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Jeremy Konyndyk: WA State COVID-19 outbreak "major surveillance failure on par with Italy and Iran"
Jeremy Konyndyk @JeremyKonyndyk
Now seems highly likely that there has been undetected community transmission ongoing in parts of the upper West Coast for weeks, at least.
How did we end up with major surveillance failure on par with Italy and Iran?
Let's talk about how that happens.
This may get spun as a technical failure (e.g. flaws in the test kits).
It's not. It's an interconnected communications, strategy, process, and execution failure, reflecting a serious breakdown of crisis mgmt.
Direct line from that failure to sick people in a nursing home.
Recall how, in the run-up to the Iraq war, the White House signaled preferred policy outcome so heavily that it skewed the analysis and advice it received.
Can see similar alignment b/w preferences Trump and his team were signaling, and strategic posture of his crisis managers.
Trump wanted to calm markets, avoid threats to his re-elex, and keep the disease out of the country.
He and his team made those preferences very clear. And got angry at those who deviated.
(WaPo has an infuriating tick-tock on all this out today):
https://www.washingtonpost.com/politics/inside-trumps-frantic-attempts-to-minimize-the-coronavirus-crisis/2020/02/29/7ebc882a-5b25-11ea-9b35-def5a027d470_story.html …
That inevitably colored - both overtly and subtly - the strategic emphasis of the crisis task force.
They operated from presumptions that containment was possible, the risk to the US was low, and transmission was not happening here yet. Repeated those things like a mantra.
And those assumptions set the frame for the testing failures.
The key question is not "why didn't CDC's test kits work?"
It's "why were flawed CDC test kits allowed to bottleneck all US testing capacity when alternatives were available?"
And to be clear, alternatives were available. China has managed to test hundreds of thousands. @WHO has sent working test kits to 50+ countries. South Korea is doing drive-through testing clinics, for goodness' sake.
And to be equally clear, experts outside the administration - including Trump's former FDA commissioner - have been clamoring for weeks about the need to ramp up testing. He and Lu Borio wrote this nearly a month ago:
Adding to the debacle, the bottlenecks on test kits meant that CDC kept the case definition artificially narrow - tied to China - even as cases were expanding globally (and, we now realize, domestically as well).
https://www.politico.com/news/2020/02/26/coronavirus-cdc-117779 …
The result of that definition, as @JenniferNuzzo and others have eloquently argued, was that we were blind to community spread - because CDC had defined suspect cases so narrowly as to exclude that possibility.
Can't see them, so can't test them, so blind to what's happening.
Now - why would policymakers let that happen?
Well, if you assume that community transmission *is* ongoing (as most experts outside USG did), then this looks like a real problem.
But if you assume it's *not* happening, as the Task Force did, this all looks much less urgent.
(Taking a lunch break and will resume later)
1:33 PM - Mar 1, 2020
Now seems highly likely that there has been undetected community transmission ongoing in parts of the upper West Coast for weeks, at least.
How did we end up with major surveillance failure on par with Italy and Iran?
Let's talk about how that happens.
This may get spun as a technical failure (e.g. flaws in the test kits).
It's not. It's an interconnected communications, strategy, process, and execution failure, reflecting a serious breakdown of crisis mgmt.
Direct line from that failure to sick people in a nursing home.
Recall how, in the run-up to the Iraq war, the White House signaled preferred policy outcome so heavily that it skewed the analysis and advice it received.
Can see similar alignment b/w preferences Trump and his team were signaling, and strategic posture of his crisis managers.
Trump wanted to calm markets, avoid threats to his re-elex, and keep the disease out of the country.
He and his team made those preferences very clear. And got angry at those who deviated.
(WaPo has an infuriating tick-tock on all this out today):
https://www.washingtonpost.com/politics/inside-trumps-frantic-attempts-to-minimize-the-coronavirus-crisis/2020/02/29/7ebc882a-5b25-11ea-9b35-def5a027d470_story.html …
That inevitably colored - both overtly and subtly - the strategic emphasis of the crisis task force.
They operated from presumptions that containment was possible, the risk to the US was low, and transmission was not happening here yet. Repeated those things like a mantra.
And those assumptions set the frame for the testing failures.
The key question is not "why didn't CDC's test kits work?"
It's "why were flawed CDC test kits allowed to bottleneck all US testing capacity when alternatives were available?"
https://www.sciencemag.org/news/2020/02/united-states-badly-bungled-coronavirus-testing-things-may-soon-improve …
The United States badly bungled coronavirus testing—but things may soon improve
A faulty reagent in a test kit and bureaucratic hurdles have slowed testing for the virus that causes COVID-19
And to be clear, alternatives were available. China has managed to test hundreds of thousands. @WHO has sent working test kits to 50+ countries. South Korea is doing drive-through testing clinics, for goodness' sake.
https://www.voanews.com/episode/south-korea-tests-coronavirus-drive-through-clinics-4207401 …
South Korea Tests for Coronavirus at Drive-through Clinics
South Korea has experienced a massive spike in confirmed coronavirus infections over the past week. One reason the numbers have jumped so quickly: South Korea is making it very easy for people to get...
And to be equally clear, experts outside the administration - including Trump's former FDA commissioner - have been clamoring for weeks about the need to ramp up testing. He and Lu Borio wrote this nearly a month ago:
https://www.wsj.com/articles/stop-a-u-s-coronavirus-outbreak-before-it-starts-11580859525 …
Stop a U.S. Coronavirus Outbreak Before It Starts
Opinion | Stop a U.S. Coronavirus Outbreak Before It Starts
It’s time to start testing patients with unexplained pneumonia, even if they haven’t traveled to China.
Adding to the debacle, the bottlenecks on test kits meant that CDC kept the case definition artificially narrow - tied to China - even as cases were expanding globally (and, we now realize, domestically as well).
https://www.politico.com/news/2020/02/26/coronavirus-cdc-117779 …
The result of that definition, as @JenniferNuzzo and others have eloquently argued, was that we were blind to community spread - because CDC had defined suspect cases so narrowly as to exclude that possibility.
Can't see them, so can't test them, so blind to what's happening.
Now - why would policymakers let that happen?
Well, if you assume that community transmission *is* ongoing (as most experts outside USG did), then this looks like a real problem.
But if you assume it's *not* happening, as the Task Force did, this all looks much less urgent.
(Taking a lunch break and will resume later)
1:33 PM - Mar 1, 2020
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2 replies
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