In Covid's Wake: How Our Politics Failed Us

In Covid's Wake: How Our Politics Failed Us by Stephen Macedo and Frances Lee

This is a liberal Democrat criticism of the handling of the Covid-19 pandemic. It is a deeply disturbing of policies that focussed on the short-term good of the elites, while paying lip-service to the concerns of the marginalized. There was an established body of research regarding pandemic response. Non-Pharmaceutical Interventions had minimal effectiveness. School closures created much more harm than good. (I even recall reading from public school and health experts at the start of the pandemic that school closures should not be implemented - shortly before they were implemented.) Some limited control of the spread of the virus may be possible very early in an outbreak. However, by the time it is present in the population, it is probably too late.

Alas, early in the pandemic officials lost their mind. A paper in Britain painted worst-case scenarios an advocated lock downs. China showed how super stricts lock downs contained the spread of the virus. (Alas, China only provided a censored version of data on their lockdowns and its effectiveness. They also had a much more draconian approach to lockdowns than would be bearable in an open country like the US.) American officials advocated for these lockdowns. Personally, I thought it was a stupid idea. But, hey we were among the first to have schools closed and be required to work from home. It was a great time for a Hawaiian vacation. Then isolation was great for introverts - especially during the cold time of year. Even if it seemed horrible for society, it was something that I personally didn't mind. Perhaps this was what contributed to the stupidity. The elected officials would easily work remotely and liked it. If they wanted to have a social event, they would sneak out and do it (like when California leaders went dining in violation of their own lockdown.)

Even worse, critics were silenced and contrary opinions were attacked. "Facts" were controlled based on political expediency. Masks were said to be ineffective  when there was a shortage. Then they were mandated for all, even in conditions were they did not provide benefit. Mention of a Chinese lab origin was not permitted. Criticism of lockdowns and social distancing measures was treated as "anti-science" and not open to debate. Trying to prevent immediate COVID-19 deaths was the prime motivator, with little consideration given to anything else. The public health experts were given full control without considering others. The result was actually more deaths and various significant negative outcomes throughout society. Those most disadvantaged ended up with the worst outcomes. 

The teacher union advocacy was prime indicator of nonsense. Some unions would go to the extent of calling it racial genocide to force teachers to return the the classroom. This help contributed to longer school closures, especially in blue states where the union welded more power. This left children without any real education. Yet teachers could seemingly show up and zoom and get their paycheck. (Where were the demands for certifications for remote education.) The poor students were hit the worst. They did not have an environment at home where they could learn.  Even worse, many of these parents were "essential workers". With no school and no day care options, grandparents would often care for children. This meant they could not isolate and would be more exposed to the virus. By forcing more "isolation" of populations less at risk, we forced less isolation of those at risk. This is the exact opposite of what should be done.

The short-term approach to the pandemic was witnessed in the criticism of Sweden. They actually followed the longstanding pandemic advice and did not impose large-scale closures and lockdowns. They did encourage voluntary measures, especially among vulnerable populations. In the short-term they did have a surge in deaths. However, over the long term, they had a lower excess mortality rate than other countries. They also had much more positive educational and psychological outcomes for the country.

A long term approach seems obviously simple. Isolate vulnerable populations. Let others continue their lives and build up herd immunity. Ensure other aspects of life are not severely impacted. Alas, the short term focus ended up dominating, to the detriment of the long term. The lack of adequate data exacerbated the problem. Stories would come out with 10-20% death rates, making this seem dire for the population. Alas, the denominator of this group was people with comorbidities who required intense hospitalization. Many others were asymptomatic or only had minor symptoms. With these in the group, the actual impact was closer to that of a bad flu season than the end of humanity.

Is there any hope for pandemic handling in a democracy? How much did the silencing of dissent make things worse? I wonder how much this lead to mistrust and vaccine hesitancy. What will happen the next time?

The First Shots: The Epic Rivalries and Heroic Science Behind the Race to the Coronavirus Vaccine

The First Shots: The Epic Rivalries and Heroic Science Behind the Race to the Coronavirus Vaccine by Brendan Borrell

The government helped enable a rapid deployment of a COVID-19 vaccine primarily by getting out of the way. The government showed that it was not prepared to handle a large-scale pandemic. In some cases, the were learning in real time. In other cases, the actions were just plain stupid. They were both too aggressive and too slow to respond. Quarantining people on a cruise ship was a great way to increase spread of the disease. Willy-nilly quarantines did little to slow things down. Knowledge of the outbreak in China was kept under wraps before it "escaped". Previous research into other coronavirus vaccines enabled rapid development of vaccines. However, they refused to allow them to be used under a compassionate use exemption until after trials completed. The government was too concerned with control and perfection. This slowed the rollout of tests and new treatments. If people have a 30% of dying, does it make sense to hold out for something that is only 2% more effective? Then there were state governors with their own policies. Cuomo in New York seemed to be great at helping to maximize the negative impact of the virus. He would force the infected to commingle with the vulnerable and later prefer vaccines to be thrown out rather than be used by people not on the list yet.

The bulk of the book describes government response and Operation WarpSpeed. The rapid production of the vaccine was enabled by the Trump administration. What would have happened with another president at top? Did Trump slow things down? Or did his zaniness help speed up the vaccine release? The "process" seemed to be the biggest slowdown. There was a mix of competition and collaboration that helped bring about the release. Moderna was primarily going within the system. Pfizer tried to do things more on its own. There was also Johnson and Johnson as well as a few others that never quite made it. Are we prepared for the next pandemic?

Chaos Under Heaven: Trump, Xi, and the Battle for the Twenty-First Century

Chaos Under Heaven: Trump, Xi, and the Battle for the Twenty-First Century by Josh Rogin

Trump's foreign policy was a mess. Little was coherent and he could jump from idea to another just on whim. The key figures in his administration were there based on relationships with Trump rather than qualifications. With Chine, he would do things that would offend China (like take a call from Taiwan president.) Then he would bend over backwards to sign deals with them. He would ban TikTok, then launch tariffs. Much of the work was to make sure he and his friends were enriched. He would even go to name calling (like the China virus). China has been holding the upper hand for a while. They have been great at extracting secrets. China has had researchers in the US send secrets back to China. Companies must have arrangements with Chinese companies and often see their deas go back to China. 

The book quickly explains China relations and Trump behavior, then goes  goes on for a bit too long. The author even toots his own horn to brag about "exposing" Chinese connections to Covid-19. 

Survival of the City: Living and Thriving in an Age of Isolation

Survival of the City: Living and Thriving in an Age of Isolation by Edward L. Glaeser and David Cutler

I wanted to like this book. The general idea and the conclusions are great. However, the execution just leaves something to desire. The authors come from different political perspectives and find issue with the way things are tackled politically. We need to get long term solutions to the big problems rather than just short term crowd pleasers. Policing is an example. On one side you have "defund the police". They are seeking to limit the harm that people experience due to police violence and excessive incarceration. On the other side you have "tough on crime" and "three strikes" policies aiming to prevent people from being harmed by crimes. People with lower incomes and minorities are often the most likely to be incarcerated and the most likely to be victim of crimes. Rather than a zero sum of "tough on crime" vs. "defund the police" we need to improve policing to reduce crime and incarceration. This does not bring itself to easy soundbites, but will provide a better solution. We need to address similar areas of education and health. Income, housing availability and costs are also related. Zoning has created havoc on the United States as a whole. Previously, people would migrate from poor areas to areas with opportunity, gradually leading to an equalization. Now the areas with opportunity are so expensive that migration is limited. The high cost of housing and limited availability makes it difficult for people to relocate there. A combination of the car and end-runs around racial integration have wreaked havoc on our cities. The poor bear the biggest burden of these changes. Despite these issues, people still desire to live in these cities. 

Economics in One Virus

Economics in One Virus: An Introduction to Economic Reasoning through COVID-19 by Ryan A. Bourne

The Covid-19 pandemic was a big mess. The world did not understand the virus well and was ill prepared to respond. Subsequent actions counteracted each other and made things worse. We gave too much latitude to public health experts to implement solutions without looking at societal impacts. The result was economic devastation, high inflation and a multitude of societal ills.

This book explores many of the responses to the virus and the associated economic principles. Each chapter discusses the pandemic and then summarizes specific principles and terms that are related. Often it becomes self-evident that basic economics were missed in the response. In some cases, policies worked against each other. Unemployment benefits were ramped up quickly to give consumers cash. Then aid was given to small businesses to keep employees. However, many employees could earn more by taking unemployment than by working. Why go back to work? This created a cascading problem as business such as child care were not fully start back up, making it difficult for others to go back to work.

The pandemic response failed to properly analyze cost and benefits. A politician would proclaim that society would spare no expense at saving a life. Alas, those measures could make the life less worth living. Grandma may hope to live to see her granddaughter's wedding. How would she feel if we preserve her life a few months, but prevent the wedding from happening? 

Centrally managed one-size fits all approaches also caused problems. Rather than let different approaches be experimented, there were similar policies enacted. Everyone was asked to isolate, regardless of risk. However, "essential" workers were still actively interacting with people, even if they did not have protective equipment. The result was both too much isolation and not enough. Things got even more bizarre as the pandemic progressed. People were arrested for solo outdoor activities, but large group protests were allowed. Stores were allowed to be open, but a section selling seeds was roped off. Central planning seemed to create ridiculousness, but didn't have a huge impact on virus spread. People were adapting better than policies. Those with minimal risk were more willing to participate in risky activities. Those at risk were isolating and protecting themselves. The "natural adaptation" was better than the centrally planned policy.

The speed of government change was also a problem. Testing was extremely helpful in containing the spread of the virus. Tests were available early in the pandemic. However, US authorities did not allow them because they were not 100% accurate. Instead, we were left with 100% inaccurate non-tests. The tests provided a better signal for those that were most contagious, but even that was lost on authorities. The problem was later repeated with rapid tests. The delays resulted in excess pandemic spread and economic lockdown.

Shortages were also caused by lack of economic signals. Rather than let important supplies sell at their value, retailers were discouraged from price gouging. Thus prices were kept artificially low, while those that could find things were encouraged to excessively stock up. If prices were allowed to better float, items like hand sanitizer would immediately spike. However, new entrants would be more encouraged to come in and meet demand.

The pandemic was great example of the flaws of centrally managed economies. It is hard to create a universal policy that works for everyone. People will try to adapt to do what they feel is best. If they feel the policy is out of touch with their reality, they will attempt to circumvent it. Many people naturally locked-down and isolated, even without government mandates. Many people later interacted publicly when they deemed their personal risk was low. The economy became a big mess because people did not understand economics.

Pandemic! & Pandemic! 2: COVID-19 Shakes the World & Chronicles of a Time Lost

Pandemic! & Pandemic! 2: COVID-19 Shakes the World & Chronicles of a Time Lost by Slavoj Žižek

This book already feels incredibly dated just a few years after publication. There were things that we cared about during the covid-19 pandemic that do not feel relevant at all today. At the onset, it was supposed to be only a brief lockdown until infection rates fell. Then it was extended and extended. Some people working in "essential" industries kept working - and suffered from significant infection rates. The professional class was able to work from home. The working class lost their livelihood. The pandemic also occurred during a US election year. And we had various riots worldwide. 

Many parts of the response and actions analyzed in this book feel largely irrelevant today. Perhaps the only conclusion that can be drawn in retrospect is that world did a horrible job of responding (or even understanding how to respond.) Our society is so tightly independent that a full lockdown is just not possible. The porous lockdowns likely did more harm than good. What seemed to be obvious benefits during the pandemic now need to be re-evaluated. This book, written during the pandemic is now a historical artifact.

The Invisible Siege: The Rise of Coronaviruses and the Search for a Cure

The Invisible Siege: The Rise of Coronaviruses and the Search for a Cure by Dan Werb

Coronaviruses have been around for a long time. However, they have only been extensively studied in the past few decades. Previously they were most commonly seen as just causing a common code and only studied by an odd dedicated researcher. This all changed with SARS. It appeared in Asia in the early 2000s. It was deadly and started to attract a great deal of interest. There was work to sequence as well as to identify the source. Work was also started on vaccines. However, after it was contained, the enthusiasm died off. 

A decade later, Mers appeared. This was also extremely deadly. Interest in Coronaviruses popped up again. It also lead to tracing the source - and identifying camels instead of bats as an animal vector. This one was also contained, and interest again died off. 

In 2020, Covid-19 started to spread. The people had been doing work on coronaviruses and vaccines were ready to jump into action. Covid-19 ended up causing a widespread worldwide pandemic. People could carry and spread the virus without showing symptoms. It could be deadly for some people, but for others they suffered minimal (or no symptoms.) This allowed it to spread much more than the previous viruses. Luckily, the past research enabled vaccines and treatments to be quickly put into place. (Though in the field of medical research, a year is seen as amazingly fast.)

This book covers the history of coronavirus research. It does a great job of putting Covid-19 in context of the previous viruses. There are a number of factors involved. Politics and relationships can be as important as science. Countries and rulers are reluctant to admit they have a problem. This can make it difficult for scientists and public health official to identify and combat the virus. One scientist that had success built up relationships by way of non-judgemental science. Science also had internal conflicts, with those advocating open science versus those concerned about patents and financial return. Money is needed to bring drugs to market, but if vaccines are too expensive, the poorer parts will not receive it, limiting world immunity.

Pandemic, Inc.: Chasing the Capitalists and Thieves Who Got Rich While We Got Sick

The COVID-19 pandemic is still in recent memory. In the future there will be a complete accounting done of the successes and failures in the response. For now, we have books like Pandemic, Inc. that provide anecdotes of some of the big failures. 

Most of the focus is on masks and government procurement. Hospitals did not have nearly enough masks. An American manufacturer was begging for contracts to help ramp up production. Back in the Bush administration, efforts were made to have a robust government stockpile. However, the stockpile was curtailed during the Obama and Trump administrations.

There were ridiculous efforts made to procure masks at the start of the pandemic. China had cut off supplies. The government was willing to get a check to anybody that could provide masks quickly. Many people legitimately thought they could and set up businesses to do it. There were others that were just in it for a quick buck. Plenty of fraud abounded. How does the government balance immediate need with the need to weed out corruption?

The vaccine production also gets some coverage. There were some people that were fighting for years to develop the technology. The few companies that were ready at the outbreak of the pandemic made good money, but they did deliver. 

There is brief discussion of lockdowns and other political actions. The author is based in Texas, so the theater of the Texas governor gets some coverage. However, the disjointed political response would require another book.

The Premonition: A Pandemic Story

The end of The Premonition drives home the big problem with our current public health system. In the mid-1970s the US public health authorities anticipated a deadly swine flu outbreak. They chose to institute a max vaccination campaign. Unfortunately, the local health infrastructure was not up to the task and was only able to vaccinate a fraction of the population. Some of those vaccinated died. Even though many of the deaths were not related to the vaccine, the presence of deaths together with the no-show of the deadly outbreak lead to a piloring of the health officials. Today, public health policy tends to be led in a cautious manner. People are concerned more about protecting their image. Government appointments are often made with regard to "optics" rather than expertise. Altogether, this leads to slow and inadequate reactions. Actions that avoid a deadly epidemic will be judged harshly if a few people had died. Meanwhile, positive improvement after a deadly epidemic are more likely to be praised.

The book traces the experience of a few key "behind-the-scenes" people that are doing the work to protect us. One person had worked as an administrator for the veterans administration. His hospital suffered greatly in the realm of public opinion because some of the patients had died. He later helped drive planning for pandemic response. Another key player worked as a public health official in Santa Barbara County, California. There she welded great power with limited resources. Then she accepted a state position where she was stuck behind bureaucracy when the covid pandemic played out. The third prong of the story focuses on research labs that have done work to identify and trace disease. They offered free, fast covid testing - yet bureaucracy slowed the uptake. (There were a variety of reasons - some places had relations with other vendors or could not bill $0). The lab also had the ability to rapidly identify different contagions. They even used this to identify drugs that could help cure things. Alas, these skills were often used. The government would even recommend a non-working treatment rather than the one that worked.

We do have great skill for responding to public health crises. We just can't necessarily take advantage of it.

Deadliest Enemy: Our War Against Killer Germs

Michael Osterholm wrote "Deadliest Enemy" a few years ago to warn against the dangers of infectious disease. There have been a number of cases of disease outbreaks that have sparked immediate action (SARS, MERS, Zika, Ebola). However, once the disease is contained the interest fades. Significant research is performed initially. However, funding goes away after the threat fades, leaving incomplete results. Even diseases like Malaria get brushed off as "third world" diseases, and little effort is spent on containing them.
We have also reached a level of complacency with the seasonal flu. The annual vaccine provides a steady revenue stream. However, getting it every year may provide less immunity than receiving it occasionally. We have also stalled on achieving a "permanent" vaccine. Like other vaccines, the financial component may be getting in the way of some research.
Many of the novel viruses transfer from animals to humans in areas where they live close together. Third world megacities are especially vulnerable. Mosquitos are also primary vector for other diseases.
In one section, he describes a flu pandemic which sounds earlier like the current Covid-19 pandemic. Alas, we have still not prepared for it.