US Response to Coronavirus Dictated by Panic, Not Policy

By Paolo von Schirach –

WASHINGTON – Nobody is prescient. No one could have foreseen the timing and the extent of the coronavirus pandemic explosion which originated in China and then from there spread all over the world. However, as I noted elsewhere, the US was especially vulnerable, because it was utterly unprepared to meet any public health emergency.

No systems, no plans

Amazing but true, America had no “pandemic early warning system” in place so that a timely alarm could be sounded, nor did America have any meaningful public health “rapid reaction force” in place that could have been activated after the alarm had been sounded, in order to deploy all the necessary medical equipment and other materials where mostly needed, while ordering and enforcing the necessary contagion prevention measures, (immediate widespread testing, quarantines, social distancing, and lock downs).

True, eventually some of these measures were ordered and implemented here in the US. But, lacking anything even resembling a master plan, all this was done very late, and in a horribly inefficient, fragmented fashion, in a climate of confusion, disorientation and –at times– sheer panic.

Panic led to an extreme response

And the panic created by a disease with no cure and catastrophic predictions about millions of dead Americans, unless we closed everything down, led to the fateful decision to shut the country down, with full knowledge of the incredible damage to the economy that this decision would imply, including a slew of bankruptcies, and tens of millions of suddenly unemployed workers.

Let me make this clear. It did not have to be this way. We closed America down because, at the time, with no deployable countermeasures available and a deadly disease spreading rapidly, there seemed to be no other viable choice, if the main goal was to save American lives.

And, again, there was no other practical choice because the US had no deployable countermeasures, no contagion mitigation systems that could be activated. Here is the sad truth. When coronavirus arrived, America was literally a sitting duck, completely unprepared and therefore defenseless.

Amazingly, this means that America, the world’s leading economic power, leader in medical research and information technology, had not thought that a pandemic could occur here, and therefore had done essentially nothing to prepare for it. As a result, when coronavirus hit, the US had no workable tools to slow down the advancing pandemic, except for quarantines and lockdowns — public health countermeasures first deployed in Europe in the Middle Ages, at a time in which public officials literally had no other remedies.

Taiwan, South Korea and Germany had systems

In contrast, other governments over time had developed pandemic preparedness plans, and they activated them –immediately, as soon as news of the pandemic originating in Wuhan, China spread.

In Taiwan the government had a system in place (created in the aftermath of the SARS pandemic in 2003) that was immediately set into action when the Taipei government realized that something bad was happening in China, back in December 2019.

In South Korea, almost overnight, the government deployed a robust virus containment strategy based on massive testing and subsequent isolation of all positive individuals.

In Germany, a national and regional network of testing facilities sprang into action, almost immediately. As a result, Germany, to date, has by far the lowest number of fatalities per unit of population compared to the rest of Europe.

Because they had robust and tested “damage limitation strategies”, these countries had tools to limit contagion. Their number of fatalities is quite low, despite no cure and no vaccine. Which is to say that, unlike the US, other governments had thought about the possibility of a pandemic and had therefore funded and put in place policies and countermeasures that helped them contain the damage. If they could do this, so could we. The fact that we did not is a huge stain on America, the country that is supposedly ahead of everyone in innovation, science and high tech.

Early warning system would have contained the pandemic

Let me be clear. A US early warning system would not –I repeat, would not– have prevented this virus for which there is no cure from reaching the US and infecting people. However, a sophisticated early warning system, (which includes the ability to learn as early as possible about an unfolding epidemic anywhere in the world, and then quickly track and isolate positive individuals in order to prevent or at least slow down contagion), combined with prepositioned stockpiles of medical emergency material, (masks, protective gear, ventilators, field hospitals easily deployable by the military in high incidence localities), most certainly would have slowed down this pandemic, while reducing its spread and scope. Which is to say that, if America had had a robust pandemic plan in place, we could have avoided shutting down almost the entire economy, while probably saving thousands of lives, even in the absence of a cure or vaccine.

Millions of victims?

As we had none of the rapid reaction tools in place, overtaken by panic, federal and state policy-makers concluded that the only choice before them was between condemning literally millions of Americans to a certain death caused by an advancing coronavirus, or closing down almost the entire US economy in order to slow down contagions, this way preventing a horrible human tragedy. And so, lacking any plausible alternatives, Washington and most of the 50 States decided to literally close down the biggest economic power on Earth.

What is terribly wrong with this scenario is that this “either we kill people, or we kill the economy” choice could have been avoided by having a tried and tested contagion prevention national plan in place that would have worked like a very powerful shock absorber. This is what Taiwan, South Korea and Germany, among others, did –rather successfully.

Of course, as I said above, even if America had been properly organized to react to this pandemic, there would have been some contagion, many deaths, huge economic damage and enormous dislocation resulting in a recession. Hence the need for the US Government to intervene with emergency funds. But, for sure, both the economic dislocation and the emergency interventions would not have been on this scale, (almost three trillion dollars!), because the damage, while still very substantial, would have been far more limited.

Are we going to learn from this disaster?

I really hope we learnt our lessons here; even if at the cost of more than 50,000 lives, and counting; and close to three trillion dollars in emergency aid to corporations and individuals, and counting. I hope that by now our elected leaders have realized that the US cannot afford to have essentially no workable rapid reaction system in place when it comes to low probability but extremely high risk public health occurrences.

Of course, it will cost money to set up and maintain the necessary early warning and rapid reaction infrastructure, trained workforce and chain of command.

But this strategic investment will be only a fraction of the close to three trillion dollars we have already spent so far, not to mention the fact that early detection will give us the ability to save thousands of lives by preventing out of control contagion via timely quarantines and other targeted isolation measures.

Paolo von Schirach is the Editor of the Schirach Report He is also the President of the Global Policy Institute, a Washington DC think tank, and Chair of Political Sciencand International Relations at Bay Atlantic University, also in Washington, DC.




How Can We Prepare For The Next Pandemic?

By Paolo von Schirach

WASHINGTON – Belatedly, all countries, including the most advanced, decided to adopt quarantines and “social distancing” as the only effective methods to slow down and hopefully stop the coronavirus contagion.

Better than doing nothing

While this is way better than doing nothing, it is somewhat disheartening that today –in the year 2020– the only contagion prevention tool in our tool box is the quarantine — a contagion prevention measure first employed as official public health policy by the Republic of Venice in 1347, during the Black Plague.

Quarantines are old remedies

Indeed, the English term “quarantine“, comes from the Venetian “quarantena“, a slight modification from the Italian “quarantina” which simply means “forty days“. At the time, Venice was already a major international port. In today’s terms, we would call the thriving maritime republic a Global Commerce Hub.

Venice depended entirely on commerce. It could not stop it, because it was the source of its gigantic wealth. But the Venetians did not want to be killed by epidemics brought in by sailors either. Therefore, the Venetian government during the 1347 Plague epidemic instituted the policy of isolating arriving ships and crews for forty days, (“the quarantine”), because they had realized that sailors and traders coming from foreign lands carried deadly diseases.

Dedicated hospitals

Well, guess what, quarantines worked, at least to some extent. Indeed, the Venetian example was soon adopted by other major port cities in the Mediterranean and beyond. The Venetians also were first in creating ad hoc health facilities for those who carried infectious diseases. Passengers coming from places known to have infections were forced to move to the island of Santa Maria di Nazareth, known as “Nazarethum”, that soon became known as “Lazzaretto”, or “Lazareth”. Besides, the Venetians created high level magistrates, called Public Health Procurators, whose job was the enforcement of the public health measures on which the very survival of the Republic depended.

Prevent diseases from crossing land borders

Later on, The Habsburg Empire created a massive system of military garrisons and fortifications along its long border with the Ottoman Empire. This system included dedicated spaces in the border areas whose main purpose was to quarantine anybody crossing into the Austrian Empire. The quarantine rules were clear and inflexible. Breaking them resulted in summary execution.

We had nothing

Well, fast forward to the present coronavirus epidemic, and we immediately realize that we are –belatedly and often half-heartedly– picking up the same anti-contagion tools first developed several hundreds years ago by the Venetians… simply because….we have nothing else!

Sadly, Western medicine has been blindsided by its own great successes. We defeated TB, smallpox, polio, and more. We have developed vaccines and treatments. We have antibiotics and what not. Therefore, somewhat superficially, we believed that we had won the infectious diseases war. Nothing more to worry about.

Bill Gates’ warnings

Strong warnings, such as the one articulated by Bill Gates in 2015 after the Ebola crisis in West Africa, were ignored. Gates did say –loud and clear– that Ebola was a Red Flag. A major pandemic coming to the US was a distinct possibility. And he did also say that we needed to prepare by creating early warning systems and well coordinates response mechanisms (including stockpiles of medical equipment) and the teams to manage them. He also suggested that the response mechanisms had to include a prominent role for the military.

Yes, Bill Gates did say all this, back in 2015.

Well, nobody paid any attention. Look, if we had listened to Gates and others who also warned about possible pandemics we could not have avoided this coronavirus pandemic, simply because, to date, we have no proven cure and no vaccine.

However, we could have dealt with this massive emergency in a smarter and much more efficient way, most likely saving many lives that have been lost simply because we were caught off guard. We know now that we had no system to quickly detect coronavirus virus carriers, so that they could be promptly isolated.

Taiwan has a system

The case of Taiwan’s public health early warning system proves this point. Taiwan learnt its painful lesson from a previous major public health scare. In the aftermath of SARS in 2003, (another deadly respiratory disease originating from China), Taiwan created a sophisticated early detection system, with dedicated professionals supervising it.

As soon as the Taiwanese authorities realized that something abnormal was happening in Mainland China at the end of 2019, they activated all their systems. Well, it may not be perfect; but Taiwan managed to quickly identify all or most coronavirus infected people, so that they could be promptly isolated, before they could spread the virus. But Taiwan could do all this only because it could activate a robust medical response mechanism it had spent years to create.

Guess what: prevention works!

US was unprepared

Here in the US, the list of what we did not have and of the systems that we could not activate simply because they did not exist is depressingly long. I really hope that this gigantic public health and now economic disaster, partly due to nature and partly due to our complete lack of any meaningful preparedness, will teach us a lesson.

We need reliable early warning

To begin with, the US and the World need much more sophisticated early warning systems. Theoretically, this should be the mission of the World Health Organization, WHO. But the record shows that the WHO is just another lumbering international bureaucracy, rarely ahead of the curve when something major happens. With all the talent in IT, superfast Supercomputers, Artificial Intelligence and indeed medical science that we have across the globe, setting up better early warning and crisis management systems is just a matter of will and coordination. We have the tools. Let’s organize them in a productive fashion.

New York City is under resourced?

Along similar lines, governments should create stockpiles of medical tools and related distribution systems that could be quickly mobilized in an emergency. It is a disgrace that New York City, the World’s financial capital, did not have the emergency facilities that could be quickly set up, along with all the medical devices necessary to deal with a sudden epidemic.

Emergency facilities are now springing up almost everywhere in the US. And this is good. This activism proves that America is resilient. However, we can no longer afford to be good only at reacting. We must learn to be proactive.

Yes, investing billions of dollars in facilities and supplies that may or may not be called into action sounds like a waste of money. And yet, if we look at the colossal economic damage caused by the need to shut everything down in order to stop contagion, all of a sudden, investing even a few hundreds billions in preventative measures looks truly cost-effective.

Those governments that lack the economic means to set emergency stockpiles should be connected to a global network that would immediately spring into action and deliver medical assistance where needed.

Paolo von Schirach is the Editor of the Schirach Report He is also the President of the Global Policy Institute, a Washington DC think tank, and Chair of Political Science and International Relations at Bay Atlantic University, also in Washington, DC.




The Coronavirus Recession and Elections

By Paolo von Schirach –

WASHINGTON – After a rather bad start, President Donald Trump is now doing a much better job in his efforts to convince America that his administration is doing all what is necessary to contain the coronavirus epidemic, while reducing its adverse impact on the US economy.

Economic measures

Some economic measures aimed at alleviating the damage and the stress to companies and workers seem appropriate. However, you can bet anything that the initial testing fiasco will be pointed out by Joe Biden and all Democrats between now and November as clear evidence of Trump’s incompetence at a time of a great national crisis.

As things will probably get worse, with more economic damage caused by the disruptions to normal activities inevitably following the coronavirus containment measures, (flights canceled, sports events, conventions and shows canceled, schools closed and more), can Trump blame the inevitable US economic recession on an uncontrollable epidemic? Will he be able to argue –convincingly– that he did all the right things, at the right time against this emergency? Will worried, if not panicky, Americans believe him?

Trump will get low grades

I doubt on Trump getting good grades on his coronavirus crisis handling. Of course the severity of the judgement will really depend on how long this epidemic will linger. Still, if we go into the November elections as the US economy is still caught in a downdraft, while the US health system is overwhelmed, or worse paralyzed by too many sick patients arriving at the same time, this is really bad news for President Trump. No matter what, at elections time, blaming the incumbent for whatever is going wrong in America is the knee-jerk reaction.

On the other hand, if the worst will soon be over, and the public will see the proverbial light at the end of the tunnel, then Trump may have a better chance at getting re-elected. But it will not be easy.

Not a popular President

Indeed, let’s not forget that this is not a popular President. Even while the economy was doing very well, with GDP growth at 2.5% or above, and with the lowest unemployment rate in half a century, Trump’s favorables never –I repeat never– went above 50%.

Of course, we know that this President has a large and fiercely loyal core group of strong supporters. They are and will be with him –no matter what. But, as important as these supporters are, they are not the majority of America’s voters, not even close.

Return to normalcy

If Joe Biden, (assuming here that eventually he will get the Democratic Party nomination), will be able to portray himself as the “Uniter“, the seasoned leader who can bring opposing factions together, he may get the nod not just from the Democrats but also from the millions of independents who are now seeking normalcy and a steady hand in Washington.

From this perspective, being part of the much maligned “Washington Establishment” will be a good thing for Biden. He will be able to say that he knows how to work productively with all lawmakers, irrespective of party, as well as many diverse constituencies in order to “get things done” for the American people.

In 2016 Americans opted for an outsider

In 2016 being part of the “Washington Establishment” was a bad stain. Trump emerged from literally nowhere largely on the basis of his starkly different resume. Indeed, he was not a professional politician.

And this is what millions of Americans, disappointed in the performance of the deeply entrenched political class, really liked back then. In Trump they saw the new champion who would upset the Washington self-dealing racket, (“Drain the swamp”), let fresh air in, and make the US Government finally work for the forgotten little guy.

Well, Trump’s got elected on the basis of his promises to do things very differently. But he assembled a mixed record in the execution of his unorthodox agenda. And his relatively low favorables indicate that most Americans, having tried the non politician in 2016, would seriously consider more traditional offerings in 2020.

Low favorables before this crisis

This mood shift back to the center became palpable after Biden regained his Democratic front runner status in the wake of the South Carolina Democratic Party Primary, held before the explosion of the coronavirus pandemic. And Biden’s rise has become irresistible as the country is in a panic. Overall, I believe that this health crisis is helping Biden, not Trump.

Again, remember that Trump’s leadership credentials were already questioned by many before coronavirus hit the US. The messy way things have been handled until recently did not contribute to change the critics’ minds.

The miracle would be to be able to present Trump’s coronavirus response as a Churchillian moment of heroic valor in front of an unprecedented adversity confronting America. I am sure that lots of communications specialists are already working on how to shape this story in order to provide a positive narrative. But somehow I do not believe that it is going to work.

Either way, Trump is in trouble

So, here is the thing. If this coronavirus emergency continues, and possibly gets worse between now and November, then Trump is in real trouble. If it goes away very soon, and America gets back to work, without too much damage to the economy, he is still in trouble on account of his low favorables.

Joe Biden’s moment?

America’s mood changed. No more wrecking balls, please. Many voters now seem to crave consensus builders who can deliver incremental reforms, hopefully with with some measure of bipartisan support.

Gaffe prone, a bit shop worn Joe Biden may not be the ideal champion, but as of now he is the man (almost) the entire Democratic Party is betting on. And, come November, millions of independents will probably agree.

Paolo von Schirach is the Editor of the Schirach Report He is also the President of the Global Policy Institute, a Washington DC think tank, and Chair of Political Science and International Relations at Bay Atlantic University, also in Washington, DC.




Wanted: Credible Centrist Political Leaders

WASHINGTON – Recently, a Democratic party elected leader of national renown argued in a public forum that in order to regain lost momentum and credibility with the American voters the Democrats have to redefine themselves as the party of economic growth and inclusiveness.

Common sense messages

At a national event focused on the future of U.S. small businesses, a Republican national leader claimed that America’s greatness rests on its foundations as an opportunity society in which people can advance because of a rules based system that recognizes and rewards merit.

John Hickenlooper, the Governor of Colorado, a successful state chief executive, stated that through collaboration between Republican and Democrats we can find workable compromises on the future of the US health care system, and other national priorities.

Well, what do I make of all this? Very simple. These statements made by credible centrists in both parties raise the hope that it may be possible, even in this incredibly poisoned political climate, to rally millions of Americans, hopefully a majority, around the basic ideas of an optimistic country in which policy-makers promote economic growth, while upward mobility is based on genuine merit; and nobody is excluded or kept from advancing because of social class, gender, race, or anything else. In fact, the opposite –equal opportunity for all- is embraced by all.

And this must include quality education, the best foundation of future success in life, available to everyone; while bridges are built across every divide, and doors are wide open to all who are willing to make an effort.

It is an old idea

This idea of America as a level playing field and fair rules used to be a shared vision embraced by most. Indeed, it was the belief that America offered genuine opportunity that attracted millions of immigrants who wanted to create in America a better life for themselves. It is about time to re-propose this vision in a manner that can be shared by today’s Americans –Democrats and Republicans.

Indeed, who could object to public policies that promote economic growth, social advancement based on merit, while all citizens have genuine access to quality education, careers and consequently a good seat at the table?

Lost hope 

Of course, the last few years have told us an entirely different story. It is a story of lost hope, deep disappointment, and resentment. A story of popular distrust in the honesty and abilities of most elected leaders. A story of exaggerated promises not kept.

This has created an emotional anti-government rebellion on the right, (“Washington is a rotten place”), and the triumph of policy agendas on the left which advocate economic and social re-balancing achieved through redistribution by taking (ill-gotten gains) from the few ultra rich and giving to the rest of society. All this will be wisely designed and orchestrated by government, through taxation and subsidies.

Despondent America 

The outcome of all this is not pretty. The unexpected outcome of the November 2016 presidential elections is evidence of the widespread feeling of deep despair. Indeed, according to millions who voted for Donald Trump, “the system” failed –period. Its failure is so deep that it is not worth salvaging. In fact, it should be dismantled. In fact, millions of Americans voted for Trump mostly because he is not a professional politician. Therefore he is untarnished by Washington’s rot and well equipped to “clean the stables”,”drain the swamp” and all by himself –with his power and superior intelligence– transform America.

Paradoxically, notwithstanding continuous economic growth and much lower unemployment since the end of the Great Recession in 2010, rightly or wrongly millions of Americans who used to be part of a self-confident middle class now are and feel poorer, left behind and alienated. At the same time, millions of young people feel hopeless facing a world of diminished opportunities, while laboring under the crushing weight of absurdly large student debts.

There is a way out

That said, I sense that there is a way out of this. Difficult, yes; but not impossible. Yes, America needs house cleaning. It needs fresh faces not tainted by the old ways of doing business.

The unimaginative political elites still populating Washington, DC have survived by over promising everything to everybody, while pretending to pay for all the goodies they offered to various (of course deserving) constituencies, knowing full well that the only way to finance all this public largess (unaffordable entitlements) was and is to borrow more and more, this way getting the country deeper and deeper into debt.

Sadly, the Washington elites have no real economic growth strategy, while their policies aimed at buying votes through entitlements funded by public money and more and more borrowing are driving America towards the abyss of insolvency.

Credible people who will tell the truth 

Most Americans have common sense. However, they need credible new leaders who will tell the unvarnished truth about the dangers of systemic and growing fiscal imbalances, (i..e we have to agree on a sensible plan to reform all major federal entitlement programs, by far our biggest fiscal problem), while pointing the only way to get out of this ditch: economic policies (think tax reform and smart deregulation affecting business activities) that will promote a more robust economic growth in a genuinely open and inclusive society. An inclusive society in which elected leaders are committed to destroying all artificial barriers to entry, while opening new avenues of opportunity to all.

(President Donald Trump, a new leader who is not carrying the baggage of the distrusted establishment politicians, could lead the way in shaping a new American political conversation. As his presidency is just getting started, it is impossible to say whether he will engage in this effort or not. We should all hope that he will. This would benefit the country and him).

Impossible?

Well, in the end all this “back to basics” idea founded on the values of openness, fairness and merit sounds too lofty, in fact unrealistic. Yes, this is an appeal to an admittedly mythologized idea of an America “where anything is possible as long as you work hard and play by the rules” which (truth be told) never fully existed in the way many refer to it.

And then there is the huge problem of yanking benefits away from millions (deserving or undeserving, it does not matter) who got used to getting them. “Come on…get real. Nobody gets elected by promising less, let alone by promising to cut existing benefits. And we in Washington just do not know how to deliver stronger economic growth. We only know how to  distribute subsidies”.

The way ahead

And yet, if we do not want to see America follow Europe on the path leading to historic decline, it is imperative to make real progress on these two related fronts:

1) restore fiscal sanity by reforming all the major entitlement programs

2) genuinely and forcefully promote economic growth and real opportunity for all

The alternative is political chaos, the de-legitimization of our institutions, and rapid economic decline.

Some elected leaders of both parties know this. I just hope that their common sense message will be heard, understood and embraced.




US: Big Problems Require Long Term Solutions

WASHINGTON – America is slowly getting into its political campaign mode. The 2016 presidential elections are getting closer; even though, for the moment, only the Washington based media and some specialists are paying attention.

A huge disconnect

Beyond the obvious commentary about who is up or down according to the polls, the main problem with these elections is the disconnect between the issues that need to be addressed –mostly complicated, systemic problem such as tax reform and entitlement reforms– and a “smart apps”, “quick fix”, culture that expects politicians to come up with clever new ideas, supported by high-tech tools, that will easily solve all problems at almost no cost.

Well, guess what, there is no such thing. America’s serious ailments –and they are serious– are rooted in slow moving systemic crises, themselves the outcome of layers of bad policies carried out over decades. Bad policies in turn are the outcome of bad or at least misguided ideas.

Changing policies is predicated on changing our understanding of what it takes to improve certain conditions, (for example: “how to reduce poverty”), not to mention societal expectations about benefits, entitlements and costs. A lot of work will be necessary to change entrenched mind sets. Bottom line, because of all this, there are no quick fixes.

Here are some of the big ticket items.

Improve public education

In America we have now a gigantic public education crisis that can be addressed only by radically transforming everything connected to public schools, beginning with the role of teachers’ unions, the qualifications for being a teacher and the need to create real incentives that will attract bright young people into the teaching profession. Too many bad or mediocre teachers equal poor education.

Health care crisis

The US health care system is a stupendous mess featuring a plethora of private providers motivated by profits whose activities are however constrained by a web of complicated federal and state mandates and costly regulations. In all this there is zero incentive to reduce costs by promoting prevention via “wellness” education. (There is no money to be made when people are healthy). The horrible outcome of all this is mediocre care, incomplete coverage, and ridiculously high costs –by far the highest in the developed world. In a partial and imperfect way, Obamacare addressed the problem of the uninsured. Everything else stayed almost the same.

Tax reform

Then we have a monstrous federal tax code that nobody understands and that objectively discourages business creation. However, simplifying it means open war with thousands of special interests that over many decades managed to insert sector specific exclusions, rebates, and subsidies. They are all ably represented by armies of well paid Washington based lobbyists. Simplifying the tax code, as a minimum, entails defeating these armies.

Entitlements need to be revised

Add to the list the pillars of the US welfare state: Social Security, (income support for the elderly), Medicare, (health care for seniors), and Medicaid, (health services for the poor).  These programs were designed decades ago (Social Security was introduced by FDR) by well meaning policy-makers who believed that it was appropriate and humane to create a social safety net that would support the elderly and the poor.

However, these programs have been expanded over time. There are now more benefits and more recipients, while America has experienced huge demographic changes –fewer births, while older people live longer–  that contributed to jack up the cost of the welfare programs while shrinking the base of those who pay into them.

Simply stated, the amount of taxes collected from a reduced pool of active workers soon enough will be unable to cover the costs of benefits paid to larger numbers of elderly people who live much longer. However, the very notion of proposing anything that may even remotely look like benefits cuts to seniors is deemed to be political suicide.

Funding for basic science

And finally we have the need to fund robust R&D programs in basic science. In the past the Federal Government did a lot. Now it does much less. The private sector is reluctant to fund open-ended research that is not tied to commercial developments.

And yet it was precisely this open-ended research that in the past created new fields of knowledge that were later on exploited by the private sector. This R&D spending used to be one of the pillars of US competitiveness.

Pain now, benefits later

Anyway, these are the main items that should be on any politician’s“to do list”. The problem is that we are talking about engineering complicated systemic transformations whose benefits, if all goes well, will become evident decades from now. And this is anathema for all politicians seeking elected office.

The system’s rewards and punishments are predicated on promising and delivering quick results that those who voted for you can see and touch almost immediately. You have to promise and deliver something tangible “now”, and voters need to see the benefits they got from you before the next election.

And it is precisely this general predisposition to make too many promises with costs that grow over time that got us into trouble.

The system rewards quick fixes 

The solutions to the systemic problems outlined above rest on long-term, carefully arranged reforms that postulate a large, bipartisan political consensus.

And here we see the disconnect. We have a political system with frequent elections (every two years for Representatives) that incentivizes politicians to deliver tangible benefits “now”. Besides, the current American political climate is fiercely partisan and ideological. This makes it almost impossible to form the large coalitions we need to create a national consensus around a big reform agenda.

On top of that, our “twitter culture” rewards disproportionately those who can come up with clever, catchy one-liners that go viral only because they sound good. In the end this is mostly about manipulation and obfuscation. But the mastery of communication tools does not add anything to any serious policy debate.

Governing is predicated on consensus 

Sadly, smart messages are not enough. The good use of social media may be enough to get someone elected; but it does not help in governing a country of 310 million people.

The problem is that, without a serious debate about the systemic crises outlined above, the critical issues will not be addressed, and nothing important will happen –no matter who gets elected president in November 2016.

America needs a broad-based coalition. We need a large consensus in which most of us agree that serious advances imply short term pain for benefits that will become obvious a decade or more from now.

In order to return to sustained growth, higher productivity, more innovation and ultimately greatness, America will have to address several systemic problems for which there are no quick fixes.

A clever Twitter message simply will not do.

 

 




The Ebola Response Reveals Incompetence

WASHINGTON – Beyond the hysteria, false alarms and exaggerations surrounding just three Ebola cases in the US, the disturbing fact is that this admittedly small crisis revealed an astonishing level of incompetence.

Disconnect

In fact, it is even worse. It shows quite clearly a dangerous disconnect between what US top public health officials claimed regarding total preparedness and lack of any preparedness. Dr. Tom Frieden, the Head of the United States Centers for Diseases Control and Prevention, (CDC), in his capacity as top US Government public  health official, went on TV and told America that he and his team of super qualified infectious diseases specialists were on top of the situation. Do not worry. We are all seasoned professionals. We know how to handle Ebola, or anything else, for that matter.

Well, the first case of Ebola revealed that in practice the state of the art system we were told by Dr. Frieden was in place was completely unable to properly handle just one patient.

Too many mistakes

Every possible mistake was made from day one. When Mr. Duncan (a visitor from Liberia) arrived at the emergency room at the Dallas Hospital with Ebola-like symptoms, the staff there failed to register that he had just arrived from Liberia –a country at the center of the Ebola pandemic. And so they did not test him for Ebola and sent him home, with some antibiotics. (I suspect that, while Duncan said where he was coming from, the nurses did not understand the implications, simply because they –just like most Americans– do not know any geography. Therefore “Liberia” meant nothing to them).

Then, according to various reports, when Duncan was finally admitted the second time, he was not properly handled. Apparently, just as in most cases of people arriving at any emergency room, he was placed somewhere to wait, while the staff had to go through paper work and all sorts of other lengthy preliminary procedures. No effort to isolate him.

But, even worse, it appears that the hospital staff was using inadequate protective clothing, and that they had received no training about safe ways to put it on and take it off. Hence contagion.

Inadequate training, no measures to contain the disease

To put it simply, the doctors and nurses caring for Mr. Duncan were winging it. The fact that two nurses got infected while treating him means that whatever system was in place, it was inadequate.

But wait, it keeps getting worse. All the hospital health care workers who had been in contact with Mr. Duncan were instructed to self-monitor their body temperatures. A fever would be the first sign of a possible Ebola contagion. Fine.

But nobody instructed them to stay at home and to avoid all contacts with other people, so that the opportunity for any additional contagion would be limited. No such instructions. One took a trip by airplane. Another one went on a cruise.

All this reveals an astonishing level of incompetence, bordering on utter stupidity. All these lapses are unforced errors that made the effort of containing the possible spread of the disease much more complicated. The more the infected nurses and/or others who may have been infected got around, the larger the number of people who could have been infected by them.

Chain of contagion

While Ebola contagion from causal contact is highly improbable, it cannot be ruled out. Hence the need to contact all the airline passengers who flew with the sick nurse, so that they could be monitored. All these additional complications could have been avoided had the nurse (and all her colleagues) been instructed to stay at home for the prescribed number of days.

The authorities did not tell the truth

Again, please compare this extremely poor record of mistakes after mistakes with the almost cocky attitude displayed on TV by Dr. Tom Frieden, Head of the CDC, the top US official in charge of public health. As indicated above, at the very beginning, he declared with no hesitation that America was fully prepared for any Ebola case. He said that all US hospitals –the best in the world– knew exactly how to handle any Ebola patient in a swift, competent and ultra-safe fashion.

Well, none of that was true. Just one Ebola patient arrives, and we have an almost complete breakdown. Clearly all the responders, while trying their best, proved to be clueless.

No training

Beyond any finger pointing, it is not surprising that the Dallas hospital staff and all the other local health authorities were clueless.

In order to have a good national response to something rather extraordinary like Ebola you need a lot more than sending around memos outlining safety steps.

You need to get everybody’s full attention. You need targeted training in all the hospitals, you need drills, and lots of them. On any given day, the nurses and doctors in your average emergency room in your average American hospital do not wear cumbersome protective gear. In fact they never do.

Therefore it is really stupid to expect that simply because someone from the CDC issued a warning with some instructions we are all prepared.

We are not prepared.

Hard to be fully prepared

And, if we want to be realistic, even though we can clearly do a better job dealing with the Ebola threat, it is hard and extremely expensive to be fully prepared for all contingencies.

Now we have Ebola. But then we have all sorts of possible terror threats, including the targeting of extremely vulnerable critical infrastructure. And then there is cyber terrorism. And may be  suicide bombers.

It is obvious that we cannot prevent each and every threat. We can and should expect the authorities to be competent. But we cannot expect them to be perfect.

Tell the truth

The truth is that a large, modern, free society is extremely vulnerable to a variety of attacks. It is impossible to create perfect shields against all natural or man-made threats.

While it is the job of public authorities to prevent panic, it would be good to tell the truth: “We shall do the best we can, but we cannot guarantee total safety”.

That said, as it will take months or may be years to contain the Ebola pandemic in Africa, let’s get serious about it. Let’s give proper training to all our health care workers.