be removed.

Our first domestic case of C19 was detected on January 20 in the Seattle area, in a patient who had recently traveled to China. The Administration took no action. This is the same date that the first case was detected in South Korea. There, leaders were notified immediately. A meeting was organized between the South Korean government and pharmaceutical CEOs a week later. South Korea deployed their public testing regimen the following week, on February 3. Other Asian governments, not waiting on leadership from the US, were already deploying their response.  

By the discovery of a US case of C19 on January 20, any administration of average competence, even if they’d missed every signal up to that point, would have snapped to attention. The only means to contain a novel virus is testing, isolation and contact tracing. It’s a formula our CDC has honed since the 1980’s into a powerful machine. It should have begun in force on January 20, but it takes a President to coordinate this multi-agency response, and our President did nothing.

The first known case of local transmission of C19 in the US was identified on January 30 in Chicago, in a family with a member who had traveled to China. There were now at least two US geographies with potential spread. With the disease spreading in the US, by January 30, 2020 the playbook moves to its domestic section, still at Phase 2a, starting on page 36. Everything at this stage assumes a robust network of testing and contact tracing.

When the events of January 30 unfolded, even a weak and chaotic administration should have been spurred to action. The most important next steps would have been the deployment of thousands of tests to the affected areas. CDC contact tracers would have been mobilized, both to trace those potentially exposed and to begin training the hundreds or even thousands of new contact tracers who would potentially be needed later.

Our playbook would also dictate new travel and border controls, along with mobilization of emergency stockpiles of medical equipment. Page 37 references the workforce protections that would need to be assessed, leveraging OSHA and the Institute for Occupational Safety to make sure workers were safe. The playbook also reminds us that coordination with Tribal authorities would be necessary for any capable response.

Page 45 describes methods for imposing a lockdown, including work-from-home rules requirements for the use of protective devices. These are practically a footnote. Lockdowns do not stop a pandemic, they merely buy time for a country that’s fallen behind the curve to set in place the testing and contact tracing necessary for a competent response. If the government fails to implement testing and tracing, then the lockdown and all its damage will have been squandered.

On January 30 there was still time to contain this pandemic. New York City didn’t get its first cases until likely mid-February. Though it was probably present, still undetected, in many locations, contact tracing could have isolated it in major cities, buying time for a response elsewhere. A response launched on January 30 might still have required interruptions in air travel and brief, localized lockdowns while the CDC ramped up testing and tracing. It’s likely that hundreds of people might still have been infected and some might have died, but we might have experienced nothing like what actually unfolded.

Across the weeks after January 20, while Asian countries rushed to build the testing and tracing infrastructure necessary for a capable response, our President continued to deny the threat, characterize it as a political hoax, and even carry on campaign rallies. Individual agencies tried to act, but without coordination from the White House and crippled by the appointment of corrupt and incompetent leadership, they accomplished little.

The CDC activated their response structure on January 17. Border control made halting and frankly pathetic attempts to screen passengers starting in earnest in early February. The FDA took erratic and uncoordinated steps to remove testing constraints, steps which had the perverse result of blocking development of tests, then unleashing a wave of unvetted and unreliable testing. When the Administration formed its task force it was stacked with campaign donors and outright grifters. The President’s corrupt son-in-law ran a shadow response that favored the family’s interests at the expense of the country.

As late as the final week in February the US outbreak of the disease was still contained mostly in the Seattle area. Even that late, a full test and trace scheme, augmented by limited lockdowns in major cities, might have been enough to contain the spread and spare us from what followed. A thoroughly incompetent regime that had disregarded all warnings up to that point might still have cut off a disaster, but it would have required a massive effort, probably calling for the training of thousands of contact tracers, deployment on a spectacular scale of a uniform testing infrastructure, and a lockdown lasting many weeks to dampen spread and buy time. That didn’t happen.

Overseas, as late as mid-February Italy still hadn’t experienced a single known C19 death. NATO members were still looking for leadership from their once-reliable ally, leadership that would never arrive. Accustomed to leaning on the US for guidance, and for crucial test and trace infrastructure in a pandemic, NATO countries would suffer a terrible toll that hasn’t yet abated.

Blame China all you want for their early missteps. They contained the virus. Neighboring countries facing the harshest, earliest exposures to China’s failures all contained the virus. C19 is on its way to becoming a lasting threat to the world thanks to collapse of US leadership, and the resulting conversion of our Atlantic alliance into a giant petri dish.

Where does this failure leave us now? Our pandemic playbook has no colors for the condition we find ourselves in. No one considered the possibility that an American President would blow through 70 pages of warning lights and sirens without lifting one of his stubby little fingers. Nevertheless, the core of traditional pandemic response, testing and tracing, remains our only path out of this crisis. A virus depends on its hosts to spread. You stop a virus by containing its spread, identifying and isolating infected hosts. Do that, the virus may not only abate, but disappear.

No vaccine or treatment will save us from the need to isolate and contain C19. Now that we’ve spread the disease broadly in US and European populations, a vaccine can only be an augment to the testing and contact tracing that will ultimately bring the disease to heel. Talk of “herd immunity” is pathetic. Do you manage malaria by infecting everyone? Is that how sane, rational governments manage tuberculosis or measles? C19 is not a cold. It appears that its pneumonia symptoms may be one manifestation of a much more dangerous immune disorder, one that seems capable of remaining a health threat to patients long after any initial flu-like symptoms have passed.

Even with vaccines, we’ve developed no herd immunity to influenza, the common cold, or previous coronavirus infections. We’ve simply been forced to tolerate their annual death toll. Just as an immunity to the flu is brief, we have no reason to expect that patients cannot contract C19 more than once over a long enough timeframe. How many times have you had a flu vaccine? How many times have you had the flu? There will be no magic cure.

America sits, today, right where we were in January and February and every moment since, still waiting on a competent response from an incompetent President. We will make no progress toward an end to this disaster until capable leadership takes the necessary steps. Those steps get harder and the toll of our incompetence more deadly with each passing day.

Containing this epidemic now will require a moonshot. Fail, and we risk becoming one of those “shithole countries” travelers are warned not to visit, one of those sad, disorganized places where travel requires a dozen immunizations and you can’t drink the water.

It didn’t have to be this way.

Hong Kong hasn’t recorded a local C19 transmission in almost a month. Their citizens are now able to travel in the region with few restrictions. Australia and New Zealand are creating a “bubble” to allow international travel among their lightly effected nations. Well-governed countries with responsible populations are moving past this pandemic, many of them having only experienced very light restrictions on business or movement. They are the new “developed world,” emerging ahead of us into a global hierarchy defined by its resilience and capacity to leverage science.

Meanwhile the US, the nation once regarded as the leader of the free world, leads the world in C19 infections and deaths, with no relief in sight. The disease continues to accelerate outside the big coastal cities, but instead of insisting on a robust response, organized resistance to the pandemic is falling apart. Instead of scientists and doctors leading our response, our future is being dictated by idiots marching with guns to complain about wearing masks. We were warned that “everything Trump touches dies,” but we didn’t imagine it would be so literal.

51 Comments

  1. Outside of WHO’s repudiation of the madman tyrant’s world view, the next sign of the destruction of the u.s.’s soft power is coming up.

    The next G-7 meeting was scheduled to be held June 10-12 at Camp David, and was quite logically converted into virtual meetings. The madman has publicly mulled that he would like to revert that back into an in-person event.

    Now, outside of the entire logistical impossibilities of re-cranking up this into an in-person event, I truly wonder how many leaders would actually show if the tyrant commanded it. Of course, there are several meetings where only the leaders are in the rooms. Indulge in the fantasy that 7 go into a room, 6 come out, and all say “we didn’t see what happened.”

    I truly wonder what would the american response would be to other 6 leaders of the G7 killing the tyrant.

  2. Good news: The tyrant has now said he is taking hydroxychloroquine. That is in spite of the latest study saying it could kill people. That means more of his cult members will as well, and the more that die, the better.

    Bad news, of course, is those that really need it are screwed.

    1. I doubt he’s actually taking it. He’s too unhealthy. I do believe he’s doubling down on his bullshit like a child would and I think he has a financial gain by pushing this drug.

      Gotta love Pelosi’s brilliant trolling. Calling him a fatass under the guise of concern.

  3. This is a fantastic piece, Chris, and I fully agree with Ken Rhodes and others that you should submit this to The New Yorker, Atlantic, NY Times, or other places where it will get a broader audience. People need to see just how badly this response has gone due to Trump and his merry band of incompetent, corrupt hucksters.

    A quick note about your previous post: while we are reasonably sure that Covid transmits via airborne droplets, the question remains *how big* a droplet is required. The size of droplet required makes a big difference in transmission characteristics. The simplest way to think about it is that for large droplets, the effect of gravity is higher than the effect of ventilation (e.g. wind patterns, etc). Which means large droplets drop out of the air and contaminate surfaces before they dry out. OTOH, small droplets are ones in which air effects are more prominent than gravity (they stay in the air longer, carried on air gusts, etc.), and which usually dry out before actually contacting a surface. Large droplet diseases primarily infect people via contact e.g. touching a door knob immediately after someone sneezes on it (although how long something remains infectious after settling on a surface is highly controversial, even for well known diseases like influenza, and is highly dependent on environmental factors like ambient humidity, heat, characteristics of the surface itself, etc.). Whereas small droplet diseases primarily infect people via airborne transmission e.g. someone sneezes and you walk through the mist of mucus before it falls to the ground.

    In the case of covid, just saying that it’s transmitted by droplets or aerosols doesn’t automatically imply that it can only be transmitted by air. We don’t know yet exactly the nature of the droplets that covid survives in, or what type of surfaces, and how long it survives, etc. and indeed, all of these are statements of probability, not certainty (i.e. in 1 million large droplets, some of them will stay in the air long enough to be inhaled by someone else, even if most of them fall to the ground. And of 1 million small droplets, some will fall to a surface and contaminate it).

    I think that the precautions you recommend are reasonable but I just want to emphasize that things still aren’t very clear cut and the best advice is to take every reasonable precaution you can. While wiping down groceries is *probably* excessive, there’s no harm in it; just don’t wipe down open food items with bleach or else you’ll be getting Trump’s favorite treatment with your next meal 🙂

    Regarding the current post, while I agree with everything you say and I’m impressed by the amount of research you must have done to put together this timeline, I think you need to be careful about dumping all of this on Trump’s feet. Sometimes I feel that you’re using Trump as a fall guy for much deeper problems within the conservative platform. I hate to use Covid as a way of whipping on conservatives, but I would assert that, while Trump is a corrupt, feckless idiot, he couldn’t have lit this fire without the groundwork laid by conservatives for decades. And I don’t mean just the crazy Tea Party conservatives.

    The free market, laissez-faire advocates of the “reasonable” wing of conservatives have magnified the mistakes (and willful negligence) of the Trump administration. What do I mean? Republicans have waged a war on competent public services ever since Reagan said “The nine most terrifying words in the English language are: I’m from the Government, and I’m here to help.” It was wrong then (how many people refuse to cash their Social Security checks, or Medicare, or FEMA assistance?). As a result, when government officials, even nominally respected ones like Fauci, are tasked with asking for tremendous sacrifices from us, is it any wonder that a large component of our society doesn’t believe them?

    Reagan’s words were false and incredibly dangerous to maintaining a competent government sector, yet most free market advocates believe it. If the foundational thesis of your style of governing is that 99% of the time, the private sector will be better than the government sector, then pretty soon it becomes true. It doesn’t require Trump to get there.

    2) I know you’re not a free market extremist and that you believe in sensible regulations and market structures. But even this needs to go deeper. Some things just don’t function well as a private market, period, regardless of what regulations and structures are put in place. I’d assert healthcare is one. For example, the reason why we had very little spare ICU bed capacity is because it makes no economic sense to maintain it. To a hospital, an empty ICU bed is a massive money loser, a high fixed cost that needs to stay occupied most of the time to turn a profit. So they either expand services until they fill it, or they cut the bed. Well managed hospitals keep ICUs about 85-95% filled, and this makes absolute micro-economic sense, from the standpoint of an individual hospital. Poorly managed hospitals have wide-open, empty ICUs and eventually either go bankrupt or get bought out (and then usually shut down). Then something like Covid hits, and all of a sudden, those individual micro-economic decisions end up causing us a trillion dollar catastrophe.

    Spare ICU and hospital beds, to deal with disasters, is one of those things that private markets never price in. Normally, that’s where government should step in. And in the past, government would pay for these “inefficiencies” either by having public hospitals as a back-stop, allowing hospitals higher margins so they can afford a little bit of “inefficiency” like keeping beds empty, or simply — when hospitals were non-profit — using that tax subsidy to force hospitals to do non-economic things that were nevertheless beneficial for the community (like keeping spare beds open, or providing care for conditions that don’t make money for the hospital, like trauma). But for-profit hospital chains, with headquarters located far away from the towns the hospitals are situated in, answerable to Wall St. board members rather than boards made up of local community leaders, has led hospitals to be more efficient 90% of the time (yay free market!), and catastrophically harmful the other 10% of the time. In Wall St. the term for this is called picking up pennies in front of a bulldozer. The same logic applies here. But when the bulldozer kills other people and not you, it makes absolutely perfect economic sense to keep picking up those pennies.

    Or take our pharmaceutical companies. South Korea could have a meeting with its pharma companies because of 2 things: First, there is still a sense that corporations have some sort of obligation to their home countries beyond just this destructive notion of “maximize shareholder value”, and second, given their single payer system, the government wields tremendous power over their pharma companies. If the Federal govt. asked the top 10 American pharma companies to meet, half would probably not bother to show up, and the other half would tell the govt to take a flying leap because their shareholders are far more important. Do you think the company that prices lifesaving treatment for deadly Spinal Muscular Atrophy at $2 million for a single dose (no discounts, but if you can’t pay, you can enter your child into their lottery; hope he/she lives long enough to watch which numbers get picked) would shed a dollar of their profit to help contain Covid?

    I could go on, but I’ll end with one final one. It is a national disgrace, and a bigger indication of our third world status than anything, that even after 6 months, our country still cannot manufacture its own adequate supplies of simple things like face masks, alcohol pads, and cleaning wipes. To a free market economist, there is no such thing as “vital to the national interest”. Anything and everything should be outsourced to the cheapest bidder. That holds true even of our defense infrastructure (just look at all the countries we shared our fighter tech to in order to get them to buy a few more F35s), so of course it holds for everything else. And it all works great until it doesn’t. How many 10ths of a penny did we save on shipping our face mask factories to Vietnam? Do they add up to the $10 trillion in economic destruction we face in just the past few months? When a vaccine is finally created, and the only place to manufacture it is in China, because we no longer have any pharma supply chain left in the U.S., will we wait patiently while China commandeers the whole supply to vaccinate their population first? Letting our citizens die because outsourcing allowed Pfizer to save a few bucks on each tablet of Viagra it sells?

    I’m getting riled up so I’ll stop 🙂 But my point is that while Trump is uniquely malignant, his brand of cancer wouldn’t have spread quite so wide without the conservative attack on our national immune system that started decades ago. While I don’t at all suggest that rational conservatives ever wished death on their fellow citizens, I do suggest that their policies (however in good faith they were made) were and remain misguided and if/when we finally move beyond the nightmare of the Trump years, we’ll need to move beyond conservative economic dogma as well.

    1. Do you think we’d find ourselves in this mess if Romney had won in ’12 & ’16? I don’t. We’d be less healthy and prosperous than if Obama & Clinton had won those elections, but I don’t think we’d be experiencing anything remotely like this disintegration.

      I don’t think the problem is “conservatism,” per se. The problem is racism. Conservatism boils down to a preference for evolution over revolution, a kind of pragmatic patience. That patience tends to favor an incumbent, and racism in our system is the incumbent. But patience isn’t always a bad idea, and you want a few conservatives in a room where policy is being made. If you think racism is an inherently conservative problem, go review the racial history of the Roosevelt Administration.

      Those racists who are tearing the country apart would be calmly going about their lives if Romney had won. I’ll bet we would have seen a version of universal health care that would have replaced the ACA. My old editor, Avik Roy, was working with Romney’s campaign on just such a plan, based on Singapore and Switzerland’s models. And no one would be screaming about socialism, because Romney is white as Mama’s wedding dress. A conservative, conscious of the need to address racial injustice (like George Romney), would recognize the value of pursuing that goal under the figurehead leadership of a calming white presence.

      Before Trump, or perhaps before the Tea Party, there was a credible path to a post-racial America that might have run, much more smoothly, through the country’s political right. It would have preserved a lot of ugly class oppression and other baggage, but by coopting an emerging black and hispanic middle class it might have been our best shot at peacefully moving past America’s racist nightmare. Who knows what options might have been available on the other side of that mountain. That option is closed now. Maybe that was always inevitable, but I don’t think so.

      Now we only get to the other side of this moment through force. That’s an unfortunate and dangerous circumstance, but I don’t think it had to be that way.

      1. >] “Before Trump, or perhaps before the Tea Party, there was a credible path to a post-racial America that might have run, much more smoothly, through the country’s political right. It would have preserved a lot of ugly class oppression and other baggage, but by coopting an emerging black and hispanic middle class it might have been our best shot at peacefully moving past America’s racist nightmare. Who knows what options might have been available on the other side of that mountain. That option is closed now. Maybe that was always inevitable, but I don’t think so.

        There’s no path to a post-racial America worth its salt if you have to assuage white fear *again* with a “calming white presence” in the Oval. How many times would we have had to repeat this farce? Until enough old white people finally died and minorities were strong enough in number to offset them?

        That’s not any kind of a victory worth being proud of. It’s just cowardice.

        Even if we knew everything that would happen back then, we still should’ve re-elected President Obama. It was important for this country to show, even when we weren’t mired in crisis, that we could elect an African-American President of the United States. And we aren’t responsible for how millions of people chose to respond to that in the absolute worst possible way.

        Maybe electing Romney would’ve been a calmer alternative, but I don’t believe it was the better one. I wouldn’t change a damn thing.

      2. So this is a two part response. First, about your general response that what’s really the problem is the racists who have hijacked the Republican party and turned it away from genuine conservative ideals. I’m actually with Ryan here. Obama was just about the whitest Black President we could have had 🙂 Heck, he’s only half-black to begin with, and was raised by the white side of his family, pretty much as an upper-middle class white kid, ever since he was a child. If this man was enough to cause half the country to lose their minds that “the Negroes are taking over!”, and wouldn’t even accept that he was a US citizen, much less their President, then I kinda agree with Ryan. There is no period of “calming white presence” long enough to ever get these people over their racist, paranoid tendencies. At some point you just rip off the bandaid.

        I’m willing to consider the possibility that among genuine, non-racist conservatives, there might have been a path to a post-racial future that could be delivered through conservative ideology. I’m certainly willing to believe that guys like Jack Kemp, Bob Dole, and Mitt Romney were sincere in believing in that. But I happen to think they’re wrong, mainly because racism is inextricably tied to classism and economic subjugation, and conservatives have very little to offer about those problems, save for, quite frankly, rejoicing in it and calling for more. Even MLK, in his later years, as you’ve mentioned before, began talking more about economic and class issues and viewed them as integral to his movement.

        Mitt Romney is a great example: he was a moderate Republican who certainly wouldn’t have fanned the flames of the racist wing of his party like Trump. That much is true. But he’s also the one who said 47% of Americans were takers, while people like him were makers. The gall of saying this just a few years after the country spent trillions of dollars bailing out so-called “makers” like him while leaving the rest of us to rot still sticks in the craw. But minorities had no doubt which side of that taker/maker divide he would put most of us on. (Even successful minorities are usually viewed as products of unfair affirmative action by country club Republicans who think their legacy admit to Yale was due to their “hard work”). Do you really think Romney would have worked to fix the structural problems in society that keep inner cities poor? (IMHO, Jack Kemp is the lone exception, and the only conservative I know who genuinely sought to fix inner city structural issues through innovative, conservative approaches. He was a true compassionate conservative, and I wonder what could have been if he ever became President).

        Second, about health care in specific. While there is definitely a racial component to the structure of our healthcare, far more damage is done by the imposition of conservative “free market” ideology. How utterly insane is it that in the midst of a pandemic straining our hospital capacity, hospitals are laying off staff, because saving a person from Covid is less profitable than replacing his knee? The deficiencies of the American health system, which has left patients unwilling to risk bankruptcy by seeking care, hospitals unable to keep their doors open even in the face of increased need for their services, and stores unable to provide even simple goods like face masks and alcohol wipes, are not due to Trump. They’re due to a health system centered around profit maximization, and an adherence to “market discipline”.

        I’m sure conservatives would argue that it would be worse under a public system, except in this case, we can see the data and it says otherwise. Every one of those Asian countries you mentioned has some sort of universal care. And that has been critical in their response. No one in S. Korea is debating whether patients should pay for Covid testing. Poor areas in Japan have access to good medical services, unlike here in the U.S. where access is concentrated in rich enclaves of big cities, because everyone is insured and therefore, there’s no extra profit in taking care of a rich person vs. a poor one. We’re going to see a massive wave of deaths in rural areas as the virus spreads there because, thanks to market economics that tailors our health system towards the needs of rich people, there are plenty of rural towns with literally no physician or hospital available in a hundred miles. Even in hard hit European countries, while they have plenty of problems, they’re not running the risk of their hospitals closing and their nurses being furloughed just when they’re needed the most. Unemployed Italians don’t have to worry about whether they’ll have health insurance should they come down with Covid in the coming weeks.

        Trump is responsible for a lot of the damage that Covid is doing, but the structural issues in healthcare which are contributing to it are not his fault, but rather the fault of a conservative economic ideology that has been dominant for decades. This is a blindspot that even the most well-meaning conservatives often refuse to acknowledge.

        FWIW, I’m sure that as a liberal, I have my own blindspots about the weaknesses of my political philosophy, which is one of the main reasons I love to read your blog and learn to see issues from a different viewpoint. So I’m not trying to accuse conservatives of being uniquely bad or anything. But on balance, at least in healthcare (and I’d argue in many industries), Covid has revealed the deadly consequences not just of Trump’s incompetence and corruption, but decades of free market policies in the industry.

      3. I think this is kind of important. It maybe even deserves a whole post.

        There’s a faulty premise underlying this approach, the notion that there was some significant body of “non-racist” white folks against whom the racist white conservatives could be compared. As we work our way back across a timeline stretching just a couple of decades, that becomes a really tenuous proposition. White people were pretty much just white people, with a nearly uniform sense of white privilege and white racial superiority, regardless of party, political orientation, or even geography. The only meaningful difference was in their relative willingness to be open about it, or violent about it.

        Joe Biden and the Clintons staked their political careers on what we would recognize as a wildly racist program of mass incarceration of black people to address the late-80’s, early-90’s crimewave. Clinton, who was regarded by some as “America’s first black President” enthusiastically backed a program to gut social services while having the galling audacity to call out and persecute black activists who complained. He used his “Sister Soulja Moment” to put black people in their place and shore up his crucial white support, no small factor in his success in the South.

        As we’ve seen from Uncle Joe in his recent interviews, he’s still an old white guy, with all the imprints of generations of racist indoctrination. He’s just nice and well-intentioned, which is enough to make him worthy of support. He’s not one iota more “woke” then Mitt Romney, he just has an interest in a political program that Romney didn’t stand to benefit from.

        Right up to this minute, the voting bloc of “non-racist” whites over, say, the age of 40, is not large enough to carry a major urban mayoral race. The difference between Democrats and Republicans in our system is that Republicans inherited Southern whites, who are a very special kind of racist, and who have operated under a single-party racial voting bloc since their states were settled. That one fact explains how Republicans have gradually developed into America’s more or less overt Party of White Power, a role which Democrats held pretty openly until about the Sixties and only gradually (and reluctantly) lost. Old white guys like Thomas Edsall still write longingly about the days before minorities forced open the Democratic Party, alienating white racists. I’m sorry, but if you make some kind of bet on the post-racial character of today’s white Democrats that bet will fail, as it failed in 2016. Trust me, I made that bet.

        White people are white people, at least above a certain age and still to a disturbing extent among the youngsters. Be very cautious in your expectations for us.

        As for the role of market forces in ruining health care, you might want to explain this to the French and Germans, who have retained an almost universally private health care system against the miserable model of the UK, who nationalized their system.

        The difference of course is that Swiss, Singaporean, French and other systems aren’t tainted by the rapacious and frankly stupid interests that have come to dominate public policy in the US, and especially in the Republican Party. The world’s best health care systems retain a very large role for private, market-driven players, and sometimes, as in the Swiss and Singaporean models, for for-profit insurance companies. They do this because markets allow a degree of distributed decision-making that’s impossible in systems like the UK’s. Those private players operate with a carefully managed market. They just aren’t stupid enough to think that an unfettered free market in health care can work. Frankly, Republicans (outside the South) weren’t either until about a decade ago. Let’s not forget that the ACA was first conceived at the Heritage Foundation and deployed by a Republican Governor. And that wasn’t so long ago.

        It would be a dangerous mistake to imagine that, because a delusion that markets could do everything led to disaster, markets are bad. That’s related to the mistake made by much of the world in the nineties, concluding that since Communist was a shitshow, every form of government intervention in the economy is bad.

        It’s a big complicated world out there.

      4. EJ

        Chris: you are my friend and I say this with love, but claiming that the French/German vs UK experience of coronavirus proves the superiority of private vs nationalised healthcare is perhaps not your best-researched point.

        The UK health system is publicly-funded, but large portions od its services (especially those portions like supply chain, cleaning and laboratories which have failed worst under coronavirus) are outsourced to very large for-profit companies, who like all outsource companies are neither accountable to the end user or incentivised to deliver a higher-quality service. As a result of this, the NHS must be understood in terms of government-outsource, which is a filthy business even before lobbyists get involved, and is hardly a good example of truly nationalised healthcare.

        In Germany, delivery of services is nominally carried out by private companies. However, these are extremely closely controlled by governments at every level, from federal down to local, and it is not uncommon for individual internal manager decisions to be changed at the instructions of elected representatives. If people want their policy to change they don’t vote with their wallets: they vote with their votes. For this reason there is a great deal of overcapacity in the system, which is unprofitable but saves lives at times like this, and is not a good example of truly privatised healthcare.

        In other words, these are both hybrid systems: one nominally publicly funded but ultimately responsible to investors, the other nominally privatised but ultimately responsible to voters. What’s the difference? One is run well and is coping with the crisis, the other has been hollowed out for decades and has mostly collapsed. This is a bad example of private vs public but an excellent example of the principle that if you do things well they turn out well.

        A better lesson, in my mind, can be drawn from the fact that te UK has a parallel system of entirely privatised health insurance for people wealthy enough to pay for it, while Germany does not; and this means that in Germany the poor and the rich are in the same boat whereas in the UK pre-pandemic they were in two separate boats. The incentives from this are pretty obvious, and this might make a really good post (if you’d like me to write it I’ll be happy to, there are many lessons that mutual-aid organising can add to it.)

      5. I would love to see that piece.

        The hybridization of the NHS remains pretty limited, and it’s a pretty new development. It’s really more of devolution or simple disintegration than a move toward decentralized decision-making, and by all accounts it’s been a shitshow. That said, the NHS has never been one of Europe’s best systems. That distinction is usually granted either to the French or Norwegians. The British accomplished nationalization of their healthcare system in a fell swoop, from Parliament, while European systems evolved into their present form over decades of gradual moves that incorporated a lot of existing, more or less successful elements.

        Yes, the effectiveness of Europe’s best systems hinges on close regulation and a general feeling of “we’re all in this together,” but they also avoided the pitfalls of total centralization. Singapore and Switzerland manage to run very successful health care systems that look an awful lot like an idealized version of the Affordable Care Act. With the right regulatory scheme in place it’s possible to allow a lot of decentralized decision-making.

        My single biggest political pet peeve, apart from perhaps racism, is the idea that “markets” = Laissez Faire. Markets are just a tool for crowd-sourcing decisions. They don’t work for everything. Without rules they simply fall apart.

      6. There may be a solitary exception, but in my reading, all of tge countries that offer universal healthcare have some degree of privatization in their system. The important element that is not well known is that in every case, government regulates the cost of drugs and medical procedures in some respect. This is an important factor in comparing healthcare systems internationally. I know of no example in which profits consume such unbridled control, either directly by setting their own prices, or, indirectly by patent manipulation and/or lobbyist influence over legislative control, or lack thereof.

        It is simply not possible for this country which spends 18%+ of its GDP on healthcare to expand universal access and sate the profit monster that has the keys to the gates.

    1. What a great question. You won’t find people writing about the answer very often because it’s unpleasant, and stating it out loud undermines many of the goals of the people who want to fix it.

      In short, Europe, which colonized the world, became a quiet protectorate after WW2. It has not yet emerged from its colonial status, and it isn’t clear yet that it should.

      After WW2, Europe was divided up between the American and Soviet empires. Like a Roman client-kingdom, or the entities of the British Raj, each nation-state (except Germany) retained the vestiges of national infrastructure, but none of those states could operate independently of their protectors, not even the Swedes or Swiss, who resisted any official participation in the protectorate.

      For most of the rest of the century there were only two national entities on the planet capable of operating at global scale. And of course, by the end there was only one. Only one country possessed the infrastructure to fight a war on another continent. Only one country printed the currency for global commerce. Our language was the language of commerce and trade.

      On paper, the EU is geographically large, wealthy, highly educated, scientifically advanced and borderless. In reality, Europe is still an aspiration. What exists on the ground are 27 countries in a fragile, chaotic and superficial alignment, with no common European identity penetrating beyond its elite classes. Remove the American Imperial project and a genocidal war would resume literally the next day in its Balkan Hillbilly backwater.

      Europe depends on the US to provide the infrastructure for all of its military, technical and commercial needs. When the EU wanted to curb the influence of Russian KGB/mafia expansion inside its borders, it turned to the US Justice Department for help, as the only semi-transparent banking regulator on the planet with the global reach necessary to contain that threat. And then, of course, that help disappeared and the situation has regressed.

      Without effective political cooperation, each individual nation is left to replicate its own, often redundant support infrastructure at enormous cost and great inefficiency. As a consequence, they look to the US for that infrastructure whenever possible. Who leads investigation of airplane crashes anywhere they occur on the planet? The US FAA. Who sets the rules for who can participate in the global banking system? As Iran discovered to its great disappointment in the last decade – the US Treasury Department. Who provides the infrastructure and often the personnel to manage pandemic outbreaks anywhere in the world? The US CDC.

      Until about the Bush II Admin, this was a golden arrangement. One could argue that there would be no EU without this relationship, because US dominance served to squash European national rivalries and provided a cafeteria of development resources that propped up European societies. With borders protected, their capacity to wage war among themselves effectively destroyed, and their empires stripped away, European governments functioned like city councils, with tremendous focus on local, lifestyle concerns.

      Trump and C19 have placed this dependence on the US in a stark light, but it still isn’t being discussed. It is almost never spoken of, either in the US or the EU for the obvious reason that it remains pretty necessary, but acknowledging it publicly would be obnoxious. This arrangement worked because the Americans didn’t push too hard. European countries were still countries. They still had armies and parliaments and their own flags. The degree of dependence on the US was de-emphasized on both sides until both sides largely forgot it even existed.

      Now, as the US is falling apart, Europe is crumbling with us. And no one is allowed to acknowledge the linkage, which is making it worse.

    2. I’d further Chris’s remarks. “The rest of NATO” is not a fighting force without the U.S. There is no European army. Yes, Europe spends a lot of money on defense. But it’s all directed by NATO. What do I mean? The longstanding dogma of NATO is that the USA would supply the majority of the actual fighting force, while other countries would supply more specialized forces. When NATO and the EU expanded, this doctrine went further. European armies became ever more specialized, with NATO deciding what each country should specialize in.

      The idea was that, in a European war, NATO forces would fight together, so instead of each country having its own small squad of infantry, air force, etc., why not have each country specialize in one aspect? It’s just like specialization in economics: enabling higher productivity and lower costs through focusing on one task.

      https://www.theatlantic.com/international/archive/2012/05/smart-defense-should-europes-militaries-specialize/257328/

      https://www.nato.int/cps/en/natohq/topics_84268.htm

      So yes, while big countries like France and the UK make a show of having their own fighters, aircraft carriers, etc. even their armies are quite small. And the rest of Europe is less able to defend itself than Canada. Many of the smaller members are being asked / pressured by NATO to largely disband their combat troops, and focus on one area of expertise like logistics, or medical, etc. Many of the smaller countries are chafing under this, because it essentially means they will forever be a small cog in a big machine, and will need to depend 100% on the big machine if/when Russian tanks ever start rolling through.

      But what it means is that Europe, despite the large amount of money spent on defense, would not actually be able to defend itself without American combat forces.

      1. But what it means is that Europe, despite the large amount of money spent on defense, would not actually be able to defend itself without American combat forces.

        BALLS
        The French, German, Polish and British forces – to name only four are more than capable of fighting without US assistance
        AND each of them is man for man MORE CAPABLE than the USA

      2. First off, there is a really good chance that Poland would side with Russia. Poland is no longer a democracy, if you have been following its recent history.

        Secondly, though no one has ever suggested that the average american soldier is as capable as most NATO nations’ individual soldier, but that is irrelevant. What you are facing is Russian armor and artillery. Do some research on quantities of both comparing to Euro based NATO hardware to Russian hardware. Then subtract all the hardware that the tyrant will be pulling out of Europe as soon as he is ordained in November. Or perhaps he will set up a protection racket. He has intimated that already, where Europe pays the U.S. (and his family) protection money.

        The Soviet armored divisions would roll across Europe in days…until Europe did what is the logical step, and started using the NATO playbook which calls for the use of battlefield nukes to counter the massive Russian land unit advantage. Of course, Russia has at least one order more of magnitude of battlefield nukes, so we know where that ends up.

        What likely happens when the tyrant openly signals his armies will not help Europe?

        Well, Russia immediately rachets up the attacks on Ukraine. Ukraine is not a NATO member, but a NATO Partner. NATO would likely not go to war over the annexation of Ukraine. But then Russian will move into the Baltic nations, which triggers Article 5. Then things get real interesting.

        I have been saying it for years. Best outcome is NATO sends a wet team to the u.s., and does what the citizenry won’t.

      3. Hi Pirhanna – BALLS!
        Poland may not be a perfect democracy but there is no way they will let Russia invade them AGAIN
        The Russian military is just about strong enough to defeat Poland – and even that is marginal as they will be attacking a prepared enemy
        People learned the wrong lesson from WW2 – you need a three to one advantage as the attacker UNLESS – as happened in WW2 your enemies high command collapses (French)
        The Winter War is a much better example of what would happen if Russia attacked
        This applies the other way as well – the “rest of NATO” is far too powerful to be defeated – but is nowhere near powerful enough to invade Russia

      4. None of them were able to do anything about the genocide in their own backyard. Does Poland have lots of big strapping lads fit for a fight? I’m sure they do. Do they have enough trucks to maintain food deliveries to the front lines? Transport aircraft? Surveillance? Ask the Ukrainians (and the Russians) how much you can accomplish on enthusiasm alone.

        Where would they get the fuel for their tanks and aircraft? Is there anyone in their military brass who’s job it is to handle these things? No. They have a phone they use to call NATO, and all of that stuff comes from the US. Or at least it used to.

        Russia isn’t the main military threat to Europe. Russia’s in worse condition militarily than the major European powers. The other members of NATO are the threat. That is, in fact, the main threat that NATO was (quietly) designed to address – that horrible tendency of these people to slaughter each other since the Romans disappeared. That’s the real, unstated, and unstatable reason why everyone was in such a damn hurry to extend NATO east after the Cold War.

        That threat also explains why the EU leadership has been slow to move away from the US even as we grow more unstable. We remain the main guarantor of European security not because we have the baddest MF’ers on the battlefield, but because that arrangement by which Europe cedes most of its fighting capacity to the US limits their capacity to kill each other.

        Just a few more generations under this order and that concern might fade away, but we aren’t there yet. If you think China is a remarkable economic power, imagine what the EU would look like after two more generations of integration. The world could really use another 50 years in which the US remains mostly sane, competent and more or less reliable. We may not get it.

      5. ‘First off, there is a really good chance that Poland would side with Russia. Poland is no longer a democracy, if you have been following its recent history’

        This shows a complete misunderstanding of Polish politics. The democracy-undermining right populists might not have much love for the EU, but they *HATE* Russia. All their conspiracy theories revolve around alleged Russian involvement in this air crash that killed the party’s leader: https://en.wikipedia.org/wiki/Smolensk_air_disaster

        https://en.wikipedia.org/wiki/Smolensk_air_disaster#Conspiracy_theories

      6. Duncan-
        No one, least of all me, is trying to insult individual British / French / Polish / etc. fighters. Man-for-man (and woman-for-woman 🙂 there are plenty that are as good or better than the best US soldiers.

        But as Lenin famously replied, when asked to weigh in on the quality-vs-quantity debate, “Quantity has a quality all its own”. War isn’t a man-for-man fight. Victory in war still boils down to whichever side has the most economic output and bodies (and will) to throw into the meatgrinder known euphemistically as a battlefield. General Lee graduated first at West Point and U.S. Grant graduated last (or near last, I think). Doesn’t matter when you have the population and economic might of the industrial North against an agrarian South.

        Europe does not have a fighting army without the U.S. Period. And as Chris has mentioned, this is a *feature* not a bug. Recall that in WWII, Russia was the ally and *Germany* was the enemy. It’s always been Germany / Central Europe that starts these Euro-wide slaughters every 100 years like clockwork (I highly, highly recommend reading Kissinger’s _Diplomacy_ for an awesome explanation of why a strong Germany has always led to instability in Europe). Russia was this weird black hole in the east, slowly swallowing up everything it touched, but they’ve never been high on France’s list of worries.

        Adenauer, Germany’s post-war leader, was smart enough to recognize that there could be no such thing as an independent Germany. IOW, Europe could never be 3 parts: Western (France) / Central (Germany) / Eastern (Russia). That has always led to instability. There could only be 2 parts: a Western (France) and Eastern (Russia). Germany could choose which side to join, but there was no independent middle. And so he wisely cast Germany’s lot with Western Europe. But that wasn’t before his country was divided and defanged to help him see that point. It was a bitter pill for e.g. Germans to accept that from that day on, France will forever have a larger army than they will and would set policy for all of Western Europe. And the only way to deal with those types of centuries-long rivalries was for everyone to agree that America was the ultimate guarantor of the peace and would set military policy for everyone.

        The Europeans agreed to accept America’s security guarantee not only because they were so weakened by WWII, but after WWI, the Thirty Years war, and so many wars before, they didn’t want to risk another burned out European landscape in another 50 years. And that’s still the case.

        If you don’t believe this, recall that after the fall of the USSR, plenty of Europeans thought it was finally time to assert a pan-European military policy without America as the defining part of it. And believe it or not, most Americans wanted to as well. This was the time of the so-called Peace Dividend, where we wanted to redirect our military spending to domestic concerns. That European optimism lasted all of about 1-2 years. When Croatia, Bosnia, and other post-Soviet satellites disintegrated, Europe stood paralyzed, as the old rivalries came back to the fore. All of a sudden, all those European politicians who felt America was no longer necessary to their security began decrying the lack of “American leadership”, and Clinton had to direct the military response in the Balkans.

        I don’t say this as some chest-thumping “America First!” type of guy. But [Western] Europe is an American protectorate just as surely as Japan is. But thanks to cultural and historical ties, American and European cooperation goes much further. True, no one is forcing Europe to look to the CDC for guidance. They could have developed their own center and spent the money to make it every bit as good as the CDC. Nothing in NATO treaties prevents that, and they certainly have enough brilliant medical personnel to staff one. But depending on American institutions, thanks to our shared historical and cultural ties, became a natural thing to do, in a way that it never did in Japan or South Korea. And now they’re paying the price for it.

  4. Predicted couple decades ago as Obama made his speech at Kerrys nom that USA was on a long path toward xenophobia and disorder as income inequality increased between interior and exterior of this country. You saw China then and now trying to mend that economic geographic breach. You see that manifest throughout the world be it Brexit to yellow vests to Hong Kong protests, all rooted in inequality to unaffordable housing. Naomi Klein dubbed it the shock doctrine. https://en.m.wikipedia.org/wiki/The_Shock_Doctrine

    That shows plutocrats also don’t let a crisis go unwasted. Question is do they see the current crisis a motivation to change their ways. I doubt it. Any more than a cancer can be convinced to change its ways. It can never be satisfied with enough; see record income inequality perpetuated to this day by a minority on the majority. As peeps suffer you already see gop rationalizing the deaths continually padded to accommodate more deaths in perpetuity. Unless covid strikes every corner of red states so they see themselves the blood and gore with their own two eyes, USA will remain a federalists red tails (eg Kentucky) wagging blue dogs (eg California) and behave as such.

    1. See also work by angus destiny and Anne case on deaths of despair. This is long time coming. It is a feature Of federalism overlaid on a economic geographic sprawl that manifested first with black crack epidemic in urban America now manifested in rural America as the simmering yet epic in scale opiate cum suicide epidemic.

      Note the full title. Deaths of despair and the *future of capitalism*
      https://press.princeton.edu/books/hardcover/9780691190785/deaths-of-despair-and-the-future-of-capitalism

      Q and A with husband wife authors with relevant context.
      https://www.vox.com/platform/amp/2020/4/15/21214734/deaths-of-despair-coronavirus-covid-19-angus-deaton-anne-case-americans-deaths

      I’ve been a student of economic geography since my uni days following krugmans economic geography and liquidity trap work. So knew since then all this writing on wall. It’s the tales of two Americas with federalism assuring America suffers and felt the worse fates as its weakest links.

    2. More digging down rabbit hole is the lie that opiate epidemic is impacting dying white guys. If site had ability for me to share charts one would vividly see opposite is true. Women are dying in record nos from despair. It has multi fold implications, economically and politically. For it’ll one it feeds into why Americas native fertility rate has been on decline. If it wasn’t for immigration USA would also be depopulating like rest of the world except Africa. It’s also why political divergence is widening between women and men.

      Anne case sums it up well. https://press.princeton.edu/ideas/deaths-of-despair-strike-women-too

      But trust the charts are pretty harrowing to witness. Covid just brought it all to forefront is all.

      1. Federalism too has its ballasts albeit activated usually during extreme pendulum swings by design. Trump won by 77,000 electoral votes. The question is has he grown that margin or shrunk it. All data pt to latter if there’s any silver linings to be had. It will be a long slog and we are all in the front row some with seat belts many without. Good night and good luck to us all.

  5. Chris said “Never waste a good crisis. This may be our chance.”
    tmerrit said “I concluded many years ago that the US requires a massive disaster to enact change.”
    Crowley said ” Why not just let it all burn down and let something else or a group of other things take its place and try to do better,”

    Precisely, what events have occurred or attitude been demonstrated that leads you to believe that any crisis-triggered change will be for the good? Many times I have provide a subset of countries where democracy has fallen in the past 3-5 years. How about someone provide a counter to that list, where democracy has taken strides forward in the same time frame.

    How on earth can anyone believe that any change will be for the good in the u.s. with a dictator at the helm, and his lackeys and similar minded people now occupying all positions of power and control, save a neutered House of Reps?

    How is this crisis, and I am talking way way beyond the virus, going to lead to a more democratic United States? Walk me through it, step by step. And not starting with some fantastical “election” in less than 6 months. Start now. I already laid out 8 possible outcomes from any election, or rather, the so-called election period. 7 of them end in violence or the confirmation of the tyrant as leader.

    Do you people seriously believe that the tyrant’s cult would accept his loss in an election, and quietly go back to merely complaining and polishing their guns?

    Once again, I ask, walk me through, step by step, how the next 9 months are going to play out, ending Jan 20th.

  6. This is a well written article, Chris. At several points you assert that the President was not briefed on the early stages of the situation. However, I’ve read that several times it was put in his daily briefing book (which I understand he doesn’t read!) Do you agree that this was the case, i.e., that Azar et al. made that ineffective effort to advise Trump of the situation? Or do you not think they did even that much?

    1. I’ve found many references to national security briefings the President received on the subject in January, but the only specifically dated references I can find begin around the 23rd. Jan 18 is the first specifically dated reference I can find to the President being briefed on this.

      Was it mentioned in the briefing binders that he doesn’t read before that? Probably. But I’m most interested in finding the first validated date when someone spoke about it to his face. So far the 18th is the earliest.

      1. Jan 18th appears to be the day when Azar tried talking to the tyrant.

        IN Nov/Dec, The Pentagon’s National Center for Medical Intelligence (NCMI) circulates a report identifying a contagion sweeping through Wuhan, China (quoted from this link)

        Also note, in the link. Redfield and Azar was warned by a Chinese colleague Jan 3, and Azar then waited 2 weeks before telling the tyrant, apparently by phone.

        https://www.justsecurity.org/69650/timeline-of-the-coronavirus-pandemic-and-u-s-response/

  7. Pinning the blame on the U.S. for what’s happened with this pandemic in Europe and the NATO countries there is unfair. Everyone in NATO has had years to see how ineffective U.S. leadership has been under the Trump Administration, and to look elsewhere for ideas and strategies of what to do on a whole number of things. Saying it’s our fault that Italy and everyone else suffered and that the U.S. has been degraded to being a member of the “developing world” is just cruelly punching down at this point. I’m sick and tired of the “Oh, America the Third-World nation” rhetoric, the kind of writing akin to a prior COVID article you wrote, “Mexico will turn away the fleeing Americans out of fear of the Gringo Flu”. It doesn’t push me or others to think of ways that my country can be better; it’s just plain demoralizing.

    If America is a failed state fallen from grace as you and so many others say, then why should anybody continue to try to fix America as it is now, Chris? Why not just let it all burn down and let something else or a group of other things take its place and try to do better, like the late Roman Empire that we’ve been compared to ad nauseam ever since Trump took his seat in the Oval Office? Then, as those disparate nation-states try to rebuild and repair, you can find the one whose policies best align with yours.

    1. Three generations ago, Germany was a failed state sitting in ruins. A generation ago India was home to the world’s largest number of the extreme poor. And don’t get me started on China.

      People don’t improve a situation until they see it. Often seeing it isn’t enough. Sometimes they need to live in until it becomes intolerable. But change can happen.

      And Europe still isn’t ready to live in a world without the US as a responsible, leading partner. In my opinion, the EU project won’t survive unless NATO survives, and that won’t happen without a return to sanity in the US.

      1. Concur fully. I would add that for the US, living in a bad situation is truly necessary. That is the reason, that dysfunctionality building to an extended crisis seems to be required. Since action was taken quickly during the Great Recession by bailing out the “Banksters” , it did not continue to degenerate to the point it was a greater depression than the Great Depression; the great masses of people did not have to live through the situation for a long enough time. It took from 1930 to 1933, for changes to begin to be implemented then. What happens this time, is yet unknown?

        NATO is still essential as the foundation and core structure to the EU and the US is essential to NATO.

      2. So the questions that I have now are these: How do we ensure that we end up like current-day Germany? India, has improved its economy but is now sliding into fascism.
        China, has a middle class for the first time ever but they have to contend with an ever-expanding authoritarian government.

        If a crisis is truly required, how many lives do you think should be lost and how much misery should be inflicted upon the people before they “come to their senses” and start to rebuild? My generational cohort (Millennials) is pretty much set to become the next Lost Generation while simultaneously being expected to be the one to fix everything. “Millennials Will Save The World”, “How Millennials Will Save Us All”, articles like this have been popping up for years but we’ve been given barely any of the power or respect needed to do that fixing. The Boomers and Xers have it all. How much more do you want us to sacrifice for the sins and failures of the Boomers and Gen Xers just so America can come back? And if we manage to pull it off, how much will you whinge and complain if that America isn’t the one you want but the one we want?

      3. Crowley, asking the question of “How much misery?”, is really unfair. We are all in this together and none of us knows. I personally consider myself an early Boomer (born just prior to VE Day), though most consider 1945 babies to be late Silents. Regardless, I have been advocating for change for many years, though I have become more convinced in recent years. But the generational alignments and leadership must be correct for that to happen. According to the generational theory of Neil Howe and William Strauss, in their ‘Generations’ and subsequent ‘The Fourth Turning’, the suitable alignment is just now occurring. They did predict, that the ‘Fourth Turning’ climax crisis (or crises) would occur circa 2025.

      4. You’re 75 and I’m 28. We are not “in this together”. Not in the slightest. The youngest generational cohorts are going to live to bear the biggest brunt and hardships of these coming decades and you won’t; that’s a fact.

        ‘Generations’ and ‘The Fourth Turning’ are also part of the the basis of the horrid man Steve Bannon’s apocalyptic philosophy, why he sought to put Trump in office. He basically rigged the geopolitical situation for the Crisis part of The Fourth Turning to happen. You talk about ‘suitable alignment’ like somebody who believes in horoscopes.

        So again I ask you, as this Crisis unfolds, how much of a price in human lives and misery do you think it’s worth to get America to, in the words of Strauss & Howe, “something better, a nation that sustains its Framers’ visions with a robust new pride.” that you’ll never see?

      5. EJ

        Crowley: you’re 28 and I’m 36, I’m an elder millenial. I’ve basically disappeared off the internet for the last two months because I’ve been organising a mutual aid local with hundreds of members. We are doing great things and I’ve heard from my comrades in American cities that some great things are happening there too.

        In my opinion the problem is not a generational one. We have many allies among older people, our enemies have some allies among people our age, and these Zoomer kids that are coming up have inspired a mixture of fear and admiration in me with how hardcore they are.

        In my opinion the problem is capital, specifically the twin needs to achieve a short-term return on capital and to externalise long-term negative effects of it. Because most owners and managers of capital are older and most of those who suffer those negative effects are younger, it looks like a generational effect.

        We should make sure to differentiate between capital and the economy, because they are not the same thing. The economy is the web of human beings who create and consume goods and services; in this context money is only useful inasmuch as it mediates this web. When I make a food delivery for someone and she sews me a mask, that is economic activity; but if I were to make a food delivery for someone and receive nothing in exchange except the knowledge that my fellow human being will survive, that is also economic activity.

        The difference is that some economic activity earns a return for capital, and some does not; we often constrain our society to only permit the former, and indeed often forget that the latter can even exist. Often, we have internalised this view so much that we cannot conceive of our own lives mattering except in the context of acquiring a return on capital.

        We can do better.

      6. Good thought, EJ. Count me as an older person who is aligned with the majority of Millennial concerns. I do become frustrated with the rigidity I see in this group but I understand why it’s so.
        I’d like to know more about the group you are organizing, in the UK ? and in the US. We have so much to discourage us these days that it’s helpful to see pickets of serious resistance quietly surviving.

      7. Not to be morbid or defeatist, but as someone in my late seventies, I am watching the house burn down with fewer hands willing to man the hoses.

        Is the real question, as Crowley stated, “is the burning house Worth saving?” In a world in which environmental change is happening faster than social change, and with fewer options to halt it, why are we still hoping people will change by becoming more “woke” in their personal responsibility to address either crisis? I don’t see any interest in those who are utterly focused on their own agenda for change for the common good. Maybe we haven’t suffered enough as individuals and as a country. If not, what will it take?

        This pandemic has illuminated the conflict between human vulnerability and the rejection of science and the role of government authority. Those who are flaunting guidance that benefits us all are bringing together many disparate social groups all of whom are singularly focused on self interest.

        There may not be a Phoenix rising from the ashes. Maybe we are too naive, clinging to a Democratic ideal that has been lost. I doubt I will be able to change my belief in the core decency of people but I admit, I am horrified by the utter selfishness I see around me. Am I expecting too much of my fellow man? Is it time to let the house burn instead of trying to remodel it while it is in flames ? (Tunde Wey)

        https://apple.news/AT8w_wN5hSzOS65KgbW6Txg)

  8. I concluded many years ago that the US requires a massive disaster to enact change. We required a Civil War to eliminate slavery. It took a Great Depression to enact some modifications to laissez faire capitalism and corporatocracy. Now we are in a major crisis due to the incompetence of our present President. This could well evolve into an existential crisis. This crisis is far greater than the COVID-19 epidemic. Hopefully the crisis will be sufficient to enact the necessary systemic changes. The Great Recession was an opportunity, but it did not impact the people of the US sufficiently to overcome the ennui and the obstacles in the system.

    The direct cause of the present crisis is our dysfunctional electoral system and government. There are numerous systemic changes required; too numerous to list in a brief comment such as this. Hopefully, the people are angry enough to elect responsive and responsible government officials in November and that anger will be sufficient to maintain the course of reform over the several election cycles that will be required to establish the structural and systemic changes required.

    1. Why, exactly, is Biden indulging these policy task forces and bringing on Sanders’ allies? For a man who’s (often rightly) been lambasted as too willing to reach out to Republicans, this is exactly the opposite of President Obama in ’09 when he let the GOP play him for a good-natured sucker.

      Any policy (whether on healthcare, immigration, climate, etc.) that comes out is going to be pretty damn massive, and subject to unmovable Republican opposition. Surely Sanders’ allies aren’t there just to be token representation and decidedly overruled at every turn; they’d speak out and be a political headache for Biden!

      Why is he doing this? To lay down a marker for future negotiations? Ehh… *maybe*, but there’s a decent case to make that a man that went from talking of restoring pre-Trump ‘normalcy’ to Warren-esque “big structural change” virtually overnight may be more serious about grabbing the reigns of power than we’re giving him credit for.

      Don’t pay attention to what he says, watch what he does.

      https://www.nytimes.com/2020/05/17/us/politics/joe-biden-economy-democrats.html

      1. Ryan, I hope you’re right about Biden. As a Warren and Bernie supporter, I was prepared to vote for Biden but didn’t see much hope of actually changing course aside from putting out the Trump fires (Admittedly a big, important task). If he’s actually planning a real change in economic course, then I’d actually get excited about his candidacy.

      2. As do I.

        Given that Biden’s said his VP pick would be more about governing, who he picks will give us better insight into his thinking. Who knows if it means anything, but he’s been commenting on Warren’s actions a fair bit recently…

  9. Chris–I wish you had the time to footnote this very impressive and thoroughly researched article. It could become an authoritative written record of what the hell happened to the once mighty USA.
    Ken
    P.S.
    It could also be published in a widely-read source like Rolling Stone or The New Yorker, where it would get the exposure it deserves.

      1. I, too, would appreciate more footnotes. Many of us share your pieces and, in the process, are challenged on sources, conclusions, and political slant. I am particularly interested in documentation that Azar did not inform Trump of the pandemic threat before January 20. I have read that the U. S. Intelligence Division informed trump directly in their briefings in early January.
        I share your political view of this administration and I read widely enough that I can see the deliberate destruction of our agencies and institutions, in a variety of ways – neglect, over riding of authority, suppression of recommendations, intimidation, etc. Just this past week, The Lancet, a century old, and very highly regarded English health journal, published a scathing criticism of the trump administration’s response to this covid 19 virus and the devastating suppression of the internationally revered CDC. In blunt language, the Lancet called for removal of this president in 2020 with an individual who respects science, and is competent. Although I doubt if either DJT or Secretary Azar or the feckless son in law cum political handyman, Jared Kushner, care what the Lancet wrote, world health and science leaders know.

        Which leaves us where? The litany of government agencies that have been destroyed by this president, his henchman, Robert Barr, the gutless administrators from Azar to Seema, pompeo, McConnell, and so on, is too long to list and too disheartening to contemplate. Whose “invisible hands” are at work?

        I worry that the scales have tipped too far to be righted. Too much damage done for the shells of our institutions and agencies to overcome. As BoBo’s link asserted, how do you fight against a force that will stop at nothing to win? Because, I fear we are in this place.

        I never dreamed a nation with the proud traditions, respected agencies, and vast resources could ever be destroyed by so few bad leaders. Surely, the system of checks and balances would always kick in. To Crowleys point, i. e. , is it fair or accurate to assign the ineptitude and corruption of America’s response to the pandemic to the international spread of this virus? I can’t answer that but I can state this: American irresponsibility and failure to utilize timely the talent, experience, plan, and resources we had, contributed to unnecessary deaths and economic disaster right here in America. It is not a stretch to see how our inaction and wrong actions impacted the rest of the world.

      2. The question of timing continues to be cloudy. Recent reports have been clear that US intelligence agencies were aware of the Wuhan Pneumonia in November and that there were mentions in the President’s Daily Briefing early, perhaps in December. I personally was aware of the Wuhan Pneumonia in early January. It was reported in the local press. Following the diagnosis of the case in Everett on January 20, the local press followed the developments extensively. The first death in Kirkland, WA in late February put the entire region on high alert. The urban portions of the 3 county area (Snohomish, King and Pierce) went into a social distancing regimen with recommendations to stay home and to work at home, beginning the last week of February and the 1st week of March. I had low priority events cancelled during the last week of February. My last non-essential activity until this week was March 7 and that was a two hour bird survey on 3 local beaches. That was outside, we travelled separately and social distanced.

        Furthermore, December deaths and cases in both the Bay Area and the Puget Sound Area have now been classified as probably being from COVID-19 with infection due to local transmission.

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