Diatribes of Jay

This is a blog of essays on public policy. It shuns ideology and applies facts, logic and math to economic, social and political problems. It has a subject-matter index, a list of recent posts, and permalinks at the ends of posts. Comments are moderated and may take time to appear. Note: Profile updated 4/7/12

06 May 2020

Incompetence or Willful Malfeasance?

For brief descriptions of and links to recent posts, click here. For an inverse-chronological list with links to all posts after January 23, 2017, click here. For a subject-matter index to posts before that date, click here.

The gold standard for competent response to society-wide threats was the Manhattan Project. In 1939, Albert Einstein and Leo Szilard wrote their famous letter to FDR. It warned that advances in nuclear physics had made an atomic bomb possible, and that the Nazis might try to make one. The risk then was only theoretical, and we Americans were not yet involved in “that war in Europe.”

We got involved the day after the Japanese attack on Pearl Harbor, December 8, 1941. Later we, not the Nazis, first demonstrated the feasibility of nuclear chain reactions. Within a year, on December 2, 1942, the Italian physicist Enrico Fermi had sustained and controlled a neutron chain reaction in a makeshift lab under the football stadium at the University of Chicago.

That first practical demonstration of probability became the first-ever explosion of a nuclear bomb at the “Trinity” site near Alamogordo, New Mexico, on July 16, 1945. Working that miracle took us only two years, 7.5 months. No other nation, before or since, has ever duplicated that feat in so short a time, not even on the path already broken by us, and not even after the Soviets stole the plans for our trigger mechanism.

The Manhattan Project, as this effort was then secretly known, was undoubtedly human history’s single most competently run crash project for developing new technology. Our government conceived, planned and ran the whole thing. A U.S. Army General, Leslie Groves, was in charge. Trained as an engineer, he managed the project with top scientists under separate and looser civilian leadership. A career military officer with top management skills, he had no political agenda but getting the job done.

Our government did not ask or bid for, but commandeered, the entire nation’s productive resources. It built the nuclear laboratories at Oak Ridge TN, Hanford WA, and Los Alamos NM entirely from scratch, including necessary living quarters, lab space, workshops, factories, and food services. At one time, the centrifuges at Oak Ridge, spinning to separate the fissionable isotope uranium-235 from the dross, commandeered 10% of the entire nation’s electrical power. Scientists, engineers, materials experts, chemists, technicians, mechanics, construction crews, cooks, and organizers came from all over the country, in secret, to make this happen.

The human story was just as remarkable as the organizational and technical one. Virtually all the Manhattan Project’s top scientists were foreign born. They included Italians, Hungarians, and Germans like Einstein, with many Jews among them. No one questioned their expertise or loyalty until much later, after the Bomb was made. No one stopped to think that the whole enterprise was based on bare scientific theory, with little practical proof until Fermi’s successful experiment.

At the outset, there was only a chance that a bomb might work. We took that chance, throwing all of our national wealth, expertise and power into the effort. It was the best organized and most concerted human effort since the Pharaohs built the pyramids.

Next to the Manhattan Project, our national effort to fight the Covid-19 pandemic ranks somewhere between pathetic and comical. The fiasco is still fresh in our collective memory, so I’ll just touch on its high points.

Unlike the nascent theories of nuclear physics that the Manhattan Project realized, the science of pandemics is well known. It has been tested over and over again. The 1918 “Spanish” flu pandemic received intense scrutiny for a century. More recently, we have had epidemics or pandemics of HIV/AIDS, SARS, MERS, Ebola and (for non-viral diseases) tuberculosis and Legionnaires Disease.

In every case, the appropriate and effective first response is testing, contact tracing, isolation and quarantine. When the disease is highly contagious, these efforts require personal protective equipment (“PPE”) in massive quantities. Masks, gowns, gloves, face shields, and full haz-mat suits are best disposed of once contaminated, rather than riskily reused.

Especially at the outset, testing is the linchpin. You can’t trace contacts or effectively isolate the infected unless you know who they are. You need active-virus (nose swab) tests to tell who’s carrying the infection, even if asymptomatic. Later, you need serological testing for antibodies to determine who’s been infected, and who may be immune. (You also need good experimental and observational science to determine what antibody tests mean, whether they indicate immunity, and, if so, how much and for how long.)

Tests are the absolute first priority, the sine qua non. PPE is the second priority because, without it, you put the testers and the first responders at risk. And once you infect the first responders, your healthcare system slows down and could even stop.

These points are not rocket science. They’re worlds away from the abstruse and untested theories of nuclear physics that motivated the Manhattan Project’s gargantuan investments. They are solid, even pedestrian, principles of basic medicine and public health, tested and proven over and over again in multiple outbreaks for a century.

So how badly did we blow this basic medical blocking and tackling? Let me count the ways.

For starters, we let our bankers, oligarchs and other pigs at the trough “globalize” our production of testing machines, reagents and PPE, along with just about everything else. Today, for example, China makes over 50% of the world’s medical masks. At 1.4 billion in 2018, China has only 18% of the world’s population, so it’s production is disproportionate, to say the least. Did anyone think that such disproportionate production, halfway around the world, might cause shortages here at home, especially if a pandemic originated in China? Apparently not.

Now tests must actually work to perform their vital protective function. If they report false negatives, they let infected people infect others, and the curves of infections and deaths spike. If they report false positives, they waste precious resources treating uninfected people, not to mention expose them to infection.

So how well did our CDC, FDA and NIH perform in making sure tests work? Abysmally. For active-virus (nose swab) testing, they refused or delayed to validate others’ tests, including one from a University of Washington researcher who had been begging for validation weeks before the infamous nursing home in that state got decimated. For antibody (serology) tests, the regulators went to the opposite extreme: they allowed in some 90 tests, domestic and foreign, with little or no validation. Many of these tests proved to be defective or even fraudulent, thereby undermining further work on this promising path (antibody testing) toward putting people safely back to work.

As a result, on the two most important and best-understood ways of fighting a pandemic (testing and PPE), our federal government rated a D-. In essence, it allowed vital production of both testing products and PPE to drift abroad, outside its and our control. And in vetting the output of both foreign and domestic production, it failed to perform its “gateway” function, either letting nothing in (for active-virus testing) or everything in (for antibody tests). In other words, a troupe of trained monkeys might have performed as well as our government in providing the two most basic necessities for pandemic preparedness.

How could we have done much better? Easy to say, but hard to do retroactively. The Manhattan Project could have been the model. Just as it got all the top nuclear physicists together to evaluate the science and pick an approach, we could have gotten all the top viral specialists and epidemiologists together to pick approaches to testing for and confining Covid-19. Just as the nuclear physicists selected two approaches to producing fissile material—centrifuge separation for Uranium-235, and reactor production of plutonium—the experts could have picked several promising approaches toward developing each type of test: (1) active-virus (nose swab) tests and (2) antibody (blood serology) tests.

Next, the powers that be could have used their authority under the Defense Production Act to take over all American plants that produce tests or PPE, and to run them according to the experts’ consensus—with no pols or ideologues invited!—on three shifts a day. If the pols wanted government supervision, they could have picked a “can do” military leader with relevant medical expertise—an analogue to ex-engineer General Groves on the Manhattan Project—to keep the trains running on time.

That’s just what the managers of the Manhattan Project did with the personnel and material resources of the entire nation. It’s also what our then-nascent military-industrial complex did, on a smaller scale, in converting our nation’s car and truck manufacturers into makers of tanks and planes for the war effort. The entire effort involved commandeered resources. Military leaders and top pols were in ultimate charge of the goals, while scientists, engineers, business executives with hands-on experience and other highly educated experts determined, in detail, how to get the job done.

The Trump Administration has used the Defense Production Act hundreds of thousands of times for more pedestrian defense purposes. But it has rarely invoked the law for Covid-19, even as the pandemic grew into a monster. Only in early April, when US deaths topped 16 thousand, did it use the law to commandeer production of ventilators and prevent the diversion of masks. And only in last three weeks has it started to use the law to comandeer production facilities for tests. While the pandemic grew uncontrolled in the US, production decisions were left to the spreadsheet makers, so they could figure out how much money they could make first.

Our president ducks responsibility at every opportunity. But the buck does indeed stop at his desk, the more so he as he claims “total” authority.

Nevertheless, not every bit of this fiasco is the president’s fault. Inveigled by two generations of Republican nonsense, we’ve let our muscles of competent government grow flabby. We’ve preferred to undermine government power and competence so that the “pigs at the trough” can manage their profit spreadsheets and work their will. For them, getting the job done well and quickly is not the primary goal; it’s making money. Now, like an out of shape and corrupted boxer, we’re letting the pandemic pummel us like no other nation.

Although the president is not the origin of this trend (Reagan is), he’s accelerated and strengthened it in two ways. First, his primary measure of personnel is loyalty, so he’s filled the ranks of our government with lackeys and sycophants, rather than competent doers. Too many of them have temporary, interim or “acting” appointments, both to avoid the requirement for Senate confirmation and to make it less visible when Trump dismisses them on a whim.

The president’s second defalcation is the clincher and our killer. He’s given every indication of making politics the deciding factor in most or all of all his executive decisions, with the goal of insuring his re-election. To that end, he has both incited and pandered to the whims of his “base,” many of whom are extremists, including zany libertarians, white supremacists, and those who conclude, without much thought, that saving some money is worth throwing away some lives.

To the extent Trump’s primary goal is his own political benefit, then his actions pass beyond mere breathtaking incompetence to deliberate malfeasance. He’s then sacrificing the greater good to his own, just as he was impeached for doing in extorting the president of Ukraine.

His partisans may disagree, of course, but one thing is certain. If we had fought Nazi and Imperial Japanese aggression this way, we likely would have lost World War II. Half of us might be speaking German, and the other half Japanese, as in the fictional TV series The Man in the High Castle. Jews like me might be an extinct ethnic group, after Nazi genocide had prevailed worldwide. I’m glad to have been born in an era when leaders could still distinguish the nation’s interest and human interest from their own, and when they knew how, if only just for a time, to set aside ideology, politics, private profit and greed, in order to get a vital job done.

Permalink to this post


Post a Comment

<< Home